RESIDENT: Examining the Impact of COVID-19 on Pediatric Psychiatric Presentations: A Retrospective Population- Based Cohort Study in Alberta (2017-2022)
Presenting Author(s): Dr. Jacquelyn Paquet, MD, PhD (c), FRCPC
Co-Author(s): Katharine Hibbard, MD, MSc, FRCPC, Pamela Brett-MacLean PhD
Date and time: 20 Mar 2026 from 14:40 to 14:55
Location: Saddleback & Glacier
Learning Objectives
1. Describe trends in psychiatric presentations among children and adolescents in Alberta from 2017 to 2022, with attention to diagnostic groups, healthcare settings, and pandemic phases;
2. Identify demographic and contextual factors-such as age, sex, and geographic location-that influenced mental health service utilization during the pre-pandemic, pandemic, and post-pandemic periods; and
3. Interpret how specific subgroups (e.g., adolescent females, adolescent males) experienced differential changes in anxiety, mood, eating, neurodevelopmental, substance use disorders, and self-harm presentations across pandemic phases.
Abstract
Background: The COVID-19 pandemic affected mental health service use globally, with children and youth showing unique vulnerabilities. This study examined psychiatric presentations among children and adolescents in Alberta from 2017 to 2022, focusing on internalizing and externalizing disorders, self-harm, and demographic factors across pandemic phases.
Methods: We conducted a retrospective cohort study using physician billing data, categorizing cases by age, sex, geographic location (rural, urban), healthcare setting, diagnostic groupings (anxiety, mood, eating, neurodevelopmental, substance use disorders, non-suicidal self-injury), and pandemic phase (pre-pandemic, pandemic, post-pandemic). Descriptive statistics, ANOVAs, and general linear models were used to examine trends over time.
Results: There were 1,244,686 psychiatric presentations between 2017 and 2022, with 81.3% occurring in outpatient settings. Rather than large overall shifts, specific disorders and populations showed relative increases across pandemic phases. Age was the strongest factor: adolescents had higher presentation rates across diagnoses. Females and urban cohorts showed higher presentation rates, and outpatient presentations increased during and after the pandemic. Key interactions included adolescent females exhibiting higher rates of anxiety, mood disorders, and non-suicidal self-injury, along with post-pandemic increases in eating disorders among females. Neurodevelopmental and substance use disorders were more prevalent among adolescent males across all phases.
Conclusion: Age, sex, healthcare setting, and geographic location were significant factors influencing pediatric psychiatric presentations, highlighting the nuanced impact of the COVID-19 pandemic on child and youth mental health service use.
Literature References
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- Brausch AM, Whitfield M, Clapham RB. Comparisons of mental health symptoms, treatment access, and self-harm behaviors in rural adolescents before and during the COVID-19 pandemic. Eur Child Adolesc Psychiatry. 2023;32:1051–60. doi:10.1007/s00787-022-02039-x.
- Cost KT, Crosbie J, Anagnostou E, Birken CS, Charach A, Monga S, et al. Mostly worse, occasionally better: impact of COVID-19 pandemic on the mental health of Canadian children and adolescents. Eur Child Adolesc Psychiatry. 2022;31:671-84. doi:10.1007/s00787-021-01744-3.