How COVID-19 Phases Have Impacted Psychiatric Risk: A Retrospective Study in an Emergency Care Unit for Adolescents
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample
- − Pre-Lockdown Group (PLG) (9 March 2019–8 March 2020): 115 patients, 63 males (54.3%) and 52 females (44.8%); mean age of 14.0 ± 2.7 years;
- − First Lockdown Group (FLG) (9 March 2020 to 10 October 2020): 65 patients, 33 males (50.8%) and 32 females (49.2%); mean age of 13.7 ± 2.9 years;
- − Second Lockdown Group (SLG) (11 October 2020 to 30 March 2021): 61 patients, 27 males (44.3%) and 34 females (55.7%); mean age 14.09 ± 2.0 years).
2.2. Measures
- − Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) [17], a semi-structured interview administered by trained child psychiatrists to patients and parent(s), to obtain categorical diagnoses, according to the DSM-5 criteria;
- − Child Global Assessment Scale (C-GAS) [18], to assess the functional impairment, with a score ranging from 0 (needs constant supervision) to 100 (superior functioning);
- − Child Behavior Checklist (CBCL) [19], a 118-item scale, completed by parents, to obtain a dimensional diagnosis of psychopathology, clustered in two broad-band scores—Internalizing Problems and Externalizing Problems—and a Total Problem Score, along with 8 different syndromes scales (withdrawal, somatic complaints, anxiety/depression, social problems, thought problems, attention problems, rule-breaking behavior, aggressive behavior);
- − Columbia–Suicide Severity Rating Scale (C-SSRS) [20] for the assessment of the suicidal ideation and behavior. Suicidal ideation in the sample is defined by a score 3 or above.
- − Assessment of the DSM-5 categorical diagnostic criteria for non-suicidal self-injury (NSSI), that is, NSSI on at least 5 days within the past year, suicidal ideation absent or low (score below 3 at the C-SSRS), and no previous suicide attempts.
2.3. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Pre-Lockdown N = 115 | First Lockdown N = 65 | Second Lockdown N = 61 | (df) | p | Comparisons between Groups | |
---|---|---|---|---|---|---|
DSM-5 Diagnosis | ||||||
Depression, N (%) | 6 (5.2) | 6 (9.2) | 3 (4.9) | 1.4 (2) | ns | - |
Bipolar disorder, N (%) | 99 (86.1) | 57 (87.7) | 56 (93.4) | 2.1 (2) | ns | - |
Anxiety Disorders, N (%) | 73 (62.9) | 47 (72.3) | 44 (72.1) | 2.4 (2) | ns | - |
ADHD, N (%) | 38 (32.8) | 28 (43.1) | 10 (16.4) | 10.6 (2) | 0.005 * | FLG/SLG |
ODD/CD, N (%) | 49 (42.2) | 36 (55.4) | 29 (47.5) | 2.9 (2) | ns | - |
Autism Spectrum Disorder, N (%) | 12 (10.3) | 8 (12.3) | 6 (9.9) | 0.7 (2) | ns | - |
Schizophrenia, N (%) | 11 (9.6) | 1 (1.5) | 4 (6.6) | 4.3 (2) | ns | - |
Obsessive-Compulsive Dis., N (%) | 14 (12.1) | 8 (12.3) | 8 (13.1) | 0.04 (2) | ns | - |
Tic/Tourette Syndrome, N (%) | 3 (2.6) | 4 (6.2) | 2 (3.3) | 1.5 (2) | ns | - |
Post-Traumatic Stress Dis., N (%) | 23 (19.8) | 19 (29.2) | 21 (34.4) | 4.9 (2) | ns | - |
Eating Disorders, N (%) | 5 (4.3) | 11 (16.9) | 16 (26.2) | 17.8 (2) | 0.001 * | PLG/FLG PLG/SLG |
Sleep Problems, N (%) | 2 (1.7) | 2 (3.1) | 8 (13.1) | 11.7 (2) | 0.003 * | PLG/SLG |
Substance Use Disorder, N (%) | 15 (9.6) | 11 (15.4) | 5 (4.9) | 3.9 (2) | ns | - |
Tobacco use, N (%) | 1 (0.9) | 2 (3.1) | 3 (4.9) | 2.8 (2) | ns | - |
Non-Suicidal Self-Injury, N (%) | 35 (30.2 | 18; 27.7 | 32 (52.5) | 10.9 (2) | 0.004 * | PLG/SLG FLG/SLG |
Persistent Suicide Ideation, N (%) | 24 (20.7 | 10; 15.4 | 25 (41) | 12.8 (2) | 0.002 * | PLG/SLG FLG/SLG |
Suicide Attempts, N (%) | 13 (11.2 | 9; 13.8 | 18 (29.5) | 10.3 (2) | 0.006 * | PLG/SLG |
Somatic Disorders, N (%) | 3 (2.6) | 1 (1.5) | 5 (8.2) | 4.7 (2) | ns | - |
Learning Disability, N (%) | 19 (16.4) | 7 (10.8) | 11 (18) | 1.5 (2) | ns | - |
Intellectual Disability N (%) | 26 (22.6) | 13 (20) | 4 (6.6) | 7.3 (2) | 0.026 * | PLG/SLG |
CBCL-Scales, Mean (sd) | Pre-Lockdown; N = 115 | First Lockdown; N = 65 | Second Lockdown; N = 61 | F (df) | p |
---|---|---|---|---|---|
Anxious/Depressed | 72.3 (10.3) | 69.8 (10.6) | 71.6 (11.7) | 0.9 (2) | ns |
Withdrawn/Depressed | 71.6 (11.4) | 70.3 (12.1) | 74.0 (14.1) | 1.2 (2) | ns |
Somatic complaints | 63.6 (9.38) | 63.0 (8.6) | 64.8 (11.2) | 0.4 (2) | ns |
Social problems | 67.4 (8.7) | 66.2 (10.2) | 65.3 (8.7) | 0.8 (2) | ns |
Thought problems | 69.0 (9.2) | 67.7 (8.4) | 69.0 (10.5) | 0.4 (2) | ns |
Attention problems | 68.5 (10.3) | 68.1 (10.3) | 64.1 (10.2) | 2.8 (2) | ns |
Rule-breaking behavior | 65.1(10.5) | 65.3 (9.6) | 63.9 (9.2) | 0.3 (2) | ns |
Aggressive behavior | 69.5 (12.3) | 68.9 (10.3) | 69.4 (12.3) | 0.05 (2) | ns |
Internalizing problems | 71.0 (7.2) | 69.1 (10.3) | 71.4 (9.4) | 1.1 (2) | ns |
Externalizing problems | 67.7 (9.8) | 67.4 (9.8) | 66.2 (10.7) | 0.3 (2) | ns |
Total problems | 71.0 (6.6) | 69.6 (8.6) | 69.7 (8.4) | 0.7 (2) | ns |
ASEBA-Affective problems | 74.8 (8.8) | 71.6 (10.3) | 75.7 (10.3) | 2.6 (2) | ns |
ASEBA-Anxiety Problems | 69.5 (6.7) | 67.9 (8.2) | 67.9 (7.3) | 1.1 (2) | ns |
ASEBA-Somatic problems | 59.9 (10.2) | 60.4 (9.4) | 61.8 (11.7) | 0.5 (2) | ns |
ASEBA- Attention Deficit-Hyperactivity problems | 63.8(8.2) | 64.7(8.5) | 61.5 (7.9) | 1.9 (2) | ns |
ASEBA-Oppositional Defiant Problems | 64.9 (9.2) | 64.7 (8.4) | 65.7 (9.6) | 0.2 (2) | ns |
ASEBA-Conduct problems | 65.4 (11.1) | 65.9 (9.6) | 65.0 (10.2) | 0.09 (2) | ns |
Direct ACE | Pre-Lockdown N = 115 | First Lockdown N = 65 | Second Lockdown N = 61 | (df) | p | Comparisons between Groups |
---|---|---|---|---|---|---|
Sexual abuse, N (%) | 0 (0) | 2; 3.1 | 2; 3.3 | 3.7 (2) | ns | - |
Physical maltreatment, N (%) | 3 (2.6) | 4; 6.2 | 1; 1.6 | 2.4 (2) | ns | - |
Psychol. maltreatment, N (%) | 3 (2.6) | 3; 4.6 | 7; 11.5 | 6.3 (2) | 0.043 * | PLG/SLG |
Neglect, N (%) | 9 (7.8) | 12; 18.5 | 18; 29.5 | 14.3 (2) | 0.001 * | PLG/SLG |
Indirect ACE | ||||||
Witnessed violence, N (%) | 7 (6) | 8 (12.3) | 5 (8.2) | 2.2 (2) | ns | - |
Alcoholism, N (%) | 6 (5.2) | 8 (12.3) | 7 (11.5) | 3.5 (2) | ns | - |
Family member jailed, N (%) | 5 (4.3) | 2 (3.1) | 1 (1.6) | 0.9 (2) | ns | - |
Uniparental family, N (%) | 8 (6.9) | 10 (15.4) | 6 (9.8) | 3.4 (2) | ns | - |
Parental psychiatric dis., N (%) | 7 (6) | 6 (9.2) | 14 (23) | 11.9 (2) | 0.003 * | PLG/SLG |
Overall % | B | df | Sig. | Exp (B) | 95% CI Per EXP (B) | ||
---|---|---|---|---|---|---|---|
Lower | Upper | ||||||
Groups (PLG) | −0.668 | 1 | ns | 0.513 | 0.109 | 2.415 | |
Groups (FLG) | 0.428 | 1 | ns | 1.534 | 0.321 | 7.332 | |
Age | 0.886 | 1 | <0.001 ** | 2.426 | 1.491 | 3.949 | |
Gender | −2.483 | 1 | 0.003 * | 0.083 | 0.016 | 0.428 | |
Indirect ACE: Witnessed violence | 1.743 | 1 | ns | 5.713 | 0.520 | 62.729 | |
Indirect ACE: Alcoholism | 1.315 | 1 | ns | 3.725 | 0.147 | 94.538 | |
Indirect ACE: Parental psychiatric disorder | 1.786 | 1 | 0.044 * | 5.965 | 1.050 | 33.883 | |
Indirect ACE: Uniparental family | −2.148 | 1 | ns | 0.117 | 0.008 | 1.761 | |
CBCL Internalizing problems | 0.197 | 1 | 0.005 * | 1.217 | 1.060 | 1.398 | |
Constant | −20.315 | 1 | <0.001 ** | 0.000 | 0.109 | 2.415 |
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Mucci, M.; Lenzi, F.; D'Acunto, G.M.; Gazzillo, M.; Accorinti, I.; Boldrini, S.; Distefano, G.; Falcone, F.; Fossati, B.; Giurdanella Annina, R.; et al. How COVID-19 Phases Have Impacted Psychiatric Risk: A Retrospective Study in an Emergency Care Unit for Adolescents. Children 2022, 9, 1921. https://doi.org/10.3390/children9121921
Mucci M, Lenzi F, D'Acunto GM, Gazzillo M, Accorinti I, Boldrini S, Distefano G, Falcone F, Fossati B, Giurdanella Annina R, et al. How COVID-19 Phases Have Impacted Psychiatric Risk: A Retrospective Study in an Emergency Care Unit for Adolescents. Children. 2022; 9(12):1921. https://doi.org/10.3390/children9121921
Chicago/Turabian StyleMucci, Maria, Francesca Lenzi, Giulia Maria D'Acunto, Marisa Gazzillo, Ilaria Accorinti, Silvia Boldrini, Giacomo Distefano, Francesca Falcone, Beatrice Fossati, Roberto Giurdanella Annina, and et al. 2022. "How COVID-19 Phases Have Impacted Psychiatric Risk: A Retrospective Study in an Emergency Care Unit for Adolescents" Children 9, no. 12: 1921. https://doi.org/10.3390/children9121921