In 2021, depression and eating disorders continued to rise among youth ages 15 to 17. Girls were treated as inpatients with mental illnesses significantly more often than boys. At primary school age there was a noticeable increase in disorders of social functions and an increase in developmental disorders. This is the result of the analysis of current hospital data from DAK-Gesundheit for the Children and Youth Report 2022. ( HERE )

DAK CEO Andreas Storm and the professional association of pediatricians are calling for quick political action in view of the dramatic development.

800,000 records of young insured people examined

For the report, scientists from Vandage and Bielefeld University examined anonymized billing data from around 800,000 children and young people aged up to 17 who are insured with DAK-Gesundheit. The years 2019 to 2021 were analyzed. The data shows that girls in their late teens in particular are suffering massively from the effects of the pandemic. Girls between the ages of 15 and 17 were hospitalized for eating disorders more than 32 times as often as boys. This trend has worsened during the pandemic. The proportion of young patients with eating disorders increased by 25 percent in 2021 compared to the previous year. They also came to German clinics five times more often because of depression, three times more often because of anxiety disorders and 2.5 times more often because of emotional disorders.

Cry for help from children and young people

The CEO of DAK-Gesundheit, Andreas Storm, outlines the drama of the situation and has clear demands on politicians:

“Our current children and youth report shows how much boys and girls are suffering in the pandemic. The sharp increase in depression and eating disorders is a silent cry for help that must wake us up. We can no longer sit by and watch, but must finally give more weight to the issue of child and adolescent health and take action. The situation has worsened dramatically in the past year, but politicians have not yet responded accordingly. That's why, in my opinion, the establishment of a study commission by the German Bundestag is the right way to further analyze the problems and implement the first consequences during this legislative period. It’s about the health future of an entire generation.”

Eating disorders: sharp increase since the start of the pandemic

Overall, the number of treatments for young people with depression and eating disorders in 2021 increased noticeably compared to the previous year. 28 percent more 15 to 17 year olds came to the clinics with depression and 17 percent more older teenagers with eating disorders. Compared to 2019, hospital stays for eating disorders increased by 40 percent in 2021. There was also an increase in treatments for emotional disorders: in 2021, 42 percent more 15- to 17-year-olds received inpatient care due to emotional disorders. Emotional disorders include, in particular, fears such as separation anxiety, social anxiety or phobic disorders, for example fear of imaginary figures. However, the number of cases here remained below the number of cases of depressive episodes and eating disorders.

There were similar trends among school children between the ages of ten and 14. Inpatient treatment for depression (plus 27 percent), anxiety disorders (plus 25 percent) and eating disorders (plus 21 percent) increased.

Psychological issues are becoming more common in adolescence

“The DAK report provides very impressive evidence of how common psychological and psychosomatic abnormalities, issues and illnesses have become in our society, especially among young people. It is to be expected that the number of mental illnesses and problem areas will continue to rise in the future,” says Prof. Dr. med. Wieland Kiess, Director of the Clinic and Polyclinic for Pediatric and Adolescent Medicine at the University Hospital Leipzig. “But the data also shows that the healthcare system is being reorganized due to changes in times of crisis, such as a pandemic, and that organizational forms should urgently be reconsidered. The separation between outpatient and inpatient treatment and care concepts is incorrect and no longer appropriate. We have to rethink forms of care and adapt the care structures to the needs of children and young people today and in the future.”

Primary school children: more disorders of social functions and developmental disorders

The data from the children and youth report also shows that primary school children suffer primarily from social function disorders and developmental disorders. In 2021, 36 percent more children between the ages of five and nine were treated in clinics due to disorders of social functions. In the case of developmental disabilities, there was an increase of eleven percent. It is striking that boys were treated more often than girls in this context: they found their way to German hospitals almost twice as often because of impaired social functions and almost three times as often because of developmental disorders.

Effects of the pandemic and pandemic measures

“The corona pandemic and especially the measures imposed by politicians to combat the pandemic have caused significant health damage to children of all ages. In addition to more organic diseases such as obesity, the detectable damage to health primarily affects the psycho-socio-emotional area,” says Dr. Thomas Fischbach, President of the Professional Association of Pediatricians and Adolescents.

“Children and young people are just as vulnerable a group within the population as old or previously ill citizens during the corona pandemic. While the latter were of course rightly given attention and care, those responsible for politics simply ignored the equally vitally important needs and needs of the young generation for over two years. The resulting damage is significant, as this DAK report shows. How much permanent damage occurred is still difficult to determine today.

Lessons must be learned from the mistakes made in combating the pandemic, especially from the political side. Children also have the same rights as adults, always. And these rights belong in our constitution.”

With 5.5 million insured people, DAK-Gesundheit is the third largest health insurance company in Germany and is particularly committed to child and adolescent health.

Criticism of the report's causal conclusions

One day after DAK-Gesundheit published its press release, another statement was released in which the quoted Prof. Dr. med. Wieland Kiess comments again. He criticizes the causal conclusions of the report and points out that significantly longer observation periods are necessary. ( HERE )

“The DAK Hospital Report 2022 has set itself the task of comparing the pandemic-related years 2020 and 2021 with each other. A criticism of the content and methodology must be permitted here: the analysis of consecutive years is permitted and possible. However, under no circumstances should causal conclusions be drawn, as the scientific authors of the report were unfortunately apparently allowed to do. Fluctuations in hospital admissions, changes in health behavior or utilization and requests for help are subject to strong regional, temporal and cultural differences. An association e.g. E.g.: drawing on a specific event with a pandemic should therefore be based on longer-term observations, such as those available to health insurance companies.

For example, the commentator's working group: For example, it has been shown that over the past 20 years the obesity frequency among German children and young people has only increased slowly. Interestingly, during the lockdown phases of the pandemic, the obesity frequency was shown by the individual weight gain of each child and young person , had increased dramatically. After the pandemic-related lockdown period, the trend towards a slow increase in obesity measured before the pandemic continues. Similar trends are also evident in e.g. For example, the use of children's preventive examinations or the inpatient admission of children and adolescents with chronic illnesses to a children's hospital in Germany has been reported by the commentator himself, but also by other working groups in Germany.

The DAK report reports that there has been a sharp increase in inpatient stays or hospitalizations of young people, in addition to emotional disorders and depressive episodes, during the pandemic.

Interestingly, fewer young people were hospitalized because of alcohol abuse. However, the interpretation of this data, which we can understand and confirm in our scientific work in the Leipzig city area and also in our clinic, is complex. It is possible that the young people's disorders were only noticed and taken seriously by their parents as a result of the lockdown in the home setting. The family may have had time to deal with the issue because other activities were pushed back due to the pandemic. It is possible that underlying and already existing psychological issues caused by the pandemic were able to manifest themselves as a result of the pandemic-related restrictions. On the other hand, excessive alcohol consumption may simply be explained by a lack of opportunity due to the pandemic-related restrictions on social interaction with peers.

Hospital care data is therefore extremely interesting and is also an important basis for planning a healthcare system. On the other hand, causal connections should only be drawn carefully or not at all and complex explanatory models should also be used to solve problems. Overall, the data shows that fewer children and young people were admitted to inpatient treatment during the lockdown phases. This may have happened due to the reorganization of hospitals (children's wards were redesignated as adult Covid wards); fear of infection prevented inpatient admissions of chronically ill children and adolescents. On the other hand, there were also fewer visits to doctors in the outpatient setting, such as: E.g. documented in child check-ups.

Also interesting: If children are unhappy during the pandemic – Can parents help?

Source: DAK


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