Ferro Valentina, Averna Roberto, Murciano Manuel, Raucci Umberto, Cristaldi Sebastian, Musolino Anna Maria Caterina, Pontillo Maria, Della Vecchia Nicoletta, Labonia Milena, Pisani Mara, Pucciarini Maria Laura, Nacca Raffaella, Reale Antonino, Vicari Stefano, Villani Alberto, Raponi Massimiliano
Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Children (Basel). 2023 Mar 17;10(3):578. doi: 10.3390/children10030578.
We described changes caused by the COVID-19 pandemic in the frequency of Emergency Department (ED) visits for mental health disorders (MHDs) in adolescents on a wider temporal range-that is, not just "the waves" of the pandemic-and characterized the profile of the adolescent seeking emergency psychiatric care. We conducted a retrospective longitudinal study by analyzing ED visits for MHDs from 10 March 2019 to 10 March 2021. A total of 1407 ED visits for MHDs were registered: 702 in the pre-COVID-19 and 707 in the COVID-19 period. The cumulative incidence of ED visits for MHDs was 1.22% in the pre-COVID-19 period and 1.77% in the COVID-19 period, with a statistically significant difference ( < 0.001). The principal characteristics of the adolescent with MHDs during the pandemic period: the odds of comorbidities decreased by 26% ( = 0.02), and the odds of transfer from other hospitals decreased by 71% ( < 0.001), while the odds of the ED presentation as first psychiatric episode were twice greater ( < 0.001). The risk of hospitalization increased by 54% ( = 0.001). Regarding psychopathology, the likelihood of attempted suicide increased by 74% during the pandemic ( = 0.02). The rate of mood and eating disorders grew significantly during the COVID-19 pandemic period ( = 0.005 and = 0.031, respectively). Monitoring ED visits for MHDs and understanding changes in the profile of adolescents presenting to ED helps to reinforce the role of ED in identifying special clinical needs for these vulnerable patients in case of a future public health crisis.
我们描述了在更广泛的时间范围内，即不仅仅是疫情“高峰期”，新冠疫情对青少年心理健康障碍（MHD）急诊就诊频率所造成的变化，并对寻求紧急精神科护理的青少年的特征进行了描述。我们通过分析2019年3月10日至2021年3月10日期间因MHD进行的急诊就诊情况，开展了一项回顾性纵向研究。共记录了1407次因MHD的急诊就诊：新冠疫情前702次，新冠疫情期间707次。新冠疫情前因MHD急诊就诊的累积发病率为1.22%，新冠疫情期间为1.77%，差异有统计学意义（<0.001）。疫情期间患有MHD的青少年的主要特征：合并症的几率降低了26%（=0.02），从其他医院转诊的几率降低了71%（<0.001），而以首次精神科发作形式到急诊就诊的几率则高出两倍（<0.001）。住院风险增加了54%（=0.001）。关于精神病理学，疫情期间自杀未遂的可能性增加了74%（=0.02）。在新冠疫情期间，情绪障碍和饮食障碍的发生率显著上升（分别为=0.005和=0.031）。监测因MHD的急诊就诊情况以及了解到急诊就诊青少年特征的变化，有助于强化急诊在未来公共卫生危机情况下识别这些脆弱患者特殊临床需求方面的作用。
