357 - Mental Health Disorders in Children During the COVID-19 Pandemic: Trends Observed in a Pediatric Emergency Department

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 357
Publication Number: 357.21

Dana Singer-Harel, The Hospital for Sick Children, toronto, ON, Canada; Basheer Nassrallah, The Hospital for Sick Children, Toronto, ON, Canada; Savithiri Ratnapalan, University of Toronto, Hospital for Sick Children,, Toronto, ON, Canada

Presenting Author(s)

DS

Dana Singer-Harel, MD (she/her/hers)

Pediatric emergency medicine fellow
The Hospital for Sick Children
toronto, Ontario, Canada

Background: The psychosocial effects of the COVID-19 pandemic have been pervasive and seems to be more profound in children. Psychosocial stressors are associated with higher risk of mental illness.

Objective:

To evaluate and characterize mental health disorders in children presenting to a large tertiary pediatric emergency department (ED) before and during the COVID-19 pandemic.

Design/Methods:

We conducted a retrospective chart review of children treated in our ED with any mental health disorder related diagnosis according to ICD-10 classification, from March 1, 2019 to February 28, 2020 (pre-pandemic), and during-pandemic period from March 1, 2020 to September 28, 2022. Data on presentation, diagnosis and outcome were extracted and a comparison before and during the pandemic was done using Chi square test and z tests as appropriate.

Results:

We reviewed 6431 charts (36.5% males and 63.5% females). 1598 (24.85%) were pre-covid and 4833 (75.15%) since declaration of the COVID-19 pandemic. Our center experienced a 42% reduction in all ED visits in the first year of the pandemic but a significant increase from 2.04% to 3.34% (p=0.0001) in mental health related issues. The second year had total of 63,858 ED visits and 3.49% were mental health related. It seems that after two years the numbers are trending down to pre-covid era but still increased compared to pre-covid era with 2.26% of mental health related visits (p=0.007). There was a significant reduction in male children presented to ED during the pandemic (44.9% Vs. 33.7%; chi=64.329, p< 0.001). The category which included “eating disorders” showed the most prominent rise from 8.1% to 15.2% (p< 0.0001; chi=38.58) in the first year and to 13.3% (p< 0.0001; chi=25.71) in the second year, with a trend towards baseline in the beginning of the third year with 10.2% (p=0.062; chi=3.5). No increase in presentation of depression and anxiety was noted during the pandemic. Total admission rates for mental health related issues were significantly higher post the pandemic (pre-covid 20.7%, first year 28.9%; {p< 0.0001; chi=28.6}, second year 25% {p=0.002; chi=9.99}, beginning of third year 22.5% {p=0.267; chi=1.23}).

Conclusion(s):

During the pandemic the percentage of ED visits related to mental health diagnoses in children increased significantly along with a significant rise in admission to hospital rates. This change is mainly attributed to a dramatic increase in eating disorder associated visits. This data might also indicate that depression in the pediatric population was underdiagnosed or under-treated in the community.