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. 2024 Sep 28;8(1):e002524.
doi: 10.1136/bmjpo-2024-002524.

Burden of the COVID-19 pandemic on adolescent mental health in the Lombardy Region, Italy: a retrospective database review

Antonio Clavenna  1 , Massimo Cartabia  2 , Ida Fortino  3 , Maurizio Bonati  4
Affiliations

Burden of the COVID-19 pandemic on adolescent mental health in the Lombardy Region, Italy: a retrospective database review

Antonio Clavenna et al. BMJ Paediatr Open. .

Abstract

Background: Previous research has assessed the impact of the COVID-19 pandemic on adolescent mental health (MH). How the pandemic changed healthcare resource utilisation for MH conditions was investigated less, however, in particular in Italy.

Methods: Data concerning outpatient visits in child and adolescent mental health services (CAMHSs), access to emergency departments (EDs), hospital admissions and drug prescriptions collected in administrative databases of the Lombardy Region, Italy, concerning adolescents 12-17 years old and occurring in the 2016-2021 period were analysed.Annual and monthly prevalence of healthcare (CAHMS/ED visits/hospital admissions) use for MH conditions and of psychotropic drug prescriptions were estimated. A negative binomial regression model was used to model the pre-pandemic monthly number of prevalent cases by gender. The total number of pandemic (1 March 2020 to 31 December 2021) cases predicted from the model was compared with the number of observed cases.

Results: The overall annual rate of healthcare service utilisation slightly increased in the 2016-2019 period (from 63.8‰ to 67.8‰), decreased in 2020 (57.1‰) and returned to values similar to 2016 (64.9‰) the following year. A 2% relative increase was observed in girls, and a 10% decrease in boys, when comparing the prevalence in 2021 with that in 2019. Differences between genders were particularly evident for ED attendance, with an observed/predicted cases ratio in 2021 of 0.81 (95% CI 0.79 to 0.83) in boys, and 1.18 (95% CI 1.16 to 1.20) in girls, and for psychotropic drug prescriptions (0.83 (95% CI 0.82 to 0.84) and 1.24 (95% CI 1.23 to 1.25), respectively).

Conclusions: The current study confirms that the use of health services for MH conditions during the COVID-19 pandemic increased among adolescent girls but decreased among boys, and that gender differences emerged in the MH impact of the pandemic.

Keywords: Adolescent Health; COVID-19; Child Psychiatry; Epidemiology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Ratio between the monthly number of observed versus predicted cases in the 2019–2021 period, by gender.
Figure 2
Figure 2. Percentage distribution of emergency department visits by mental disorder in 2019 (light colour) versus 2021 (dark colour).
See this image and copyright information in PMC

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