Mental Health Admissions in Child and Adolescents Over Pandemic Period: A Health Records Study

The emergence of the coronavirus disease 2019 (COVID-19) pandemic led to numerous changes worldwide. Due to restrictive measures, hospital admission patterns changed in child and adolescent psychiatry, as in all other medical specialties. Although there are studies investigating the impact of the COVID-19 pandemic on mental health, research examining the reasons for hospital admissions and changing trends among children and adolescents remains limited.

This study used data from the hospital information system of a university hospital and included patients aged 0-18 years. Data were analyzed across three periods: one year before the pandemic, one year during the pandemic, and one year after the complete lifting of all COVID-19-related restrictions. All 10th revision of the International Classification of Diseases "F" diagnostic codes were included in the analysis.

A total of 7,500 unique admissions were included. Diagnostic distributions differed significantly across periods (p<0.001). The leading causes of admission were attention-deficit/hyperactivity disorder (23.5%, n=1,766), psychiatric evaluation (16.3%, n=1,223), and childhood- and adolescent-onset disorders (13.6%, n=1,022). The diagnosis of other childhood- and adolescent-onset behavioral and emotional disorders (F98) showed significant changes in the pre-pandemic period and as a secondary diagnosis post-pandemic.

Changes in hospital admissions during the pandemic, especially for neurodevelopmental and severe mental disorders (e.g., autism), suggest stable overall admission rates but a possible increase in externalizing problems. It was suggested that the pandemic did not directly increase psychiatric disorders in children and adolescents but was associated with an increase in externalizing problems.