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Abstract Introduction The prevalence of psychiatric disorders has not shifted widely through the COVID pandemic, except for some specific groups such as young people or women. Our objective is to examine prospectively the evolution of children and adolescents who consulted in a psychiatric emergency service during the COVID-19 confinements. Method We collected prospective clinical information about 296 young people under 18 who visited a tertiary hospital for psychiatric reasons during the confinement periods in Spain. Clinical diagnoses, suicide attempts, hospital admissions, and pharmacological prescriptions were extracted from electronic health records through 2020, 2021, and 2022. Features of those who maintained psychiatric care and those who did not were compared. Results Three out of four children and adolescents who visited the psychiatric emergency department during the confinements continued psychiatric care at the end of 2022. Those who did not showed better premorbid adjustment at baseline. During follow-up, diagnoses of neurodevelopmental disorders and eating disorders, as well as the dosage of psychotropic drug prescriptions, increased. The diagnoses of major depressive disorder and eating disorder at baseline were associated with attempting suicide during follow-up. Patients with internalizing symptoms were admitted earlier than those with externalizing symptoms but no differences were found in terms of suicide attempts. Conclusions The continuity of psychiatric care after an initial emergency visit during the confinements implied greater clinical severity, as reflected by changes in clinical diagnoses and pharmacological regimens. Emergent symptoms of depression or eating disorders after social distancing or isolation could predict subsequent suicidal behavior in young populations.

Abstract The pandemic has gotten a high impact in mental health including general population and patients with mental illness before the pandemic, who has seen increase their symptoms and/or their treatment interrupted. This letter aims to describe the sociodemographic and clinical variables that converge in patients who come to the psychiatry emergency department during the pandemic without being under prior follow-up at least the previous six months. The database was obtained through a retrospective review of digital medical record, which registers sociodemographic, diagnosis, reason for consultation and hospital admissions. The observatory periods were: 1) Before the lockdown, from 13th of January, 2020 to 14th of March, 2020; 2) During the lockdown by the first alarm state, from the beginning of the alarm state in Spain (15th of March, 2020) until its end (20th of June, 2020) and 3) while the second state of alarm in Spain (from the 25th of October, 2020 to 9th of May, 2021). In the first state of alarm the psychotic decompensations increased from 5.1% before the pandemic to 12.5% (p=0.015), and the unipolar depression decreased from 15.3% to 9.3% (p=0.026). About the therapeutic decision, stands out that in the first alarm state the hospitalizations increased to 30.6% while before the lockdown the income was 21% (p=0.039). During the second state of alarm the number of pacients without previous follow-up increased from 22.4% to 29.4% (p