Pandemic-related emergency psychiatric presentations for self-harm of children and adolescents in 10 countries (PREP-kids): a retrospective international cohort study.
Adolescents
COVID-19
Children
Emergency presentation
Pandemic
Self-harm
Journal
European child & adolescent psychiatry
ISSN: 1435-165X
Titre abrégé: Eur Child Adolesc Psychiatry
Pays: Germany
ID NLM: 9212296
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
received:
17
11
2020
accepted:
08
02
2021
pubmed:
8
3
2021
medline:
4
8
2022
entrez:
7
3
2021
Statut:
ppublish
Résumé
To examine the differences in hospital emergency psychiatric presentations for self-harm of children and adolescents during the covid-19 lockdown in March and April 2020 compared with the same period in 2019. Retrospective cohort study. We used electronic patient records from 23 hospital emergency departments in ten countries grouped into 14 areas. We examined data on 2073 acute hospital presentations by 1795 unique children and adolescents through age 18. We examined the total number of emergency psychiatric hospital presentations and the proportion of children and adolescents presenting with severe self-harm as our two main outcome measures. In addition, we examined sociodemographic and clinical characteristics and clinical management variables for those presenting with self-harm. To compare the number of hospital presentations between 2020 and 2019 a negative binomial model was used. For other variables, individual participant data (IPD) meta-analyses were carried out. Emergency psychiatric hospital presentations decreased from 1239 in 2019 to 834 in 2020, incident rate ratio 0.67, 95% CI 0.62-0.73; p < 0.001. The proportion of children and adolescents presenting with self-harm increased from 50% in 2019 to 57% in 2020, odds ratio 1.33, 1.07-1.64; p = 0.009 but there was no difference in the proportion presenting with severe self-harm. Within the subpopulation presenting with self-harm the proportion of children and adolescents presenting with emotional disorders increased from 58 to 66%, odds ratio 1.58, 1.06-2.36; p = 0.025. The proportion of children and adolescents admitted to an observation ward also decreased from 13 to 9% in 2020, odds ratio 0.52, 0.28-0.96; p = 0.036. Service planners should consider that, during a lockdown, there are likely to be fewer emergency psychiatric presentations. Many children and adolescents with psychiatric emergencies might not receive any service. A focus on developing intensive community care services with outreach capabilities should be prioritised.
Identifiants
pubmed: 33677628
doi: 10.1007/s00787-021-01741-6
pii: 10.1007/s00787-021-01741-6
pmc: PMC7937052
doi:
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-13Subventions
Organisme : National Institute for Health Research
ID : NIHR127408
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021. The Author(s).
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