Impact of the COVID-19 pandemic on mental healthcare consultations among children and adolescents in Norway: a nationwide registry study.
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SUBMITTER: Evensen M
PROVIDER: S-EPMC9330988 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundDespite concern about migrant children's mental health and their access to mental healthcare services during the COVID-19 pandemic, this topic has attracted little research attention. This study aimed to examine the impact of the COVID-19 pandemic on the use primary and specialist healthcare services for mental health problems among children and adolescents with migrant background.MethodsUsing event study models, we investigated the impact of lockdown and subsequent COVID-19 infection control measures on children's health service use for mental health problems according to migrant background. Drawing on reimbursement data from Norwegian public healthcare providers we observe consultations in a pre-pandemic (2017-2019) and pandemic cohort (2019-2021) in primary and specialised care.ResultsThe pre-pandemic cohort included 77 324 migrants, 78 406 descendants of migrants and 746 917 non-migrants and the pandemic cohort included 76 830 migrants, 88 331 descendants and 732 609 non-migrants (age 6-19). The full cohorts were observed for mental healthcare use in primary care while a subsample (age 6-16) was observed for health care use in specialist care. Lockdown resulted in a dip in consultation volumes for mental disorders for all children, but this dip was relatively larger and more persistent for children with migrant background. After lockdown, consultation volumes rose more for non-migrant children than for children with migrant background. Consultations in primary healthcare peaked during January to April 2021 for non-migrants and descendants of migrants, but not for migrants (4%, 95% CI -4 to 11). In specialist care during the same period, consultations dropped by 11% for migrants (95% CI -21 to -1). By October 2021, all mental health consultations in specialist care were up with 8% for non-migrants (95% CI 0 to 15), and down with -18% for migrants and -2% for descendants (95% CIs -31 to -5 and -14 to 10). Migrant males experienced the largest reduction in consultations.ConclusionsChanges in consultation volumes among children with migrant background after lockdown were not as pronounced as for non-migrants, and at times actually decreased. This suggests that an increase in barriers to care emerged during the pandemic for children with a migrant background.
| S-EPMC10314381 | biostudies-literature
Project description:BackgroundStudies have reported the worsening of psychiatric symptoms during the COVID-19 pandemic. However, few studies have evaluated the impact on the access to mental health services during COVID-19. Our aim was to analyze temporal trends and prediction of appointments held in Brazil's public health system, to compare the observed and expected number of mental healthcare appointments during the COVID-19 pandemics.MethodsAn ecological time-series study was performed, analyzing mental health appointments before and during the pandemic (from 2016 and 2020) from the Brazilian governmental database. The structural break in the data series was assessed using the Chow test, with the break considered in March 2020. Bayesian structural time-series models were used to estimate current average appointments and the predicted expectation if there was no pandemic.FindingsCompared to the expected, between March and August 2020 about 28% less outpatient appointments in mental health were observed, totaling 471,448 individuals with suspended assistance. Group appointments and psychiatric hospitalizations were also severely impacted by the pandemic (decreased of 68% and 33%, respectively). On the other hand, mental health emergency consultations and home care increased during this period (36% and 52%, respectively).InterpretationOur findings demonstrate a dramatic change in mental health assistance during the COVID-19 pandemic, which corroborates a recent WHO survey. This phenomenon can aggravate the mental health crisis and generate a parallel pandemic that may last for a longer time than the COVID-19 pandemic.FundingThis study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.
| S-EPMC8427141 | biostudies-literature
Project description:BackgroundThe general health of children of parents with mental illness is overlooked.AimsTo quantify the difference in healthcare use of children exposed and unexposed to maternal mental illness (MMI).MethodThis was a retrospective cohort study of children aged 0-17 years, from 1 April 2007 to 31 July 2017, using a primary care register (Clinical Practice Research Datalink) linked to Hospital Episodes Statistics. MMI included non-affective/affective psychosis and mood, anxiety, addiction, eating and personality disorders. Healthcare use included prescriptions, primary care and secondary care contacts; inflation adjusted costs were applied. The rate and cost was calculated and compared for children exposed and unexposed to MMI using negative binomial regression models. The total annual cost to NHS England of children with MMI was estimated.ResultsThe study included 489 255 children: 238 106 (48.7%) girls, 112 741 children (23.0%) exposed to MMI. Compared to unexposed children, exposed children had a higher rate of healthcare use (rate ratio 1.27, 95% CI 1.26-1.28), averaging 2.21 extra contacts per exposed child per year (95% CI 2.14-2.29). Increased healthcare use among exposed children occurred in inpatients (rate ratio 1.37, 95% CI 1.32-1.42), emergency care visits (rate ratio 1.34, 95% CI 1.33-1.36), outpatients (rate ratio 1.30, 95% CI 1.28-1.32), prescriptions (rate ratio 1.28, 95% CI 1.26-1.30) and primary care consultations (rate ratio 1.24, 95% CI 1.23-1.25). This costs NHS England an additional £656 million (95% CI £619-£692 million), annually.ConclusionsChildren of mentally ill mothers are a health vulnerable group for whom targeted intervention may create benefit for individuals, families, as well as limited NHS resources.
| S-EPMC8387858 | biostudies-literature
Project description:ObjectivesTo explore patients' experiences with receiving sick leave certificates via remote consultations during the COVID-19 pandemic and investigate whether there were differences among the types of remote consultation (telephone, video or text).DesignA nationwide online patient survey consisting of quantitative data supplemented by qualitative opinions conducted in Norway.SettingPrimary care.ParticipantsPatients who received a sick leave certificate via remote consultation in the period from 16 November to 15 December 2020.ResultsOf the 5429 respondents, 3233 (59.6%) received a sick leave certificate via telephone consultation, 657 (12.1%) via video consultation and 1539 (28.3%) via text-based e-consultation. Most respondents (76.8%) were satisfied. Only 10% of the respondents thought that the doctor would have obtained more information through an office appointment. The majority of the respondents (59.6%) found that they had as much time to explain the problem as at an office appointment. Some patients also thought that it was easier to formulate the problem via a remote consultation (18.2%) and agree with the doctor on the sick leave (10.3%).The users of text-based e-consultations were the most satisfied (79.3%, p<0.001) compared with those using telephone or video consultations. Among users of text-based e-consultations, there was a higher proportion of patients who thought that they had more time to explain the problem compared with an office appointment (p<0.001), it was easier to explain the problem (p<0.001) and agree with the doctor (p<0.001). Most respondents would use the same type of remote consultation if they were to contact the general practitioner (GP) for the same problem, with the highest proportion among the users of video consultations (62.1%, p<0.001).ConclusionsPatients were satisfied with communicating and receiving sick leave certificates via remote consultations. Future studies should investigate patients' and GPs' use and experiences in a postpandemic setting.
| S-EPMC10824015 | biostudies-literature
Project description:ObjectiveTo assess the impact of COVID-19 on pregnancy-related healthcare utilisation and differences across social groups.DesignNationwide longitudinal prospective registry-based study.SettingNorway.ParticipantsFemale residents aged 15-50 years (n=1 244 560).Main outcome measuresPregnancy-related inpatient, outpatient and primary care healthcare utilisation before the COVID-19 pandemic (prepandemic: 1 January to 11 March 2020), during the initial lockdown (first wave: 12 March to 3 April 2020), during the summer months of low restrictions (summer period: 4 April to 31 August 2020) and during the second wave to the end of the year (second wave: 1 September to 31 December 2020). Rates were compared with the same time periods in 2019.ResultsThere were 130 924 inpatient specialist care admissions, 266 015 outpatient specialist care consultations and 2 309 047 primary care consultations with pregnancy-related diagnostic codes during 2019 and 2020. After adjusting for time trends and cofactors, inpatient admissions were reduced by 9% (adjusted incidence rate ratio (aIRR)=0.91, 95% CI 0.87 to 0.95), outpatient consultations by 17% (aIRR=0.83, 95% CI 0.71 to 0.86) and primary care consultations by 10% (aIRR=0.90, 95% CI 0.89 to 0.91) during the first wave. Inpatient care remained 3%-4% below prepandemic levels throughout 2020. Reductions according to education, income and immigrant background were also observed. Notably, women born in Asia, Africa or Latin America had a greater reduction in inpatient (aIRR=0.87, 95% CI 0.77 to 0.97) and outpatient (aIRR 0.90, 95% CI 0.86 to 0.95) care during the first wave, compared with Norwegian-born women. We also observed that women with low education had a greater reduction in inpatient care during summer period (aIRR=0.88, 95% CI 0.83 to 0.92), compared with women with high educational attainment.ConclusionFollowing the introduction of COVID-19 mitigation measures in Norway in March 2020, there were substantial reductions in pregnancy-related healthcare utilisation, especially during the initial lockdown and among women with an immigrant background.
| S-EPMC9577276 | biostudies-literature
Project description:This large cross-sectional study examined the impact of COVID-19 emergency measures on child/adolescent mental health for children/adolescents with and without pre-existing psychiatric diagnoses. Using adapted measures from the CRISIS questionnaire, parents of children aged 6-18 (N = 1013; 56% male; 62% pre-existing psychiatric diagnosis) and self-reporting children/adolescents aged 10-18 (N = 385) indicated changes in mental health across six domains: depression, anxiety, irritability, attention, hyperactivity, and obsessions/compulsions. Changes in anxiety, irritability, and hyperactivity were calculated for children aged 2-5 years using the Strengths and Difficulties Questionnaire. COVID-19 exposure, compliance with emergency measures, COVID-19 economic concerns, and stress from social isolation were measured with the CRISIS questionnaire. Prevalence of change in mental health status was estimated for each domain; multinomial logistic regression was used to determine variables associated with mental health status change in each domain. Depending on the age group, 67-70% of children/adolescents experienced deterioration in at least one mental health domain; however, 19-31% of children/adolescents experienced improvement in at least one domain. Children/adolescents without and with psychiatric diagnoses tended to experience deterioration during the first wave of COVID-19. Rates of deterioration were higher in those with a pre-exiting diagnosis. The rate of deterioration was variable across different age groups and pre-existing psychiatric diagnostic groups: depression 37-56%, anxiety 31-50%, irritability 40-66%, attention 40-56%, hyperactivity 23-56%, obsessions/compulsions 13-30%. Greater stress from social isolation was associated with deterioration in all mental health domains (all ORs 11.12-55.24). The impact of pre-existing psychiatric diagnosis was heterogenous, associated with deterioration in depression, irritability, hyperactivity, obsession/compulsions for some children (ORs 1.96-2.23) but also with improvement in depression, anxiety, and irritability for other children (ORs 2.13-3.12). Economic concerns were associated with improvement in anxiety, attention, and obsessions/compulsions (ORs 3.97-5.57). Children/adolescents with and without pre-existing psychiatric diagnoses reported deterioration. Deterioration was associated with increased stress from social isolation. Enhancing social interactions for children/adolescents will be an important mitigation strategy for current and future COVID-19 waves.
| S-EPMC7909377 | biostudies-literature
Project description:The COVID-19 pandemic has caused unprecedented changes in the lives of 1.6 billion children and adolescents. First non-representative studies from China, India, Brazil, the US, Spain, Italy, and Germany pointed to a negative mental health impact. The current study is the first nationwide representative study to investigate the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) and mental health of children and adolescents in Germany from the perspective of children themselves. A representative online survey was conducted among n = 1586 families with 7- to 17-year-old children and adolescents between May 26 and June 10. The survey included internationally established and validated instruments for measuring HRQoL (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), and depression (CES-DC). Results were compared with data from the nationwide, longitudinal, representative BELLA cohort study (n = 1556) conducted in Germany before the pandemic. Two-thirds of the children and adolescents reported being highly burdened by the COVID-19 pandemic. They experienced significantly lower HRQoL (40.2% vs. 15.3%), more mental health problems (17.8% vs. 9.9%) and higher anxiety levels (24.1% vs. 14.9%) than before the pandemic. Children with low socioeconomic status, migration background and limited living space were affected significantly more. Health promotion and prevention strategies need to be implemented to maintain children's and adolescents' mental health, improve their HRQoL, and mitigate the burden caused by COVID-19, particularly for children who are most at risk.
| S-EPMC7829493 | biostudies-literature
Project description:PurposeLower COVID-19 vaccination rates have been observed among some adult immigrant populations in Norway, and there appears to be an association with sociodemographic factors. However, knowledge is lacking on the distribution of vaccination rates and role of sociodemographic factors among adolescents. This study aims to describe COVID-19 vaccination rates among adolescents according to immigrant background, household income, and parental education.MethodsIn this nationwide registry study, we analyzed individual-level data on adolescents (12-17 years) from the Norwegian Emergency preparedness register for COVID-19 until September 15th, 2022. We estimated incidence rate ratios (IRR) for receiving at least one COVID-19 vaccine dose by country background, household income and parental education, using Poisson regression, adjusting for age, sex, and county.ResultsThe sample comprised 384,815 adolescents. Foreign-born and Norwegian-born with foreign-born parents, had lower vaccination rates (57 % and 58 %) compared to adolescents with at least one Norwegian-born parent (84 %). Vaccination rates by country background varied from 88 % (Vietnam) to 31 % (Russia). Variation and associations by country background, household income, and parental education were greater among 12-15-year-olds than 16-17-year-olds. Household income and parental education were positively associated with vaccination. Compared to the lowest income and education category, IRRs for household income ranged from 1.07 (95 % CI 1.06-1.09) to 1.31 (95 % CI 1.29-1.33) among 12-15-year-olds, and 1.06 (95 % CI 1.04-1.07) to 1.17 (95 % CI 1.15-1.18) among 16-17-year-olds. For parental education, from IRR 1.08 (95 % CI 1.06-1.09) to 1.18 (95 % CI 1.17-1.20) among 12-15-year-olds, and 1.05 (95 % CI 1.04-1.07) to 1.09 (95 % CI 1.07-1.10) among 16-17-year-olds.ConclusionCOVID-19 vaccination rates varied by immigrant background and age group, with lower rates especially among adolescents with background from Eastern Europe and among younger adolescents. Household income and parental education were positively associated with vaccination rates. Our results may help target measures to increase vaccination rates among adolescents.
| S-EPMC10150188 | biostudies-literature
Project description:The COVID-19 pandemic has affected the life of children and adolescents in an unprecedented way. In the present study, we focused on two activities that have been likely affected by mitigation measures: screen time and green time. We investigated how both influenced each other during the pandemic, how they affected children's and adolescents' mental health, and which role socio-demographic characteristics have in predicting screen time, green time, and mental health. We used data collected between autumn 2020 and spring 2021 from 844 participants aged 5 to 19 of a population-based, prospective cohort study in Canton Ticino, Italian-speaking Switzerland. We analyzed the data using an extended version of the Random Intercept Cross-Lagged Panel Model with time-invariant socio-demographic covariates and mental health as outcome. Results showed that, at the between-person level, screen time was a risk factor and green time a protective factor of mental health. However, within-person deviations of screen time and green time during the pandemic did not consistently predict mental health. Furthermore, they did not influence each other over time. Gender, age, perceived economic situation of the family, Body Mass Index and the availability of green space nearby all influenced stable measures of green time and screen time (i.e., random intercepts). Our results highlight the need for targeted actions to promote green time and raise awareness about the detrimental effect of screen time on children's and adolescents' mental health.
| S-EPMC9121633 | biostudies-literature
Project description:ImportanceThere are suggestions that school pressure may be stressful and a factor in child and adolescent mental health disturbances, but data about this association are scarce and inconclusive.ObjectiveTo assess whether varying degrees of school interruption were associated with changes in emergency department (ED) psychiatric visits of children and adolescents before and after the COVID-19 outbreak.Design, setting, and participantsA cross-sectional observational study was conducted at 9 urban university hospitals in Italy. All ED visits from January 1, 2018, to December 31, 2021, for psychiatric reasons of patients younger than 18 years were examined for demographic characteristics and type of psychopathologic factors. Data analysis was conducted from July 1 to August 31, 2023.ExposureThe disruption in the usual succession of school and holiday periods brought on by the COVID-19 pandemic at different times and with various degrees of intensity.Main outcomes and measuresTotal number of pediatric ED visits, psychiatric ED visits, and psychiatric ED visits categorized by specific reasons (eg, psychomotor agitation, suicide ideation [SI] or suicide attempt [SA], and eating disorders) on a weekly basis.ResultsA total of 13 014 psychiatric ED visits (1.3% of all pediatric ED visits) were recorded (63.2% females; mean [SD] age, 13.8 [3.8] years). The number of ED psychiatric visits increased over time (incidence rate ratio [IRR], 1.19; 95% CI, 1.16-1.22 for each year). Significant increases in ED visits were observed for eating disorders (294.8%), SI (297.8%), and SA (249.1%). School opening, but not social lockdown restriction, was associated with an increase in the number of ED psychiatric visits (IRR, 1.29; 95% CI, 1.23-1.34), which was evident for females and for SI with SA. Socioeconomic status was associated with an increase in psychiatric visits for males (IRR, 1.12; 95% CI, 1.04-1.20) but not females (IRR, 1.04; 95% CI, 0.98-1.10).Conclusions and relevanceIn this study, school opening was associated with an increased incidence of acute psychiatric emergencies among children and adolescents, suggesting that school can be a substantial source of stress with acute mental health implications.
| S-EPMC11301547 | biostudies-literature