Dramatic increase of suicidality in children and adolescents after COVID-19 pandemic start: A two-year longitudinal study.
The COVID-19 pandemic has impacted the mental health of the youngest, worsening their emotional well-being. The demand for care in psychiatric emergencies may indirectly reflect the mental health state of children and adolescents and the emotional consequences of the pandemic. Moreover, suicidality can be considered a marker of severity in this population group. Therefore, we have aimed to longitudinally describe the number of children and adolescents attended in the psychiatry emergency department due to suicidal ideation or attempts and, to explore differences in suicidality according to gender and age. A retrospective study was carried out in the University Hospital of San Juan, Alicante, Spain, from January 01, 2018 to December 31, 2021. A total of 138 participants under 18 years requesting psychiatric care due to suicidal ideation or attempts were included. The sample was composed by 35% of males and the mean age was 14.8 years old (SD = 2.2). The number of cases per year range from 10 in 2018 to 88 in 2021. Attendances were significantly higher between 2021 and the three previous years. Besides, the number of attentions registered in the last 9 months of 2021 equals those that occurred in the entire previous period. Most of the cases were girls and middle adolescents. Suicide ideation or attempts have skyrocketed in children and adolescents. This alarming increase presents a one-year lag peak from the COVID-19 outbreak and continues until the end of 2021. Girls and those over 12 years have been identified as risk groups to present suicidal ideation or attempts.
García-Fernández L
，Romero-Ferreiro V
，Izquierdo-Izquierdo M
，Rodríguez V
，Alvarez-Mon MA
，Lahera G
，Santos JL
，Rodriguez-Jimenez R
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Comparison of paediatric emergency department visits for attempted suicide, self-harm, and suicidal ideation before and during the COVID-19 pandemic: a systematic review and meta-analysis.
There is a lack of consensus about the effect of the COVID-19 pandemic on the mental health of children and adolescents. We aimed to compare rates of paediatric emergency department visits for attempted suicide, self-harm, and suicidal ideation during the pandemic with those before the pandemic.
For this systematic review and meta-analysis, we searched MEDLINE, Embase, and PsycINFO for studies published between Jan 1, 2020, and Dec 19, 2022. Studies published in English with data on paediatric (ie, those aged <19 years) emergency department visits before and during the COVID-19 pandemic were included. Case studies and qualitative analyses were excluded. Changes in attempted suicide, self-harm, suicidal ideation, and other mental-illness indicators (eg, anxiety, depression, and psychosis) were expressed as ratios of the rates of emergency department visits during the pandemic compared with those before the pandemic, and we analysed these with a random-effects meta-analysis. This study was registered with PROSPERO, CRD42022341897.
10 360 non-duplicate records were retrieved, which yielded 42 relevant studies (with 130 sample-estimates) representing 11·1 million emergency department visits for all indications of children and adolescents across 18 countries. The mean age of the samples of children and adolescents across studies was 11·7 years (SD 3·1, range 5·5-16·3), and there were on average 57·6% girls and 43·4% boys as a proportion of emergency department visits for any health reasons (ie, physical and mental). Only one study had data related to race or ethnicity. There was good evidence of an increase in emergency department visits for attempted suicide during the pandemic (rate ratio 1·22, 90% CI 1·08-1·37), modest evidence of an increase in emergency department visits for suicidal ideation (1·08, 0·93-1·25), and good evidence for only a slight change in self-harm (0·96, 0·89-1·04). Rates of emergency department visits for other mental-illness indications showed very good evidence of a decline (0·81, 0·74-0·89), and paediatric visits for all health indications showed strong evidence of a reduction (0·68, 0·62-0·75). When rates for attempted suicide and suicidal ideation were combined as a single measure, there was good evidence of an increase in emergency department visits among girls (1·39, 1·04-1·88) and only modest evidence of an increase among boys (1·06, 0·92-1·24). Self-harm among older children (mean age 16·3 years, range 13·0-16·3) showed good evidence of an increase (1·18, 1·00-1·39), but among younger children (mean age 9·0 years, range 5·5-12·0) there was modest evidence of a decrease (0·85, 0·70-1·05).
The integration of mental health support within community health and the education system-including promotion, prevention, early intervention, and treatment-is urgently needed to increase the reach of mental health support that can mitigate child and adolescent mental distress. In future pandemics, increased resourcing in some emergency department settings would help to address their expected increase in visits for acute mental distress among children and adolescents.
None.
Madigan S
，Korczak DJ
，Vaillancourt T
，Racine N
，Hopkins WG
，Pador P
，Hewitt JMA
，AlMousawi B
，McDonald S
，Neville RD
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《Lancet Psychiatry》
What about adolescents' mental health after the pandemics? An analyses of a grade II hospital.
Suicidal ideation and suicide are serious situations that affect children and adolescents. The restrictions imposed by the SARS-CoV-2 pandemic have had a significant negative impact, due to social isolation, prolonged screen exposure and reduced outdoor activities. This study aims to compare the access to the Pediatric Emergency Department due to suicidal ideation and suicide attempts before and during the pandemic.
This descriptive and retrospective study analyzed clinical records of children/adolescents who attended a Level II Pediatric Emergency Department of a hospital due to suicidal ideation and/or suicide attempts, between March 2018 and March 2020 (pre-pandemic period) and April 2020 to March 2022 (pandemic period). Demographic (age and sex) and clinical (psychopharmacological therapy, discharge destination and follow-up psychiatric/psychological consultations) variables were collected. Statistical analysis was performed using Microsoft Excel 2022® and SPSS v20.0®, considering statistical significance at p<0.05.
A total of 71 children/adolescents were admitted for suicidal ideation, with a median age of 15 years (minimum: 10 years, maximum: 17 years), 27 in pre-pandemic period and 44 in pandemic period (p<0.001). The majority were girls, with a significant increase in pandemic period (pre-pandemic: 55.6 %, pandemic: 79.6 %; p<0.05). The age group with the highest increase in admissions was 15 years. There was a significant increase in suicidal attempts among girls (p<0.05) as well as self-harm behaviors (p<0.01). There was also a significant increase in the number of psychology/child psychiatry follow-up consultations in pandemic period (p<0.05). Most patients were referred to another hospital in both periods (pre-pandemic: 55.6 %, pandemic: 68.2 %) at discharge.
During the pandemic period, there was an increase in the number of suicidal ideation cases, particularly among females, as well as in suicide attempts cases, which appears to be correlated with the pandemic restrictions. Larger-scale studies are needed to draw more accurate conclusions.
Mendonça C
，Passos Croca G
，Magalhães T
，Viegas M
，Marques B
，Morais A
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Hospital admissions due to suicide attempts during the COVID-19 pandemic, a 3-year longitudinal study.
The appearance of the SARS CoV-2 virus and the associated COVID-19 pandemic has been associated with the onset of mental disorders in healthy people and the worsening in those with pre-existing mental conditions. One of the areas that has raised the greatest concern is that of suicidality. Most of the published studies have been carried out cross-sectional or with small samples, without stratifying by age and gender. Thus, the aim of this longitudinal research is to study, in a large population sample of around 6,700,000 inhabitants belonging to the entire region of Madrid (Spain), the admissions in psychiatric hospitalization units due to suicidal attempts along 2019, 2020 and 2021. No clear increase in the number of admissions due to suicidality in the total population have been found. In addition, a higher prevalence in admissions among women is verified. Moreover, stratifying by age and gender, a striking and significant increase in hospital admissions due to suicidality has been observed in the group up to 17 years old, from September 2020 until the end of the study. These results highlight the special vulnerability of children and adolescents, specifically girls, and the need for preventive measures in the face of future pandemics.
Rodriguez-Jimenez R
，García-Fernández L
，Baón-Pérez B
，Ansede-Cascudo JC
，Arroba CM
，Sendra-Gutierrez JM
，Romero-Ferreiro V
，Sánchez-Cabezudo Á
，Alvarez-Mon MA
，Navío-Acosta M
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ResearchGate
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