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. 2025 Jan 22;25(1):68.
doi: 10.1186/s12888-024-06422-7.

Patterns of psychiatric healthcare use during pandemic times among boys and girls with pre-existing diagnoses: a Norwegian nationwide primary and specialist healthcare registry study

Ingunn Olea Lund  1   2   3 , Pia Jensen #  4   5 , Christian Madsen #  6 , Lars Johan Hauge  7 , Alexandra Havdahl  4   8   9 , Anne Reneflot  7 , Ragnhild Brandlistuen  5 , Helga Ask  4   5   9
Affiliations

Patterns of psychiatric healthcare use during pandemic times among boys and girls with pre-existing diagnoses: a Norwegian nationwide primary and specialist healthcare registry study

Ingunn Olea Lund et al. BMC Psychiatry. .

Abstract

Background: The COVID-19 pandemic introduced complexities that were likely more demanding for some groups, such as children and adolescents, and especially those with pre-existing mental health diagnoses. This study examines long-term patterns of psychiatric healthcare use among this vulnerable group, providing insights into shifts in psychiatric healthcare use during a global health crisis.

Methods: We use data from the primary and specialist healthcare registries available from the Norwegian emergency preparedness register for COVID-19 (Beredt C19) to estimate patterns of psychiatric healthcare use. The data spans 2017 to 2022, covering children and adolescents aged 6-19. We identified young people with recent diagnoses of mental health conditions and compared weekly consultation volumes before and during the pandemic for mental health conditions overall and the following diagnostic or symptom categories separately: anxiety/depression and Attention-Deficit Hyperactivity Disorders (ADHD). Analyses were stratified by gender.

Results: There was a consistent trend of lower-than-predicted weekly healthcare consultations among young people with pre-existing mental health diagnoses in both primary and specialist healthcare during the pandemic. The reduction was more pronounced in later follow-up periods. The study highlights gender disparities, with boys experiencing more notable declines in healthcare consultations, especially in specialist care. Additionally, the time trends varied across different diagnostic groups. While consultations for anxiety/depression were consistently below the predicted levels, declines in ADHD occurred later in the pandemic. The data suggests an overall decline in healthcare use rather than a shift between sectors.

Conclusion: The findings offer insights into healthcare use during pandemic times among children and adolescents with pre-existing mental health diagnoses. The study underscores the importance of continuous monitoring and support for this group, ensuring accessible and responsive healthcare during public health emergencies.

Keywords: Adolescents; COVID-19; Children; Health registry; Mental disorders; Primary health care; Specialist health care; Time trends.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Regional Ethics Committee for Medical Research South-East Norway approved the current study #267200. For data minimization purposes, we only had access to the data needed from the Beredt C19, not the entire database (data minimization). Data was based on de-identified and routinely collected registry data from the Norwegian population. According to the Norwegian Health Registry Act § 19, The Regional Ethics Committee for Medical Research South-East Norway waived the informed consent requirement. The study was carried out following the ethical standards of the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Illustration of the four datasets in the study. Inclusion year is the year we used to define individuals as having a pre-existing mental health diagnosis based on individuals having one or more weekly consultations in primary or specialist healthcare for one or more of the pre-selected symptoms and diagnoses
Fig. 2
Fig. 2
(a) Time series plots for weekly consultations in primary healthcare (ICPC-2 codes, chapter P). (b) Time series plots for weekly consultations in specialist healthcare (ICD codes, chapter F). Both figures show consultations per 100,000 (solid red line) for boys (top row) and girls (bottom row). The dashed blue line represents predicted consultations with a 99.9% confidence interval (grey shading). Light blue columns indicate periods of strict social distancing measures by the Norwegian government. The left column shows results for inclusion year 2018 with follow-up years 2019–2020, while the right column shows inclusion year 2019 with follow-up years 2020–21
Fig. 3
Fig. 3
a Time series plots for observed weekly consultations in primary healthcare for anxiety/depression (ICPC-2 codes: P01, P03, P74, P76, P79, P81, P82). b Time series plots for observed weekly consultations in specialist healthcare for anxiety/depression (ICD codes: F32, F33, F40, F41, F43, F93.0, F93.1, F93.2). For both figures, observed consultations per 100,000 are shown as a solid red line, with predicted consultations represented by a dashed blue line and 99.9% confidence interval in grey shading. Light blue columns indicate periods of strict social distancing measures implemented by the Norwegian government. The left column displays results for inclusion year 2018 with follow-up years 2019–2020, while the right column shows inclusion year 2019 with follow-up years 2020–2021. Results for boys are in the top row, and for girls in the bottom row
Fig. 4
Fig. 4
(a) Time series plots for weekly consultations for ADHD in primary healthcare (ICPC-2 code: P81). (b) Time series plots for weekly consultations for ADHD in specialist healthcare (ICD code: F90). For both figures, observed consultations per 100,000 are shown as a solid red line, with predicted consultations represented by a dashed blue line and 99.9% confidence interval in grey shading. Light blue columns indicate periods of strict social distancing measures implemented by the Norwegian government. The left column displays results for inclusion year 2018 with follow-up years 2019–2020, while the right column shows inclusion year 2019 with follow-up years 2020–2021. Results for boys are in the top row, and for girls in the bottom row
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References

    1. Hafstad GS, Sætren SS, Wentzel-Larsen T, Augusti EM. Changes in adolescent mental and somatic health complaints throughout the COVID-19 pandemic: a three-wave prospective longitudinal study. J Adolesc Heal. 2022;71(4):406–13. 10.1016/j.jadohealth.2022.05.009 - PMC - PubMed
    1. WHO. Mental health and covid-19: scientific brief; 2022.
    1. Solmi M, Radua J, Olivola M, Croce E, Soardo L, Gonzalo Salazar De Pablo, et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry. 2022;27:281–95. 10.1038/s41380-021-01161-7 - PMC - PubMed
    1. Nøkleby H, Borge TC, Lidal IB, Bjerke Johansen T, Langøyen LJ. Konsekvenser Av covid-19-pandemien for barn og unges Liv Og psykiske helse: andre oppdatering av en hurtigoversikt [Consequences of the Covid-19 pandemic on children and youth’s life and mental health: second update of a rapid review]. Norway: Oslo; 2023.
    1. Burdzovic Andreas J, Brunborg GS. Self-reported mental and physical health among norwegian adolescents before and during the COVID-19 pandemic. JAMA Netw Open. 2021 Aug 2;4(8):e2121934–e2121934. 10.1001/jamanetworkopen.2021.21934 - PMC - PubMed

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