Yesterday in JAMA Network Open, a study of adolescents admitted to eight children's hospitals for mental illness before and during the COVID-19 pandemic reveals a steep increase in the monthly proportion of hospitalizations tied to psychological issues after the emergence of SARS-CoV-2 in the United States but not in France.
Harvard Medical School researchers led the study of 9,696 US and French 11- to 17-year-olds hospitalized for at least one mental health condition before the pandemic (Feb 1, 2019, to Mar 31, 2020) and 11,101 admitted after it began (Apr 1, 2020, to Apr 30, 2021). Median hospital stay was 7 days during both periods.
Average age was 14.6 years in the prepandemic group and 14.7 in the pandemic group; 61.5% and 68.5%, respectively, were girls. The 8 hospitals, 5 in the United States and 3 in France, were participants in the Consortium for Clinical Characterization of COVID-19.
Girls hit particularly hard
The monthly proportion of mental illness hospitalizations rose 0.60% after the pandemic began. When aggregated by country, the average differences in proportion weren't significant in France (0.32%) but were in the United States (0.80%). During the pandemic, there was a significant increase (0.77%) in the monthly proportion of hospitalizations for girls.
The most common diagnoses were anxiety (57.4%), depression (48.0%), and suicidality or self-injury (44.2%). The share of monthly hospitalizations during the pandemic rose for anxiety (0.55%), depression (0.50%), and suicidality or self-injury (0.38%).
Adolescents were diagnosed as having anxiety disorders in 5,083 hospitalizations (52.4%) before the pandemic, rising to 6,066 (57.4%) after it began. The proportion of adolescents diagnosed with suicidality or self-injury also climbed significantly between the two periods (4,101 [42.3%] to 4,673 [44.2%]), although no significant change was seen in the percent diagnosed with depression (4,545 [46.9%] vs 5,065 [48.0%]).
The study authors noted that physical distancing measures limited educational and recreational activities and social interactions and increased exposure to stressors at home. "These findings support the need for greater resources within children's hospitals to care for adolescents with mental health conditions during the pandemic and beyond," they wrote.