Self-harm among youth during the first 28 months of the COVID-19 pandemic in Ontario, Canada: a population-based study

Mitchell, Rachel H.B.; Toulany, Alene; Chung, Hannah; Cohen, Eyal; Fu, Longdi; Strauss, Rachel; Vigod, Simone N.; Stukel, Therese A.; Moran, Kimberly; Guttmann, Astrid; Kurdyak, Paul; Artani, Azmina; Kopec, Monica; Saunders, Natasha R.

doi:10.1503/cmaj.230127

Cited by 8 publications

(4 citation statements)

References 73 publications

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“…However, most of them mention the occurrence of suicidal thoughts themselves and not the frequency of suicidal behavior [18]. By contrast, the increase in the occurrence of self-harm behavior intensity has been noted in most studies [19]. All reports emphasize preventive actions related to life-protective factors [20].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of COVID-19 Effect on Mental Health, Self-Harm, and Suicidal Behaviors in Children and Adolescents Population

Grzejszczak,

Strzelecki,

Gabryelska

et al. 2024

JCM

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Objectives: The impact of the COVID-19 pandemic on the psychological state of the under-18 population includes an increased risk of psychopathological symptoms development and exacerbation of already present psychiatric disorders. This study aimed to assess the prevalence of mental health problems in Polish children and adolescents with a focus on suicidal and self-harm behavior with the impact of the pandemic. Methods: The questionnaire collected demographic data, information regarding mental states and psychopathological symptoms, history of self-harm and suicidal behaviors, as well as the experience of psychological, and physical violence, and suicidal self-harm behaviors before and during the COVID-19 pandemic. Results: In the final analysis, 782 responses were included. Self-evaluation of general and mental health scores was significantly lower during the pandemic among children (both p < 0.001) and adolescents (both p < 0.001). Moreover, general and mental health scores were lower among adolescents compared to children before (both p < 0.001) and during (both p < 0.001) the pandemic. The frequency of seeking help because of mental health problems increased during the pandemic among children and adolescents, while no changes were observed in the prevalence of psychiatric hospitalizations in either of the populations (p = 0.317 and p = 1.00, respectively). Out of autoregressive behaviors among children during the pandemic period, only the frequency of thinking about death increased (p = 0.038). No suicidal attempts were undertaken by children in either of the evaluated time periods. The presence of all autoaggressive behaviors was greater among adolescents compared to children both before and during the COVID-19 pandemic (all p<0.05). Conclusions: A subjective decrease in psychophysical well-being, an increase in the frequency of seeking mental health help during the pandemic, as well as an increased prevalence of depressive and anxiety symptoms were observed in the under-18 population as a potential consequence of the COVID-19 pandemic and related socioeconomic changes. The marked increase in self-harm behavior in the adolescent population (age > 12) and the marked increase in the frequency of death thinking in children (age ≤ 12) suggests the need for greater awareness and easier access to professional help from mental health specialists, particularly in a time of unprecedented stress and social isolation.

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Section: Introductionmentioning

confidence: 99%

Evaluation of COVID-19 Effect on Mental Health, Self-Harm, and Suicidal Behaviors in Children and Adolescents Population

Grzejszczak,

Strzelecki,

Gabryelska

et al. 2024

JCM

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“…The adolescent population has greater vulnerability, especially those who already had mental disorders prior to the COVID-19 crisis [ 17 , 18 ]. There has been a worsening of serious mental disorders in this population and an increase in the demand for care in emergency services after the first two and a half year of the pandemic, specifically due to symptoms of anxiety, depression and eating behavior [ 19 , 20 ]. There is also evidence of an increase in suicide attempts treated in emergency departments [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Posttraumatic Stress Disorder and Mental Health among Spanish Adolescents: SESSAMO Project

Yárnoz-Goñi,

Goñi-Sarriés,

Díez-Suárez

et al. 2024

JCM

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Background: Child and adolescent mental health problems have increased after the COVID-19 pandemic. The objective of this study was to establish the association of the presence and intensity of posttraumatic stress due to COVID-19 with the presence of (1) self-harm and suicide risk, (2) depressive and anxious symptoms, (3) eating disorders and (4) problematic Internet and video game use. Methods: A cross-sectional analysis was performed on a sample of second–fourth grade secondary school students (14 to 16 years old) from Navarra and the Canary Islands recruited at the SESSAMO project. Validated questionnaires were used to assess the intensity of posttraumatic stress due to COVID-19, risk of suicide and presence of self-harm, symptoms of mental disorder and problematic use of the Internet and video games. Results: Out of 1423 participants analyzed, those with the highest level of posttraumatic stress showed a significant increase in the risk of suicide (OR = 5.18; 95% CI = 2.96–9.05) and in the presence of eating disorder symptoms (OR = 3.93; 95% CI = 2.21–7.00), and higher anxiety and depression scores (b coefficient for anxiety = 11.1; CI = 9.7–12.5; for depression = 13.0; CI = 11.5–14.5) as compared to those with the lowest level. Participants with a high level of posttraumatic stress were almost 10 times more likely to present problematic video game use (OR = 9.49; 95% CI = 3.13–28.82). Conclusions: Years after the pandemic, posttraumatic stress derived from it continues to impact the mental health of adolescents. Further long-term research is needed, as well as close follow-up and intervention in this population.

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“…Public health measures deployed to minimize hospitalizations and death from COVID-19 impacted multiple domains of child and youth well-being indirectly . In particular, an association between the pandemic period and an increase in mental health conditions, including eating disorder presentations, has been described …”

Section: Introductionmentioning

confidence: 99%

“…P ublic health measures deployed to minimize hospitalizations and death from COVID-19 impacted multiple domains of child and youth well-being indirectly. [1][2][3] In particular, an association between the pandemic period and an increase in mental health conditions, including eating disorder presentations, has been described. 4,5 Eating disorders are a group of heterogeneous illnesses that significantly impact the psychosocial and medical health of children and adolescents.…”

mentioning

confidence: 99%

Pandemic Stringency Measures and Hospital Admissions for Eating Disorders

Roumeliotis,

Carwana,

Charland

et al. 2024

JAMA Pediatr

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ImportanceHospitalizations for eating disorders rose dramatically during the COVID-19 pandemic. Public health restrictions, or stringency, are believed to have played a role in exacerbating eating disorders. Few studies of eating disorders during the pandemic have extended to the period when public health stringency restrictions were lifted.ObjectiveTo assess the association between hospitalization rates for eating disorders and public health stringency during the COVID-19 pandemic and after the easing of public health restrictions.Design, Setting, and ParticipantsThis Canadian population-based cross-sectional study was performed from April 1, 2016, to March 31, 2023, and was divided into pre–COVID-19 and COVID-19–prevalent periods. Data were provided by the Canadian Institute for Health Information and the Institut National d’Excellence en Santé et Services Sociaux for all Canadian provinces and territories. Participants included all children and adolescents aged 6 to 20 years.ExposureThe exposure was public health stringency, as measured by the Bank of Canada stringency index.Main Outcomes and MeasuresThe primary outcome was hospitalizations for a primary diagnosis of eating disorders (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code F50), stratified by region, age group, and sex. Interrupted time series analyses based on Poisson regression were used to estimate the association between the stringency index and the rate of hospitalizations for eating disorders.ResultsDuring the study period, there were 11 289 hospitalizations for eating disorders across Canada, of which 8726 hospitalizations (77%) were for females aged 12 to 17 years. Due to low case counts in other age-sex strata, the time series analysis was limited to females within the 12- to 17-year age range. Among females aged 12 to 17 years, a 10% increase in stringency was associated with a significant increase in hospitalization rates in Quebec (adjusted rate ratio [ARR], 1.05; 95% CI, 1.01-1.07), Ontario (ARR, 1.05; 95% CI, 1.03-1.07), the Prairies (ARR, 1.08; 95% CI, 1.03-1.13), and British Columbia (ARR, 1.11; 95% CI, 1.05-1.16). The excess COVID-19–prevalent period hospitalizations were highest at the 1-year mark, with increases in all regions: Quebec (RR, 2.17), Ontario (RR, 2.44), the Prairies (RR, 2.39), and British Columbia (RR, 2.02).Conclusion and RelevanceIn this cross-sectional study of hospitalizations for eating disorders across Canada, hospitalization rates for eating disorders in females aged 12 to 17 years were associated with public health measure stringency. The findings suggest that future pandemic preparedness should consider implications for youths at risk for eating disorders and their resource and support needs.

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Self-harm among youth during the first 28 months of the COVID-19 pandemic in Ontario, Canada: a population-based study

Cited by 8 publications

References 73 publications

Evaluation of COVID-19 Effect on Mental Health, Self-Harm, and Suicidal Behaviors in Children and Adolescents Population

Evaluation of COVID-19 Effect on Mental Health, Self-Harm, and Suicidal Behaviors in Children and Adolescents Population

COVID-19 Posttraumatic Stress Disorder and Mental Health among Spanish Adolescents: SESSAMO Project

Pandemic Stringency Measures and Hospital Admissions for Eating Disorders

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