COVID-19 and Youth Psychopathological Distress in Umbria, Central Italy: A 2-Year Observational Study in a Real-World Setting

Overview

Journal Front Psychiatry

Specialty Psychiatry

Date 2022 Jun 6

PMID 35664479

Authors

Giulia Menculini

Giorgio Pomili

Francesca Brufani

Agnese Minuti

Niccolo Mancini

Martina DAngelo

Sonia Biscontini

Enrico Mancini

Andrea Savini

Laura Orsolini

Umberto Volpe

Alfonso Tortorella

Luca Steardo Jr

Affiliations

Soon will be listed here.

Abstract

Introduction: Adolescents and young adults represent a vulnerable population in the context of the Coronavirus disease 2019 (COVID-19) pandemic. The present retrospective study aims to investigate the pandemic's psychological impact on adolescents and young adults by analyzing data from an outpatient mental health service dedicated to youths in Umbria, central Italy.

Materials And Methods: The clinical charts of subjects aged 14-24 who first accessed the service in the timeframe between March 1st, 2019, and February 28th, 2021, were reviewed. Subjects were divided into two subgroups according to the period of time when they accessed the service (pre-COVID-19 vs. during- COVID-19 outbreak). Bivariate analyses were performed using the Chi-square test and the Welch's -test. A secondary analysis was performed considering only subjects suffering from psychiatric disorders. Furthermore, data concerning individuals who were already followed by the service before the pandemic were analyzed by the McNemar's test and the -paired test to assess changes in treatment features.

Results: The number of new accesses during the pandemic period remained stable. After the emergency onset, youths accessing the service showed a higher prevalence of anxiety disorders ( = 0.022). During the COVID-19 period, services were more frequently delivered by using a digital mental health approach ( = 0.001). Psychopharmacological treatment was more frequently prescribed among subjects that were referred to the service after the pandemic onset ( = 0.033). As for substance use, a highly significant reduction in opioid use was observed ( = 0.003). Family therapy was delivered less frequently in the during-COVID-19 subgroup, especially in the subpopulation of subjects suffering from psychiatric disorders ( = 0.013). When considering subjects referred to the service in the pre-COVID-19 period, the number of interventions provided to this population increased after the pandemic outbreak ( = 0.038).

Conclusion: In the context of the COVID-19-related public health crisis, youths represent an at-risk population for which pathways to care should be reinforced, and targeted interventions, including psychosocial treatments, should be implemented.

References

Nearchou F, Flinn C, Niland R, Subramaniam S, Hennessy E . Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review. Int J Environ Res Public Health. 2020; 17(22). PMC: 7698263. DOI: 10.3390/ijerph17228479. View

Mohler-Kuo M, Dzemaili S, Foster S, Werlen L, Walitza S . Stress and Mental Health among Children/Adolescents, Their Parents, and Young Adults during the First COVID-19 Lockdown in Switzerland. Int J Environ Res Public Health. 2021; 18(9). PMC: 8124779. DOI: 10.3390/ijerph18094668. View

McGorry P, Hartmann J, Spooner R, Nelson B . Beyond the "at risk mental state" concept: transitioning to transdiagnostic psychiatry. World Psychiatry. 2018; 17(2):133-142. PMC: 5980504. DOI: 10.1002/wps.20514. View

Brothwood P, Baudinet J, Stewart C, Simic M . Moving online: young people and parents' experiences of adolescent eating disorder day programme treatment during the COVID-19 pandemic. J Eat Disord. 2021; 9(1):62. PMC: 8142071. DOI: 10.1186/s40337-021-00418-4. View

Orsolini L, Pompili S, Salvi V, Volpe U . A Systematic Review on TeleMental Health in Youth Mental Health: Focus on Anxiety, Depression and Obsessive-Compulsive Disorder. Medicina (Kaunas). 2021; 57(8). PMC: 8398756. DOI: 10.3390/medicina57080793. View

Fegert J, Vitiello B, Plener P, Clemens V . Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health. 2020; 14:20. PMC: 7216870. DOI: 10.1186/s13034-020-00329-3. View

Menculini G, Steardo Jr L, Verdolini N, Cirimbilli F, Moretti P, Tortorella A . Substance use disorders in bipolar disorders: Clinical correlates and treatment response to mood stabilizers. J Affect Disord. 2022; 300:326-333. DOI: 10.1016/j.jad.2022.01.001. View

Ghasemi A, Zahediasl S . Normality tests for statistical analysis: a guide for non-statisticians. Int J Endocrinol Metab. 2013; 10(2):486-9. PMC: 3693611. DOI: 10.5812/ijem.3505. View

Penner F, Rajesh A, Kinney K, Mabus K, Barajas K, McKenna K . Racial and demographic disparities in emergency department utilization for mental health concerns before and during the COVID-19 pandemic. Psychiatry Res. 2022; 310:114442. PMC: 8840823. DOI: 10.1016/j.psychres.2022.114442. View

10.

Carvalho H, Mota C, Santos B, Costa M, Matos P . From Chaos to Normalization and Deconfinement: What did the Pandemic Unveil in Youth Residential Care. Child Adolesc Social Work J. 2022; :1-13. PMC: 8782691. DOI: 10.1007/s10560-021-00808-2. View

11.

Torous J, Choudhury T, Barnett I, Keshavan M, Kane J . Smartphone relapse prediction in serious mental illness: a pathway towards personalized preventive care. World Psychiatry. 2020; 19(3):308-309. PMC: 7491614. DOI: 10.1002/wps.20805. View

12.

Lambert M, Schottle D, Ruppelt F, Rohenkohl A, Sengutta M, Luedecke D . Early detection and integrated care for adolescents and young adults with psychotic disorders: the ACCESS III study. Acta Psychiatr Scand. 2017; 136(2):188-200. DOI: 10.1111/acps.12762. View

13.

Firth J, Torous J, Nicholas J, Carney R, Pratap A, Rosenbaum S . The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials. World Psychiatry. 2017; 16(3):287-298. PMC: 5608852. DOI: 10.1002/wps.20472. View

14.

Pringsheim T, Hirsch L, Gardner D, Gorman D . The pharmacological management of oppositional behaviour, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: a systematic review and.... Can J Psychiatry. 2015; 60(2):52-61. PMC: 4344947. DOI: 10.1177/070674371506000203. View

15.

Greenland S, Senn S, Rothman K, Carlin J, Poole C, Goodman S . Statistical tests, P values, confidence intervals, and power: a guide to misinterpretations. Eur J Epidemiol. 2016; 31(4):337-50. PMC: 4877414. DOI: 10.1007/s10654-016-0149-3. View

16.

Slavova S, Rock P, Bush H, Quesinberry D, Walsh S . Signal of increased opioid overdose during COVID-19 from emergency medical services data. Drug Alcohol Depend. 2020; 214:108176. PMC: 7351024. DOI: 10.1016/j.drugalcdep.2020.108176. View

17.

Andrews G, Basu A, Cuijpers P, Craske M, McEvoy P, English C . Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. J Anxiety Disord. 2018; 55:70-78. DOI: 10.1016/j.janxdis.2018.01.001. View

18.

Fasshauer J, Bollmann A, Hohenstein S, Mouratis K, Hindricks G, Meier-Hellmann A . Impact of COVID-19 pandemic on involuntary and urgent inpatient admissions for psychiatric disorders in a German-wide hospital network. J Psychiatr Res. 2021; 142:140-143. PMC: 8417753. DOI: 10.1016/j.jpsychires.2021.07.052. View

19.

Altman D, Bland J . Statistics notes: the normal distribution. BMJ. 1995; 310(6975):298. PMC: 2548695. DOI: 10.1136/bmj.310.6975.298. View

20.

Secer I, Ulas S . An Investigation of the Effect of COVID-19 on OCD in Youth in the Context of Emotional Reactivity, Experiential Avoidance, Depression and Anxiety. Int J Ment Health Addict. 2020; 19(6):2306-2319. PMC: 7293436. DOI: 10.1007/s11469-020-00322-z. View