Impact of the COVID-19 pandemic on mental healthcare consultations among children and adolescents in Norway: a nationwide registry study

This article has been Reviewed by the following groups

Read the full article See related articles

Abstract

The COVID-19 pandemic and its associated restrictions may have affected children and adolescent’s mental health adversely. We cast light on this question using primary and specialist consultations data for the entire population of children of age 6–19 years in Norway ( N  = 908 272). Our outcomes are the monthly likelihood of having a consultation or hospitalization related to mental health problems and common mental health diagnoses. We compared a pandemic (2019–2021) to a pre-pandemic (2017–2019) cohort using event study and difference-in-difference designs that separate the shock of the pandemic from linear period trends and seasonal variation. We found temporary reductions in all mental health consultations during lockdown in spring 2020. In fall 2020 and winter 2021, consultation volumes in primary care increased, stabilizing at a higher level in 2021. Consultations in specialist care increased from spring 2021. Our findings could suggest a worsening of mental health among adolescents.

Article activity feed

  1. SciScore for 10.1101/2021.10.07.21264549: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are strengths and limitations to our study. Unlike prior studies, that use self-report data, we likely capture clinically relevant symptoms and conditions causing distress in everyday life. Our inclusion of hospitalizations also means that we can examine changes among vulnerable children, which are likely not included in survey-based studies. However, relying on healthcare data also means that we only examine a small proportion of children with mental disorders. To the extent that one is interested in underlying mental health, it is a limitation with our study that our results can also be influenced by other changes affecting health service use, as discussed above. Future studies should examine underlying prevalence trends and using direct mental health measures in an equally robust design would be particularly valuable. As for the validity of diagnoses in primary care, a previous study compared interview-based diagnoses for depression and anxiety with diagnoses taken from KUHR and NPR and found that registry-based diagnoses have moderate sensitivity and excellent specificity, with very few false positives (35). While we are not able to rule out that physician evaluations may have changed during the pandemic, we consider it unlikely that the increase is caused by sudden changes in diagnostic practice. Finally, our results are found in a context with relatively low COVID-19 mortality rates and less social restrictions than other European countries such as England and Ger...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.