@article{ref1,
title="Self-harm in children and adolescents who presented at emergency units during the COVID-19 pandemic: an international retrospective cohort study",
journal="Journal of the American Academy of Child and Adolescent Psychiatry",
year="2023",
author="Hoi-Ching Wong, Ben and Cross, Samantha and Zavaleta-Ramírez, Patricia and Bauda, Ines and Hoffman, Pamela and Ibeziako, Patricia and Nussbaum, Laura and Berger, Gregor E. and Hassanian-Moghaddam, Hossein and Kapornai, Krisztina and Mehdi, Tauseef and Tolmac, Jovanka and Barrett, Elizabeth and Romaniuk, Liana and Davico, Chiara and Moghraby, Omer S. and Ostrauskaite, Giedra and Chakrabarti, Sulagna and Carucci, Sara and Sofi, Gyula and Hussain, Haseena and Lloyd, Alexandra S. K. and McNicholas, Fiona and Meadowcroft, Ben and Rao, Manish and Csábi, Györgyi and Gatica-Bahamonde, Gabriel and Öğütlü, Hakan and Skouta, Eirini and Elvins, Rachel and Boege, Isabel and Dahanayake, Dulangi M. A. and Anderluh, Marija and Chandradasa, Miyuru and Girela-Serrano, Braulio M. and Uccella, Sara and Stevanovic, Dejan and Lamberti, Marco and Piercey, Amy and Nagy, Peter and Mehta, Varun S. and Rohanachandra, Yasodha and Li, Jie and Tufan, Ali Evren and Mirza, Hassan and Rozali, Farah and Baig, Benjamin J. and Noor, Isa M. and Fujita, Saori and Gholami, Narges and Hangül, Zehra and Vasileva, Anna and Salucci, Katie and Bilaç, Öznur and Yektaş, Çiğdem and Cansiz, Mehmet Akif and Aksu, Gülen Güler and Babatunde, Suleiman and Youssef, Fatima and Al-Huseini, Salim and Kiliçaslan, Fethiye and Kutuk, Meryem Ozlem and Pilecka, Izabela and Bakolis, Ioannis and Ougrin, Dennis",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: To compare psychiatric emergencies and self-harm at emergency departments (EDs) one year into the pandemic, to early pandemic and pre-pandemic, and to examine the changes in the characteristics of self-harm presentations. <br><br>METHOD: This retrospective cohort study expanded on the Pandemic-Related Emergency Psychiatric Presentations (PREP-kids) study. Routine record data in March-April of 2019, 2020, and 2021 from 62 EDs in 25 countries were included. ED presentations made by children and adolescents for any mental health reasons were analyzed. <br><br>RESULTS: Altogether, 8174 psychiatric presentations were recorded (63.5% female; mean [SD] age, 14.3 [2.6] years), 3742 of which were self-harm presentations. Rate of psychiatric ED presentations in March-April 2021 was twice as high as March-April 2020 (IRR, 1.93; 95% CI, 1.60-2.33), and 50% higher than March-April 2019 (IRR, 1.51; 95% CI, 1.25-1.81). Rate of self-harm presentations doubled between March-April 2020 and March-April 2021 (IRR, 1.98; 95% CI, 1.68-2.34), and overall 1.7 times higher than March-April 2019 (IRR, 1.70; 95% CI, 1.44-2.00). Comparing self-harm characteristics in March-April 2021 with March-April 2019, self-harm contributed to a higher proportion of all psychiatric presentations (OR, 1.30; 95% CI, 1.05-1.62), whilst female representation in self-harm presentations doubled (OR, 1.98; 95% CI, 1.45-2.72) and follow-up appointments were offered four times as often (OR, 4.46; 95% CI, 2.32-8.58). <br><br>CONCLUSION: Increased pediatric ED visits for both self-harm and psychiatric reasons were observed, suggesting potential deterioration in child mental health. Self-harm in girls possibly increased and needs to be prioritized. Clinical services should continue utilizing follow-up appointments to support discharge from EDs. DIVERSITY & INCLUSION STATEMENT: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.<p /> <p>Language: en</p>",
language="en",
issn="0890-8567",
doi="10.1016/j.jaac.2022.11.016",
url="http://dx.doi.org/10.1016/j.jaac.2022.11.016"
}