Mental health disparities were prevalent among racially and ethnically minoritized youth prior to the COVID-19 pandemic. As complete datasets from 2022 become available, we can estimate the extent to which the pandemic further magnified existing inequities. To quantify disparities in trajectories of depression, anxiety, and suicide risk-related diagnoses in youth before and after the start of the COVID-19 pandemic, using an intersectional lens of race, ethnicity and gender. Using Electronic Medical Record data from one mid-Atlantic health care system (2015-2022), we evaluated changes in annual rates of depression, anxiety and suicide risk-related diagnoses in 29,117 youths, aged 8-20 years, using graphical analysis, comparison of adjusted mean differences (AMD) and adjusted mixed multilevel logistic regression. Almost all racial and gender subgroups had significantly higher rates of depression and anxiety after the start of COVID-19 compared to the years prior, with the greatest changes observed in Hispanic and Asian females. Suicide risk-related diagnoses significantly increased among all female subgroups, with the largest increase among Asian females (AMD 4.8, 95% CI 0.2-9.3) and Black females (AMD 4.6, 95% CI 2.2-6.9). Rates of depression, anxiety, and suicidal thoughts and/or behaviors in young people continued to increase in the post-pandemic period. Many pre-existing disparities between subgroups, especially females, significantly widened, highlighting the importance of using an intersectional lens. Urgent action is warranted, including universal screening of pediatric patients for suicide risk, broadening effective treatment and support options in minoritized patients, and increasing support services to patients and families. We used an intersectional approach to elucidate changes in disparities during the COVID-19 pandemic. We found that rates of depression, anxiety, and suicidality in youth increased in the post-pandemic period and many pre-existing disparities between subgroups, especially females, widened significantly.

中文翻译：

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COVID-19 与青少年心理健康差异：抑郁、焦虑和自杀风险相关诊断的交叉趋势

在 COVID-19 大流行之前，心理健康差异在种族和族裔少数群体的年轻人中普遍存在。随着 2022 年完整数据集的出现，我们可以估计疫情进一步加剧现有不平等的程度。使用种族、民族和性别的交叉视角，量化 COVID-19 大流行之前和之后青少年抑郁、焦虑和自杀风险相关诊断轨迹的差异。我们使用来自大西洋中部医疗保健系统（2015-2022）的电子病历数据，通过图形分析和比较，评估了 29,117 名 8-20 岁青少年的抑郁、焦虑和自杀风险相关诊断的年发生率变化调整后的平均差（AMD）和调整后的混合多级逻辑回归。与前几年相比，在 COVID-19 爆发后，几乎所有种族和性别亚组的抑郁和焦虑率均显着升高，其中西班牙裔和亚洲女性的变化最大。所有女性亚组中与自杀风险相关的诊断均显着增加，其中亚洲女性（AMD 4.8，95% CI 0.2-9.3）和黑人女性（AMD 4.6，95% CI 2.2-6.9）增幅最大。在大流行后时期，年轻人的抑郁、焦虑和自杀念头和/或行为的发生率持续上升。亚群体（尤其是女性）之间许多先前存在的差异显着扩大，凸显了使用交叉视角的重要性。需要采取紧急行动，包括对儿科患者的自杀风险进行普遍筛查，扩大少数患者的有效治疗和支持选择，以及增加对患者和家庭的支持服务。我们采用交叉方法来阐明 COVID-19 大流行期间差异的变化。我们发现，在大流行后时期，青少年的抑郁、焦虑和自杀率有所增加，并且亚群体之间，特别是女性之间的许多先前存在的差异显着扩大。