OBJECTIVES To describe the proportion of pediatric mental health emergency department (MH-ED) visits across 5 COVID-19 waves in New York City (NYC) and to examine the relationship between MH-ED visits, COVID-19 prevalence, and societal restrictions. METHODS We conducted a time-series analysis of MH-ED visits among patients ages 5 to 17 years using the INSIGHT Clinical Research Network, a database from 5 medical centers in NYC from January 1, 2016, to June 12, 2022. We estimated seasonally adjusted changes in MH-ED visit rates during the COVID-19 pandemic, compared with predicted prepandemic levels, specific to each COVID-19 wave and stratified by mental health diagnoses and sociodemographic characteristics. We estimated associations between MH-ED visit rates, COVID-19 prevalence, and societal restrictions measured by the Stringency Index. RESULTS Of 686 500 ED visits in the cohort, 27 168 (4.0%) were MH-ED visits. The proportion of MH-ED visits was higher during each COVID-19 wave compared with predicted prepandemic trends. Increased MH-ED visits were seen for eating disorders across all waves; anxiety disorders in all except wave 3; depressive disorders and suicidality/self-harm in wave 2; and substance use disorders in waves 2, 4, and 5. MH-ED visits were increased from expected among female, adolescent, Asian race, high Child Opportunity Index patients. There was no association between MH-ED visits and NYC COVID-19 prevalence or NY State Stringency Index. CONCLUSIONS The proportion of pediatric MH-ED visits during the COVID-19 pandemic was higher during each wave compared with the predicted prepandemic period, with varied increases among diagnostic and sociodemographic subgroups. Enhanced pediatric mental health resources are essential to address these findings.

中文翻译：

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纽约市 5 波 COVID-19 期间的儿科心理健康紧急情况。

目的 描述纽约市 (NYC) 在 5 波 COVID-19 浪潮中儿科精神健康急诊科 (MH-ED) 就诊的比例，并检查 MH-ED 就诊、COVID-19 患病率和社会限制之间的关系。方法 我们使用 INSIGHT 临床研究网络（2016 年 1 月 1 日至 2022 年 6 月 12 日期间来自纽约市 5 个医疗中心的数据库）对 5 至 17 岁患者的 MH-ED 就诊进行了时间序列分析。我们按季节进行估计与预测的大流行前水平相比，调整了 COVID-19 大流行期间 MH-ED 就诊率的变化，具体针对每次 COVID-19 浪潮，并根据心理健康诊断和社会人口学特征进行分层。我们估计了 MH-ED 就诊率、COVID-19 患病率和通过严格指数衡量的社会限制之间的关联。结果 在该队列的 686 500 次急诊就诊中，27 168 次 (4.0%) 是 MH-ED 就诊。与预测的大流行前趋势相比，每次 COVID-19 浪潮期间 MH-ED 就诊的比例较高。在所有浪潮中，因饮食失调而就诊的 MH-ED 均有所增加；除第 3 波之外的所有焦虑症；第 2 波中的抑郁症和自杀/自残；第 2、4 和 5 波中的物质使用障碍。女性、青少年、亚洲人种、高儿童机会指数患者的 MH-ED 就诊次数比预期有所增加。MH-ED 就诊与纽约市 COVID-19 患病率或纽约州严格指数之间没有关联。结论 与预测的大流行前时期相比，COVID-19 大流行期间每一波儿童 MH-ED 就诊的比例均较高，诊断亚组和社会人口学亚组之间的增幅各不相同。加强儿科心理健康资源对于解决这些问题至关重要。