COVID-19 pandemic may affect children's mental health. Children <18 years in-patiently admitted for mental health emergencies between March 2020 and June 2021 were compared to those admitted in the same period of 2018–2019 in terms of sociodemographic and clinical characteristics. There were 49 admissions in the pre-pandemic period and 60 in the pandemic period (IRR: 1.22; 95% CI: 0.84–1.79), with the latter more likely to have a family history of psychiatric disorders, a personal history of physical disturbances, present with suicidal risk, and being diagnosed with an externalizing disorder. This study underscores the increased need for pediatric mental health services.

Mosaic trisomy 20 is a genetic condition in which three chromosomes 20 are found in some cells. Its clinical phenotype seems to be highly variable, with most features not reported across all individuals and not considered pathognomonic of the condition. Limited and recent evidence indicates that neuropsychiatric manifestations may be more present in the context of trisomy 20 than was once thought. Here, we present a case of a 14-year-old female adolescent of White/Caucasian ethnicity with mosaic trisomy 20, who was admitted twice to an inpatient Child and Adolescent Neuropsychiatry Unit for persisting self-injury and suicidal ideation. A severe and complex neuropsychiatric presentation emerged at the cognitive, emotional, and behavioral levels, including mild neurodevelopmental issues, isolation, socio-relational difficulties, depressed mood, temper outbursts, irritability, low self-esteem, lack of interest, social anxiety, panic attacks, self-cutting, and low-average-range and heterogeneous intelligence quotient profile. Particularly, the patient was considered at high risk of causing harm, mainly to self, and appeared to be only partially responsive to medication, even when polypharmacy was attempted to improve clinical response. Except for school bullying, no other severe environmental risk factors were present in the patient’s history. The patient received a diagnosis of disruptive mood dysregulation disorder.

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