Jule Leickert, Stephan Zillmer, Christian J Bachmann, Annika Vivirito, Dirk Enders, Christoph U Correll, Charlotte Jaite
{"title":"德国青年创伤后应激障碍：covid -19大流行前后的代表性索赔数据","authors":"Jule Leickert, Stephan Zillmer, Christian J Bachmann, Annika Vivirito, Dirk Enders, Christoph U Correll, Charlotte Jaite","doi":"10.1080/20008066.2025.2512683","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> COVID-19-exposure and related restrictions may have contributed to the development or exacerbation of post-traumatic stress disorders (PTSD), especially in youth. However, data in this population is lacking.<b>Objective:</b> This study aimed to provide a thorough insight into the epidemiology and psychiatric comorbidities of PTSD as well as in- and outpatient treatment utilisation by those affected during vs. before COVID-19 in a representative sample of children and adolescents statutorily insured in Germany.<b>Methods:</b> The study is based on anonymized claims data of statutory insured youth aged 0.0-17.9 years from the InGef research database, which is representative of the German population. Prevalence, incidence, comorbidities of PTSD (ICD-10: F43.1, F43.8, F43.9) and in- and outpatient treatment for those affected were compared pre-COVID (01/2018-03/2020; <i>N</i> = 710.629) vs. intra-COVID (04/2020-12/2021; <i>N</i> = 698.108) using descriptive statistics, <i>χ</i><sup>2</sup> tests, Welch-tests and interrupted time series analyses stratified by sex, age (children: 0-13 years; adolescents: 14-17 years), and socio-economic status (SES).<b>Results:</b> PTSD prevalence decreased intra-COVID (girls: 0.8%, <i>n</i> = 2.595 vs. 0.6%, <i>n</i> = 1.965; OR = 0.77 [0.73, 0.82]; boys: 0.6%, <i>n</i> = 2.066 vs. 0.4%, <i>n</i> = 1.547; OR = 0.76 [0.71, 0.81]). Quarterly incidence in female children with high SES showed a significant increase in slope pre-COVID to intra-COVID (<i>p</i> = .018). Externalising comorbidities increased especially in female adolescents (OR = 1.34 [1.05, 1.72]). Psychotherapy utilisation decreased in male children with low SES (OR = 0.63 [0.41, 0.98]) and increased in adolescent girls with low SES (OR = 1.73 [1.09, 2.74]). Hospitalisations among female adolescents only decreased for those with low SES (OR = 0.67 [0.38, 1.19]).<b>Conclusions:</b> We observed similar decreases in clinical PTSD-diagnoses for girls and boys, possibly reflecting overstretched health services, particularly at an early stage of COVID-19. However, treatment utilisation shows sex and SES differences that cannot be fully explained by our data.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2512683"},"PeriodicalIF":4.1000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Post-traumatic stress disorder in German youth: representative claims data pre- vs. intra-COVID-19-pandemic.\",\"authors\":\"Jule Leickert, Stephan Zillmer, Christian J Bachmann, Annika Vivirito, Dirk Enders, Christoph U Correll, Charlotte Jaite\",\"doi\":\"10.1080/20008066.2025.2512683\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background:</b> COVID-19-exposure and related restrictions may have contributed to the development or exacerbation of post-traumatic stress disorders (PTSD), especially in youth. However, data in this population is lacking.<b>Objective:</b> This study aimed to provide a thorough insight into the epidemiology and psychiatric comorbidities of PTSD as well as in- and outpatient treatment utilisation by those affected during vs. before COVID-19 in a representative sample of children and adolescents statutorily insured in Germany.<b>Methods:</b> The study is based on anonymized claims data of statutory insured youth aged 0.0-17.9 years from the InGef research database, which is representative of the German population. Prevalence, incidence, comorbidities of PTSD (ICD-10: F43.1, F43.8, F43.9) and in- and outpatient treatment for those affected were compared pre-COVID (01/2018-03/2020; <i>N</i> = 710.629) vs. intra-COVID (04/2020-12/2021; <i>N</i> = 698.108) using descriptive statistics, <i>χ</i><sup>2</sup> tests, Welch-tests and interrupted time series analyses stratified by sex, age (children: 0-13 years; adolescents: 14-17 years), and socio-economic status (SES).<b>Results:</b> PTSD prevalence decreased intra-COVID (girls: 0.8%, <i>n</i> = 2.595 vs. 0.6%, <i>n</i> = 1.965; OR = 0.77 [0.73, 0.82]; boys: 0.6%, <i>n</i> = 2.066 vs. 0.4%, <i>n</i> = 1.547; OR = 0.76 [0.71, 0.81]). Quarterly incidence in female children with high SES showed a significant increase in slope pre-COVID to intra-COVID (<i>p</i> = .018). Externalising comorbidities increased especially in female adolescents (OR = 1.34 [1.05, 1.72]). Psychotherapy utilisation decreased in male children with low SES (OR = 0.63 [0.41, 0.98]) and increased in adolescent girls with low SES (OR = 1.73 [1.09, 2.74]). Hospitalisations among female adolescents only decreased for those with low SES (OR = 0.67 [0.38, 1.19]).<b>Conclusions:</b> We observed similar decreases in clinical PTSD-diagnoses for girls and boys, possibly reflecting overstretched health services, particularly at an early stage of COVID-19. However, treatment utilisation shows sex and SES differences that cannot be fully explained by our data.</p>\",\"PeriodicalId\":12055,\"journal\":{\"name\":\"European Journal of Psychotraumatology\",\"volume\":\"16 1\",\"pages\":\"2512683\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2025-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Psychotraumatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/20008066.2025.2512683\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Psychotraumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/20008066.2025.2512683","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/25 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Post-traumatic stress disorder in German youth: representative claims data pre- vs. intra-COVID-19-pandemic.
Background: COVID-19-exposure and related restrictions may have contributed to the development or exacerbation of post-traumatic stress disorders (PTSD), especially in youth. However, data in this population is lacking.Objective: This study aimed to provide a thorough insight into the epidemiology and psychiatric comorbidities of PTSD as well as in- and outpatient treatment utilisation by those affected during vs. before COVID-19 in a representative sample of children and adolescents statutorily insured in Germany.Methods: The study is based on anonymized claims data of statutory insured youth aged 0.0-17.9 years from the InGef research database, which is representative of the German population. Prevalence, incidence, comorbidities of PTSD (ICD-10: F43.1, F43.8, F43.9) and in- and outpatient treatment for those affected were compared pre-COVID (01/2018-03/2020; N = 710.629) vs. intra-COVID (04/2020-12/2021; N = 698.108) using descriptive statistics, χ2 tests, Welch-tests and interrupted time series analyses stratified by sex, age (children: 0-13 years; adolescents: 14-17 years), and socio-economic status (SES).Results: PTSD prevalence decreased intra-COVID (girls: 0.8%, n = 2.595 vs. 0.6%, n = 1.965; OR = 0.77 [0.73, 0.82]; boys: 0.6%, n = 2.066 vs. 0.4%, n = 1.547; OR = 0.76 [0.71, 0.81]). Quarterly incidence in female children with high SES showed a significant increase in slope pre-COVID to intra-COVID (p = .018). Externalising comorbidities increased especially in female adolescents (OR = 1.34 [1.05, 1.72]). Psychotherapy utilisation decreased in male children with low SES (OR = 0.63 [0.41, 0.98]) and increased in adolescent girls with low SES (OR = 1.73 [1.09, 2.74]). Hospitalisations among female adolescents only decreased for those with low SES (OR = 0.67 [0.38, 1.19]).Conclusions: We observed similar decreases in clinical PTSD-diagnoses for girls and boys, possibly reflecting overstretched health services, particularly at an early stage of COVID-19. However, treatment utilisation shows sex and SES differences that cannot be fully explained by our data.
期刊介绍：
The European Journal of Psychotraumatology (EJPT) is a peer-reviewed open access interdisciplinary journal owned by the European Society of Traumatic Stress Studies (ESTSS). The European Journal of Psychotraumatology (EJPT) aims to engage scholars, clinicians and researchers in the vital issues of how to understand, prevent and treat the consequences of stress and trauma, including but not limited to, posttraumatic stress disorder (PTSD), depressive disorders, substance abuse, burnout, and neurobiological or physical consequences, using the latest research or clinical experience in these areas. The journal shares ESTSS’ mission to advance and disseminate scientific knowledge about traumatic stress. Papers may address individual events, repeated or chronic (complex) trauma, large scale disasters, or violence. Being open access, the European Journal of Psychotraumatology is also evidence of ESTSS’ stand on free accessibility of research publications to a wider community via the web. The European Journal of Psychotraumatology seeks to attract contributions from academics and practitioners from diverse professional backgrounds, including, but not restricted to, those in mental health, social sciences, and health and welfare services. Contributions from outside Europe are welcome. The journal welcomes original basic and clinical research articles that consolidate and expand the theoretical and professional basis of the field of traumatic stress; Review articles including meta-analyses; short communications presenting new ideas or early-stage promising research; study protocols that describe proposed or ongoing research; case reports examining a single individual or event in a real‑life context; clinical practice papers sharing experience from the clinic; letters to the Editor debating articles already published in the Journal; inaugural Lectures; conference abstracts and book reviews. Both quantitative and qualitative research is welcome.
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