Pediatric ICU Admissions After Adolescent Suicide Attempts During the Pandemic

Author:

Bruns Nora1,Willemsen Lea1,Stang Andreas2,Kowall Bernd2,Holtkamp Katharina1,Kamp Oliver3,Dudda Marcel3,Hey Florian4,Hoffmann Florian4,Blankenburg Judith5,Eifinger Frank6,Fuchs Hans7,Haase Roland8,Baier Jan8,Andrée Clemens9,Heldmann Michael10,Maldera Vanessa10,Potratz Jenny11,Kurz Daniel12,Mand Nadine13,Doerfel Claus14,Rothoeft Tobias15,Schultz Michel15,Ohlert Manuel16,Silkenbäumer Katrin17,Boesing Thomas17,Indraswari Fithri18,Niemann Frank19,Jahn Peter20,Merker Michael21,Braun Nicole22,Nunez Francisco Brevis23,Engler Matthias24,Heimann Konrad25,Brasche Milian25,Wolf Gerhard26,Freymann Holger27,Dercks Martin28,Hoppenz Marc29,Felderhoff-Müser Ursula1,Dohna-Schwake Christian1

Affiliation:

1. aDepartment of Pediatrics I, Pediatric Intensive Care Medicine

2. bInstitute of Medical Informatics, Biometry and Epidemiology

3. cDepartment of Trauma, Hand and Reconstructive Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany

4. dPediatric Clinic and Pediatric Polyclinic at the Dr. von Haunerschen Children's Hospital, Interdisciplinary pediatric ICU - Pediatric Emergency Medicine, LMU Munich, Munich, Germany

5. eDepartment of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Dresden, University of Technology Dresden, Dresden, Germany

6. fDepartment of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany

7. gDepartment of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Freiburg, University of Freiburg, Freiburg, Germany

8. hDepartment of Pediatrics, Neonatology and Pediatric Intensive Care Medicine, University Hospital Halle, University of Halle, Halle, Germany

9. iDepartment of Pediatrics, Pediatric Intensive Care Medicine, Helios Hospital Krefeld, Krefeld, Germany

10. jDepartment of Pediatrics, Pediatric Intensive Care Medicine, Helios University Hospital Wuppertal, Wuppertal, Germany

11. kDepartment of Pediatrics, Pediatric Intensive Care Medicine, University Hospital, Münster, Münster, Germany

12. lDepartment of Pediatrics 3, Pediatric Cardiology, Pediatric Intensive Care Medicine, Olgahospital Stuttgart, Stuttgart, Germany

13. mDepartment of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Marburg, Philipps University of Marburg, Marburg, Germany

14. nDepartment of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Jena, University of Jena, Jena, Germany

15. oDepartment of Pediatrics, Pediatric Intensive Care Medicine, Catholic Hospital Bochum, Ruhr-University of Bochum, Bochum, Germany

16. pDepartment of Pediatrics, Pediatric Intensive Care Medicine, Community Hospital Koblenz, Koblenz, Germany

17. qDepartment of Pediatrics, Pediatric Intensive Care Medicine, Protestant Hospital Bethel, University of Bielefeld, Bielefeld, Germany

18. rDepartment of Pediatrics, Pediatric Intensive Care Medicine, Hospital Fulda, Fulda, Germany

19. sDepartment of Pediatrics, Pediatric Intensive Care Medicine, Bergmannsheil and Pediatric Hospital Buer, Gelsenkirchen, Germany

20. tDepartment of Pediatrics, Pediatric Intensive Care Medicine, Hospital Leverkusen gGmbH, Leverkusen, Germany

21. uDepartment for Children and Adolescents, Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany

22. vClinic of Pediatric Surgery, Klinikum Ernst von Bergmann, Potsdam, Germany

23. wDepartment of Pediatrics, Pediatric Intensive Care Medicine, Sana Hospitals Duisburg, Duisburg, Germany

24. xDepartment of Pediatrics, Pediatric Intensive Care Medicine, Sana Hospital Offenbach, Offenbach, Germany

25. yDepartment of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Aachen, RWTH Aachen University, Aachen, Germany

26. zDepartment of Pediatrics, Pediatric Intensive Care Medicine, Hospital of Traunstein, Southeast Bavaria Hospitals, Traunstein, Germany

27. aaDepartment of Pediatrics, Pediatric Intensive Care Medicine, Florence Nightingale Hospital, Düsseldorf, Germany

28. bbDepartment of Pediatrics, Pediatric Intensive Care Medicine, Clemenshospital Münster, Münster, Germany

29. ccDepartment of Pediatrics, Pediatric Intensive Care Medicine, Cologne Hospitals, Children’s Hospital Amsterdamer Str., Cologne, Germany

Abstract

BACKGROUND AND OBJECTIVES The worldwide severe acute respiratory syndrome coronavirus 2 pandemic challenges adolescents’ mental health. In this study, we aim to compare the number of pediatric ICU (PICU) admissions after suicide attempts during the first German lockdown and one year later during a second, prolonged lockdown with prepandemic years. METHODS A retrospective multicenter study was conducted among 27 German PICUs. Cases <18 years admitted to the PICU because of accidents or injuries between March 16 and May 31 of 2017 to 2021 were identified based on International Classification of Diseases, 10th Revision codes (German modification) and patient data entered into a database. This study is a subset analysis on suicide attempts in adolescents aged 12 to 17.9 years. The Federal Statistics Office was queried for data on fatal suicides, which were available only for 2020 in adolescents aged 10 to 17.9 years. RESULTS Total admissions and suicide attempts declined during the first lockdown in 2020 (standardized morbidity ratio 0.74 (95% confidence interval; 0.58–0.92) and 0.69 (0.43–1.04), respectively) and increased in 2021 (standardized morbidity ratio 2.14 [1.86–2.45] and 2.84 [2.29–3.49], respectively). Fatal suicide rates remained stable between 2017 to 2019 and 2020 (1.57 vs 1.48 per 100 000 adolescent years) with monthly numbers showing no clear trend during the course of 2020. CONCLUSIONS This study shows a strong increase in serious suicide attempts among adolescents during the course of the pandemic in Germany. More research is needed to understand the relation between pandemic prevention measures and suicidal ideation to help implement mental health support for adolescents.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference21 articles.

1. Psychiatric emergencies during the height of the COVID-19 pandemic in the suburban New York City area;Ferrando;J Psychiatr Res,2021

2. Debate: Emergency mental health presentations of young people during the COVID-19 lockdown;Ougrin;Child Adolesc Ment Health,2020

3. The impact of COVID-19 related lockdown measures on self-reported psychopathology and health-related quality of life in German adolescents;Koenig;Eur Child Adolesc Psychiatry,2021

4. Association between suicide behaviours in children and adolescents and the COVID-19 lockdown in Paris, France: a retrospective observational study;Mourouvaye;Arch Dis Child,2021

5. Depression in the pediatric otolaryngology clinic setting;MacDonald;Laryngoscope,2021

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