Study: New psychiatric diagnoses among Finnish children, adolescents increased by nearly 20% after first pandemic phase

by University of Turku

Observed (solid line) and predicted (dashed line) monthly diagnoses by specialist services and psychiatric diagnoses for the different diagnostic groups between March 2020 and September 2021. The light gray shaded areas represent the first phase months (March–May 2020). The scale of the y-axis differs for the panels to facilitate comparison between observed and predicted rates within diagnostic groups. Credit: PLOS Medicine (2023). DOI: 10.1371/journal.pmed.1004072

According to a new study conducted by the Research Center for Child Psychiatry of the University of Turku and the Finnish Institute for Health and Welfare, the amount of new psychiatric diagnoses by Finnish specialist services increased by nearly a fifth among children and adolescents in Finland after the first phase of the COVID-19 pandemic.

The diagnoses increased particularly among females, adolescents and those living in the Helsinki region, which had the highest COVID-19 rates and tightest restrictions when compared to the rest of the country. The largest increases by diagnostic groups were found for eating disorders, depression and anxiety.

The research article, "Comparison of new psychiatric diagnoses among Finnish children and adolescents before and during the COVID-19 pandemic: A nationwide register-based study," was published in a special issue on COVID-19 of PLOS Medicine.

The new study discovered a significant increase particularly in the psychiatric diagnoses among children and adolescents during the pandemic. The national register study focused on the use of specialist services among all Finnish residents aged 0–17 years from January 2017 to September 2021.

The researchers studied the diagnoses for psychiatric and neurodevelopmental disorders in specialist services according to sex, age and geographic area among others. The study compared the diagnoses received by children and adolescents to predictive models based on previous years. The number of diagnoses was 18.5% higher than predicted.

"Between June 2020 and September 2021, altogether 3,821 more patients were diagnosed than anticipated based on predictions. During this time, the number of psychiatric diagnoses increased particularly among young females and adolescents. The number of diagnoses among children did not increase significantly from the predictions," says Assistant Professor David Gyllenberg from the Research Center for Child Psychiatry of the University of Turku who led the study.

Gyllenberg and his research group discovered that psychiatric diagnoses had increased from the predictive models particularly in the areas with highest COVID-19 morbidity and tightest restrictions.

"The increase in the number of diagnoses was most evident in the Helsinki region and big cities. It is important that further studies determine the role of COVID-19 morbidity and restrictions in the increase in diagnoses," says Gyllenberg.

Eating disorders as well as depression and anxiety increased significantly

The research group also analyzed the prevalence of different diagnostic groups in the diagnoses by psychiatric specialist services. The study found the largest increase in diagnoses for eating disorders (33.4%), depression and anxiety (21%) and neurodevelopmental disorders.

"No significant difference was observed in psychotic and bipolar disorders. The number of behavioral and learning disorders also remained on the predicted level during the pandemic. In some diagnostic groups, the study even reported decreases when the data was compared with the predictions. For example, diagnoses related to self-harm and substance use disorders decreased," tells David Gyllenberg.

According to the researchers, the rapid increase in diagnoses after the first three months of the pandemic raises concern about gaps in services as well as accessibility in times of crisis.

"Possible explanations to the increase in diagnoses are changes in seeking help as well as delayed service access when most of society is shut down. The results of our study emphasize the importance of preparing for sudden changes in service use during times of crisis," says director of the Research Center for Child Psychiatry, Professor Andre Sourander.

More information: David Gyllenberg et al, Comparison of new psychiatric diagnoses among Finnish children and adolescents before and during the COVID-19 pandemic: A nationwide register-based study, PLOS Medicine (2023). DOI: 10.1371/journal.pmed.1004072

Journal information: PLoS Medicine 

Provided by University of Turku