Psychiatric crises among youth with a history of trauma during COVID-19: A retrospective study of psychiatrically hospitalized children and adolescents

Abstract

BackgroundYouth hospitalized in inpatient child psychiatry units have a high prevalence of trauma and this population may have been especially affected by the pandemic. ObjectiveThis study examined the clinical and sociodemographic characteristics of hospitalized youth with a history of trauma prior to, during, and after the pandemic. Additionally, youth who reported a trauma history were compared to those who denied having a trauma history. Participants and settingThis retrospective study utilized data gathered from (n = 1101) first admissions to a child and adolescent inpatient psychiatry unit of a New York City hospital during the pandemic. MethodsHospital admission records were reviewed for clinical and sociodemographic variables. Statistical analyses evaluated whether there were significant differences in these variables throughout the pandemic. ResultsThe clinical severity of inpatient youth with trauma increased during the quarantine period compared to pre-pandemic. The percentage of youth admitted for psychosis increased by 3 % (φc = 0.15, p = 0.03), suicide attempt by 14.8 % (φc = 0.15, p = 0.03), and suicidal ideation without suicide attempt decreased by 9.6 % (φc = 0.15, p = 0.03). Clinically, patients with a history of trauma were more likely to have greater comorbidity and clinical severity. Demographically, patients with a history of trauma were more likely to be female or transgender/non-binary (φc = 0.11, p < 0.01), Black or Latinx (φc = 0.14, p < 0.01), and on public insurance (φc = 0.11, p < 0.01). ConclusionsIn an urban area inpatient youth psychiatric unit, the clinical severity of inpatient youth with trauma increased during COVID-19 quarantines. The clinical severity of inpatient youth with trauma was greater than those without during and after COVID-19 and youth with certain minority and marginalized identities were particularly impacted.