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Self-harm in children and adolescents who presented at emergency units during the COVID-19 pandemic: An international retrospective cohort study

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dc.contributor.author Wong, B.H.
dc.contributor.author Cross, S.
dc.contributor.author Zavaleta-Ramírez, P.
dc.contributor.author Bauda, I.
dc.contributor.author Hoffman, P.
dc.contributor.author Ibeziako, P.
dc.contributor.author Nussbaum, L.
dc.contributor.author Berger, G.E.
dc.contributor.author Hassanian-Moghaddam, H.
dc.contributor.author Kapornai, K.
dc.contributor.author Mehdi, T.
dc.contributor.author Tolmac, J.
dc.contributor.author Barrett, E.
dc.contributor.author Romaniuk, L.
dc.contributor.author Davico, C.
dc.contributor.author Moghraby, O.S.
dc.contributor.author Ostrauskaite, G.
dc.contributor.author Chakrabarti, S.
dc.contributor.author Carucci, S.
dc.contributor.author Sofi, G.
dc.contributor.author Hussain, H.
dc.contributor.author Lloyd, A.S.K.
dc.contributor.author McNicholas, F.
dc.contributor.author Meadowcroft, B.
dc.contributor.author Rao, M.
dc.contributor.author Csábi, G.
dc.contributor.author Gatica-Bahamonde, G.
dc.contributor.author Öğütlü, H.
dc.contributor.author Skouta, E.
dc.contributor.author Elvins, R.
dc.contributor.author Boege, I.
dc.contributor.author Dahanayake, D.M.A.
dc.contributor.author Anderluh, M.
dc.contributor.author Chandradasa, M.
dc.contributor.author Girela-Serrano, B.M.
dc.contributor.author Uccella, S.
dc.contributor.author Stevanovic, D.
dc.contributor.author Lamberti, M.
dc.contributor.author Piercey, A.
dc.contributor.author Nagy, P.
dc.contributor.author Mehta, V.S.
dc.contributor.author Rohanachandra, Y.
dc.contributor.author Li, J.
dc.contributor.author Tufan, A.E.
dc.contributor.author Mirza, H.
dc.contributor.author Rozali, F.
dc.contributor.author Baig, B.J.
dc.contributor.author Noor, I.M.
dc.contributor.author Fujita, S.
dc.contributor.author Gholami, N.
dc.contributor.author Hangül, Z.
dc.contributor.author Vasileva, A.
dc.contributor.author Salucci, K.
dc.contributor.author Bilaç, Ö.
dc.contributor.author Yektaş, Ç.
dc.contributor.author Cansız, M.A.
dc.contributor.author Aksu, G.G.
dc.contributor.author Babatunde, S.
dc.contributor.author Youssef, F.
dc.contributor.author Al-Huseini, S.
dc.contributor.author Kılıçaslan, F.
dc.contributor.author Kutuk, M.O.
dc.contributor.author Pilecka, I.
dc.contributor.author Bakolis, I.
dc.contributor.author Ougrin, D.
dc.date.accessioned 2023-05-15T08:57:53Z
dc.date.available 2023-05-15T08:57:53Z
dc.date.issued 2023
dc.identifier.citation Journal of the American Academy of Child and Adolescent Psychiatry.2023; 62(9): 998-1009 [Epub 2023 Feb 16] en_US
dc.identifier.issn 0890-8567
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/26297
dc.description Indexed in MEDLINE & Scopus en_US
dc.description.abstract OBJECTIVE: To compare psychiatric emergencies and self-harm at emergency departments (EDs) 1 year into the pandemic, to early pandemic and pre-pandemic, and to examine the changes in the characteristics of self-harm presentations. METHOD: This retrospective cohort study expanded on the Pandemic-Related Emergency Psychiatric Presentations (PREP-kids) study. Routine record data in March to 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. RESULTS: Altogether, 8,174 psychiatric presentations were recorded (63.5% female; mean [SD] age, 14.3 [2.6] years), 3,742 of which were self-harm presentations. Rate of psychiatric ED presentations in March to April 2021 was twice as high as in March to April 2020 (incidence rate ratio [IRR], 1.93; 95% CI, 1.60-2.33), and 50% higher than in March to April 2019 (IRR, 1.51; 95% CI, 1.25-1.81). Rate of self-harm presentations doubled between March to April 2020 and March to April 2021 (IRR, 1.98; 95% CI, 1.68-2.34), and was overall 1.7 times higher than in March to April 2019 (IRR, 1.70; 95% CI, 1.44-2.00). Comparing self-harm characteristics in March to April 2021 with March to April 2019, self-harm contributed to a higher proportion of all psychiatric presentations (odds ratio [OR], 1.30; 95% CI, 1.05-1.62), whereas female representation in self-harm presentations doubled (OR, 1.98; 95% CI, 1.45-2.72) and follow-up appointments were offered 4 times as often (OR, 4.46; 95% CI, 2.32-8.58). 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 using 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. en_US
dc.language.iso en en_US
dc.publisher Elsevier en_US
dc.subject COVID-19 pandemic en_US
dc.subject Emergency psychiatric services en_US
dc.subject Epidemiology en_US
dc.subject Self-injurious behavior en_US
dc.subject Youth mental health en_US
dc.title Self-harm in children and adolescents who presented at emergency units during the COVID-19 pandemic: An international retrospective cohort study en_US
dc.type Article en_US


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