Hospitalizations Associated With Mental Health Conditions Among Adolescents in the US and France During the COVID-19 Pandemic
Authors: Gutiérrez-Sacristán Alba , Serret-Larmande Arnaud , Hutch Meghan R. , Sáez Carlos , Aronow Bruce J. , Bhatnagar Surbhi , Bonzel Clara-Lea , Cai Tianxi , Devkota Batsal , Hanauer David A. , Loh Ne Hooi Will , Luo Yuan , Moal Bertrand , Ahooyi Taha Mohseni , Njoroge Wanjikũ F. M. , Omenn Gilbert S. , Sanchez-Pinto L. Nelson , South Andrew M. , Sperotto Francesca , Tan Amelia L. M. , Taylor Deanne M. , Verdy Guillaume , Visweswaran Shyam , Xia Zongqi , Zahner Janet , Avillach Paul , Bourgeois Florence T. ,   Consortium for Clinical Characterization of COVID-19 by EHR (4CE), Aaron James R , Agapito Giuseppe , Albayrak Adem , Albi Giuseppe , Alessiani Mario , Alloni Anna , Amendola Danilo F , Angoulvant François , Anthony Li L.L.J , Ashraf Fatima , Atz Andrew , Azevedo Paula S , Balshi James , Beaulieu-Jones Brett K , Bell Douglas S , Bellasi Antonio , Bellazzi Riccardo , Benoit Vincent , Beraghi Michele , Bernal-Sobrino José Luis , Bernaux Mélodie , Bey Romain , Blanco-Martínez Alvar , Boeker Martin , Booth John , Bosari Silvano , Bradford Robert L , Brat Gabriel A , Bréant Stéphane , Brown Nicholas W , Bruno Raffaele , Bryant William A , Bucalo Mauro , Bucholz Emily , Burgun Anita , Cannataro Mario , Carmona Aldo , Caucheteux Charlotte , Champ Julien , Chen Jin , Chen Krista Y , Chiovato Luca , Chiudinelli Lorenzo , Cho Kelly , Cimino James J , Colicchio Tiago K , Cormont Sylvie , Cossin Sébastien , Craig Jean B , Cruz-Bermúdez Juan Luis , Cruz-Rojo Jaime , Dagliati Arianna , Daniar Mohamad , Daniel Christel , Das Priyam , Dionne Audrey , Duan Rui , Dubiel Julien , DuVall Scott L , Esteve Loic , Estiri Hossein , Fan Shirley , Follett Robert W , Ganslandt Thomas , García-Barrio Noelia , Garmire Lana X , Gehlenborg Nils , Getzen Emily J , Geva Alon , González González Tomás , Gradinger Tobias , Gramfort Alexandre , Griffier Romain , Griffon Nicolas , Grisel Olivier , Guzzi Pietro H , Han Larry , Haverkamp Christian , Hazard Derek Y , He Bing , Henderson Darren W , Hilka Martin , Ho Yuk-Lam , Holmes John H , Hong Chuan , Huling Kenneth M , Issitt Richard W , Jannot Anne Sophie , Jouhet Vianney , Kavuluru Ramakanth , Keller Mark S , Kennedy Chris J , Kernan Kate F , Key Daniel A , Kirchoff Katie , Klann Jeffrey G , Kohane Isaac S , Krantz Ian D , Kraska Detlef , Krishnamurthy Ashok K , L'Yi Sehi , Le Trang T , Leblanc Judith , Lemaitre Guillaume , Lenert Leslie , Leprovost Damien , Liu Molei , Long Qi , Lozano-Zahonero Sara , Lynch Kristine E , Mahmood Sadiqa , Maidlow Sarah E , Makoudjou Adeline , Malovini Alberto , Mandl Kenneth D , Mao Chengsheng , Maram Anupama , Martel Patricia , Martins Marcelo R , Marwaha Jayson S , Masino Aaron J , Mazzitelli Maria , Mensch Arthur , Milano Marianna , Minicucci Marcos F , Moore Jason H , Moraleda Cinta , Morris Jeffrey S , Morris Michele , Moshal Karyn L , Mousavi Sajad , Mowery Danielle L , Murad Douglas A , Murphy Shawn N , Naughton Thomas P , Neto Carlos Tadeu B , Neuraz Antoine , Newburger Jane , Ngiam Kee Yuan , Norman James B , Obeid Jihad , Okoshi Marina P , Olson Karen L , Orlova Nina , Ostasiewski Brian D , Palmer Nathan P , Paris Nicolas , Patel Lav P , Pedrera-Jiménez Miguel , Pfaff Ashley C , Pfaff Emily R , Pillion Danielle , Pizzimenti Sara , Priya Tanu , Prokosch Hans U , Prudente Robson A , Prunotto Andrea , Quirós-González Víctor , Ramoni Rachel B , Raskin Maryna , Rieg Siegbert , Roig-Domínguez Gustavo , Rojo Pablo , Rubio-Mayo Paula , Sacchi Paolo , Salamanca Elisa , Samayamuthu Malarkodi Jebathilagam , Sandrin Arnaud , Santhanam Nandhini , Santos Janaina CC , Sanz Vidorreta Fernando J , Savino Maria , Schriver Emily R , Schubert Petra , Schuettler Juergen , Scudeller Luigia , Sebire Neil J , Serrano-Balazote Pablo , Serre Patricia , Shah Mohsin , Shakeri Hossein Abad Zahra , Silvio Domenick , Sliz Piotr , Son Jiyeon , Sonday Charles , Spiridou Anastasia , Strasser Zachary H , Tan Bryce WQ , Tan Byorn WL , Tanni Suzana E , Terriza-Torres Ana I , Tibollo Valentina , Tippmann Patric , Toh Emma MS , Torti Carlo , Trecarichi Enrico M , Vallejos Andrew K , Varoquaux Gael , Vella Margaret E , Vie Jill-Jênn , Vitacca Michele , Wagholikar Kavishwar B , Waitman Lemuel R , Wang Xuan , Wassermann Demian , Weber Griffin M , Wolkewitz Martin , Wong Scott , Xiong Xin , Ye Ye , Yehya Nadir , Yuan William , Zambelli Alberto , Zhang Harrison G , Zöller Daniela , Zuccaro Valentina , Zucco Chiara 
Published: December 2022

Importance

The COVID-19 pandemic has been associated with an increase in mental health diagnoses among adolescents, though the extent of the increase, particularly for severe cases requiring hospitalization, has not been well characterized. Large-scale federated informatics approaches provide the ability to efficiently and securely query health care data sets to assess and monitor hospitalization patterns for mental health conditions among adolescents.

Objective

To estimate changes in the proportion of hospitalizations associated with mental health conditions among adolescents following onset of the COVID-19 pandemic.

Design, Setting, and Participants

This retrospective, multisite cohort study of adolescents 11 to 17 years of age who were hospitalized with at least 1 mental health condition diagnosis between February 1, 2019, and April 30, 2021, used patient-level data from electronic health records of 8 children’s hospitals in the US and France.

Main Outcomes and Measures

Change in the monthly proportion of mental health condition–associated hospitalizations between the prepandemic (February 1, 2019, to March 31, 2020) and pandemic (April 1, 2020, to April 30, 2021) periods using interrupted time series analysis.

Results

There were 9696 adolescents hospitalized with a mental health condition during the prepandemic period (5966 [61.5%] female) and 11 101 during the pandemic period (7603 [68.5%] female). The mean (SD) age in the prepandemic cohort was 14.6 (1.9) years and in the pandemic cohort, 14.7 (1.8) years. The most prevalent diagnoses during the pandemic were anxiety (6066 [57.4%]), depression (5065 [48.0%]), and suicidality or self-injury (4673 [44.2%]). There was an increase in the proportions of monthly hospitalizations during the pandemic for anxiety (0.55%; 95% CI, 0.26%-0.84%), depression (0.50%; 95% CI, 0.19%-0.79%), and suicidality or self-injury (0.38%; 95% CI, 0.08%-0.68%). There was an estimated 0.60% increase (95% CI, 0.31%-0.89%) overall in the monthly proportion of mental health–associated hospitalizations following onset of the pandemic compared with the prepandemic period.

Conclusions and Relevance

In this cohort study, onset of the COVID-19 pandemic was associated with increased hospitalizations with mental health diagnoses among adolescents. These findings support the need for greater resources within children’s hospitals to care for adolescents with mental health conditions during the pandemic and beyond.