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Available online 30 October 2023
Upward trends in eating disorders, self-harm, and suicide attempt emergency admissions in female adolescents after COVID-19 lockdown
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Adriana Forteaa,b,c,d, Lydia Forteab,d, Marta Gómez-Ramiroa,b,c,d,e,f, Giovanna Ficoa,b,c,d,g, Anna Giménez-Palomoa,d,g, Maria Sagué-Vilavellaa,c,d,g, Maria Teresa Ponsa, Mireia Vázqueza, Nuria Baldaquía, Lluc Colomera, Tábatha Maria Fernándeza, Felipe Gutiérrez-Arangoa, Maria Llobeth, Ester Pujala, Luisa Lázarob,c,d,h, Eduard Vietaa,b,c,d,g, Joaquim Raduab,c,d,
Corresponding author
radua@recerca.clinic.cat

Corresponding author.
, Inmaculada Baezab,c,d,h
a Department of Psychiatry and Psychology, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona 08036, Spain
b Medicina i Recerca Translacional, Institute of Neuroscience, University of Barcelona, 143 Casanova St., Barcelona 08036, Spain
c Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 3-5, Monforte de Lemos Av., Madrid 28029, Spain
d Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), 153 Roselló St., Barcelona 08036, Spain
e Department of Psychiatry, Hospital Alvaro Cunqueiro, Servizo Galego de Saúde (SERGAS), 341 Estrada de Clara Campoamor, Vigo 36312, Spain
f Translational Neuroscience Research Group, Galicia Sur Health Research Institute (IISGS), 341 Estrada de Clara Campoamor, Vigo 36312, Spain
g Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona 08036, Spain
h Department of Child and Adolescent Psychiatry and Psychology, SGR-2021-01319, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona 08036, Spain
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Received 10 February 2023. Accepted 04 September 2023
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Table 1. Changes in the number of admissions to the Pediatric Psychiatric Emergency Department.
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Abstract
Introduction

Increased mental health problems have been reported in children and adolescents related to the COVID-19 lockdown and its immediate aftermath, especially among adolescent females. However, the longer-term impact of persistent quarantine measures and social restrictions on this population is yet to be further explored.

Materials and methods

We compared the number of children/adolescents admissions to the psychiatric emergency department (ED) of Hospital Clínic de Barcelona during the COVID-19 lockdown and the following year with the numbers of admissions the year before lockdown, adjusting for variations in the population. We also conducted separate analyses by gender, age group, and diagnostic categories. Finally, we also repeated the analyses considering the cumulated deficit/excess since the start of the lockdown. Statistical significance was estimated using binomial tests with Bonferroni correction.

Results

A total of 2425 admissions were recorded. Globally, admission rates decreased during the lockdown (46%) and progressively increased during the one-year aftermath (43% by spring 2021). This increase was particularly high in adolescent females (85%) while unclear in children and/or males. The main diagnostic categories involved were anxiety, depressive, and eating disorders, as well as self-harm behavior, suicidal ideation, and suicide attempts. The increase in eating disorders, self-harm behavior, and suicide attempts admissions in female adolescents remained statistically significant when considering the cumulated deficit/excess.

Conclusions

We found increased ED admissions during the aftermath of the COVID-19 lockdown among adolescent females. We recommend strengthening the attention to this population to provide adequate specialized care and prevention strategies.

Keywords:
Adolescent psychiatry
SARS-CoV-2
Suicide
Eating disorder
Self-harm

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