The hidden pandemic: changes in outpatient mental health care among French children and adolescents.

IF 4.9 2区 医学 Q1 PEDIATRICS
Zaba Valtuille, Vincent Trebossen, Naim Ouldali, Michael Huguet, Hugo Peyre, Richard Delorme, Florentia Kaguelidou
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Abstract

The COVID-19 pandemic significantly worsened mental health (MH) challenges among young people. We aimed to assess changes in mental health-related outpatient care before and after the onset of the pandemic. In this nationwide cross-sectional study, we retrieved visits to general practitioners (GP) resulting in the coding of a MH disorder and/or the prescribing of any psychotropic medication for children aged 6 to 17 years, from January 1, 2016 to May 31, 2022 in France. Interrupted time series analysis of monthly rates of MH-related outpatient visits (per 100,000) was conducted to assess changes in trends overall and by age and sex group (girls/boys- 6 to 11 years; girls/boys- 12 to 17 years). Rate ratios (RR) were also calculated to compare estimated rates after the pandemic onset with expected rates. In total, 5,271,958 MH-related outpatient visits were analyzed. We noted an immediate decrease of the outpatient visit rate by 30.8% in the initial pandemic period (March-May 2020). Hereafter, visit rates increased by 0.4% per month, eventually exceeding expected levels by 6% overall. Notably, outpatient visit rates for adolescent girls (12-17 years) rose 20% above expected levels, while rates for younger girls (6-11 years) declined by 6%. Trends remained stable for other age-sex groups. These findings indicate a persistent increase in outpatient mental healthcare use in children, especially adolescent girls, more than two years after the pandemic onset. Future research should explore the factors contributing to the increased mental health burden in adolescent girls and the potential resilience observed in boys.

隐藏的流行病:法国儿童和青少年门诊心理保健的变化。
2019冠状病毒病大流行严重加剧了年轻人面临的精神健康挑战。我们的目的是评估大流行发生前后精神健康门诊护理的变化。在这项全国性的横断面研究中,我们检索了2016年1月1日至2022年5月31日期间法国6至17岁儿童的全科医生(GP)就诊记录,这些记录导致了MH障碍的编码和/或任何精神药物的处方。对每月mh相关门诊就诊率(每10万人)进行中断时间序列分析,以评估总体趋势变化以及年龄和性别群体(女孩/男孩- 6至11岁;女孩/男孩- 12至17岁)。还计算了发病率比(RR),以比较大流行发病后的估计发病率与预期发病率。总共分析了5271,958例与mh相关的门诊就诊。我们注意到,在大流行初期(2020年3月至5月),门诊就诊率立即下降了30.8%。此后,访问率每月增长0.4%,最终总体超出预期水平6%。值得注意的是,青春期女孩(12-17岁)的门诊诊断率比预期水平上升了20%,而年龄较小的女孩(6-11岁)的诊断率下降了6%。其他年龄组的趋势保持稳定。这些发现表明,在大流行开始两年多后,儿童,特别是少女,使用门诊精神保健的人数持续增加。未来的研究应该探索导致青春期女孩心理健康负担增加的因素以及在男孩中观察到的潜在恢复力。
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来源期刊
CiteScore
12.80
自引率
4.70%
发文量
186
审稿时长
6-12 weeks
期刊介绍: European Child and Adolescent Psychiatry is Europe''s only peer-reviewed journal entirely devoted to child and adolescent psychiatry. It aims to further a broad understanding of psychopathology in children and adolescents. Empirical research is its foundation, and clinical relevance is its hallmark. European Child and Adolescent Psychiatry welcomes in particular papers covering neuropsychiatry, cognitive neuroscience, genetics, neuroimaging, pharmacology, and related fields of interest. Contributions are encouraged from all around the world.
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