The Pediatric Outcome ImProvement through COordination of Research Networks (POPCORN) — which involves BC Children’s Hospital Research Institute (BCCHR) — has published, in JAMA Network Open, their latest research findings on mental health hospitalizations of children and youth throughout the COVID-19 pandemic. These findings led the team to a second study where they evaluated the relationship between hospital admissions for eating disorders and public health restrictions, published in JAMA Pediatrics.
“This is the first study, to our knowledge, that has linked the hospitalization rate for a mental health disorder in youth not just to the general pandemic period, but specifically with public health measure stringency,” says Dr. Matthew Carwana, co-lead in the studies, investigator at BCCHR, and clinical assistant professor in the Department of Pediatrics at the University of British Columbia (UBC). Stringency was measured by collecting government policy and restrictions over time and across regions, following the methodology of the Oxford COVID-19 government response tracker. This includes indicators such as work, office, and school closures; public event cancellations; and restrictions on private gatherings and travel.
When comparing hospitalizations for mental health conditions before and during the pandemic, the researchers found a decrease in mood disorders, substance-related disorders, and other mental health disorders, as well as a decrease in the overall rate of mental health admissions. However, they did find an increase in admissions for anxiety disorders, personality disorders, and suicide attempts in females, and an increase in eating disorders in both sexes. Their research also showed that admissions for eating disorders more than doubled in most Canadian regions for female patients aged 12–17 years old in the first year of the pandemic.
Public health restrictions during the pandemic, such as lockdowns and school closures, varied from region to region. “Working in the emergency department, I saw that the public health measures resulted in reduced volume of visits overall, but the reduction in mental health-related visits, particularly for eating disorders, did not seem to decrease to the same extent. I thought we should look into this more dutifully and see if it is a signal that is observed across the country,” says Dr. Quynh Doan, senior executive director and associate dean, research at BCCHR and associate professor in the Department of Pediatrics at UBC, who also co-led the studies.
The researchers found that, among adolescent females, the largest cohort of participants, for every 10 per cent increase in the strictness of public health measures, there was an 11 per cent increase in hospital admissions for eating disorders in British Columbia. In Quebec and Ontario, there was a five per cent increase and, in the Prairies, an eight per cent increase.
Parents and youth with lived experiences of eating disorders were involved in the interpretation of the results throughout the studies. These studies highlight the importance of how necessary public health measures indirectly affected youth’s health and wellness. Future public health planning will need to consider implications for youth at risk for mental health conditions, and their resources and support needs. While researchers are still learning more about which public health measure is the most associated with the increases in mental health conditions and hospitalizations, social isolation and a lack of medical services severely affected those with — and at risk of — eating disorders. Moving forward, it’s vital to provide screening and monitoring for eating disorders, maintain clinical services, and ensure ongoing support for this vulnerable group.
Adapted from the Pediatric Outcome ImProvement through COordination of Research Networks’ news release.
Top photo by Priscilla Du Preez on Unsplash
