Background: Limited early results indicate that the COVID-19 outbreak has had a significant impact on the mental health of children and adolescents. Pediatric emergency departments (PED) play a pivotal role in the identification, treatment, and coordination of care for children with mental health disorders, however, there is a dearth of literature evaluating the effects of the COVID-19 pandemic on mental health care provision in the PED. Objectives: We sought to evaluate whether changes in frequency or patient demographics among children and adolescents presenting to the PED has occurred. Methods: This is a cross-sectional study conducted at the Yale New Haven Children’s Hospital (YNHCH) PED. Data representing the early COVID-19 pandemic period was abstracted from the electronic medical record and compared using descriptive statistics to the same time period the year prior. Patient demographics including patient gender, ED disposition, mode of arrival, race-ethnicity, and insurance status were assessed. Results: During the pandemic period, 148 patients presented to the YNHCH PED with mental health-related diagnoses, compared to 378 in the pre-pandemic period, a reduction of 60.84%. Compared to white children, black children were 0.55 less likely to present with a mental health condition as compared to the pre-pandemic study period (p = 0.002; 95% CI 0.36–0.85). Conclusions: Children with mental and behavioral health disorders who seek care in PEDs may be at risk for delayed presentations of mental health disorders. African American children may be a particularly vulnerable population to screen for mental health disorders as reopening procedures are initiated and warrants further study.

中文翻译：

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COVID-19 大流行期间儿科急诊就诊的心理健康变化：一项横断面研究

背景：有限的早期结果表明，COVID-19 疫情对儿童和青少年的心理健康产生了重大影响。儿科急诊科 (PED) 在精神健康障碍儿童的识别、治疗和护理协调方面发挥着关键作用，然而，缺乏评估 COVID-19 大流行对精神卫生保健提供的影响的文献PED。目的：我们试图评估儿童和青少年就诊于 PED 的频率或患者人口统计数据是否发生了变化。方法：这是一项在耶鲁纽黑文儿童医院 (YNHCH) PED 进行的横断面研究。代表早期 COVID-19 大流行期间的数据是从电子病历中提取的，并使用描述性统计数据与前一年的同一时间段进行比较。评估了患者的人口统计数据，包括患者性别、ED 处置、到达方式、种族和保险状况。结果：在大流行期间，有 148 名患者因精神健康相关诊断而就诊于 YNHCH PED，与大流行前时期的 378 人相比，减少了 60.84%。与大流行前研究期相比，黑人儿童出现心理健康状况的可能性降低了 0.55（p = 0.002；95% CI 0.36-0.85）。结论：在 PED 中寻求治疗的精神和行为健康障碍儿童可能存在延迟出现精神健康障碍的风险。