2.26 Impact of the COVID-19 Pandemic on the Child and Adolescent Psychiatric Consultation-Liaison Service (CL) in a Large Urban Hospital

Objectives

The objective is to assess the impact of the pandemic on patients seen by the Psychiatry Consultation-Liaison (CL) service in a tertiary care hospital in Dallas, Texas. Our hypothesis was that an increased number of patients diagnosed with depression, anxiety, and suicidal ideation (SI) with and without attempts were seen during the pandemic.

Methods

The authors have completed a retrospective review of consults requested from January 2017 to December 2021. We analyzed the presence of SI, suicide attempts (SA), primary psychiatric diagnosis, demographics, and disposition of patients prior to and during the COVID-19 pandemic. The project was given an exemption from the UT Southwestern Human Research Protocol under 45 CFR 46.102. The 2334 patients in the study were divided into pre–COVID-19 (January 2017 to February 2020, n = 1497) and post–COVID-19 (March 2020 to December 2021, n = 837) groups. Patients were ages 2 to 18 years, 66% were female, and were of various race, ethnicities, and socioeconomic groups. Statistics were completed in SPSS (software version 28) using χ² analysis with post hoc test results including Bonferroni corrections.

Results

Results indicated a significant increase in the proportion of patients with a primary diagnosis of depression (Δ23.6% post; χ² [1] = 13.07; p < .001) and of bipolar disorder (Δ1.4% post, χ² [1] = 4.62; p < .04). The number of patients with a primary anxiety diagnosis decreased by 3% post–COVID-19 (χ² [1] = 4.87; p = .03). No other significant differences between diagnosis were observed. Patients who presented after SA were more likely to have been previously hospitalized. Additionally, an increase in post–COVID-19 SAs were seen in patients with a primary depression disorder (Δ11.2%; χ² [1] =11.29; p < .004) and patients with a primary anxiety disorder (Δ14.7%; χ² [1] = 8.61; p = .003).

Conclusions

There was an increase in consults for individuals with a depression or bipolar diagnosis post–COVID-19, whereas a decrease was seen in individuals with anxiety disorders. Despite an overall decrease in anxiety patients post–COVID-19, the individuals who did require a consult were more likely to have had an SA then their pre–COVID-19 counterparts, which may point to individuals with anxiety being more hesitant to present for evaluation during the pandemic unless they exhibited high safety or medical acuity.

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