Adolescent Mental Health During COVID-19 Pandemic and Beyond


by Kristin Weinschenk
By Becky Burger

The year 2020 has presented tremendous challenges and changes to all fields of medicine.  As this pandemic has grown in size and impact, there has been growing concern about the impact of social, economic and political stressors on mental health (MH).  Early data from the CDC has shown rising prevalence of symptoms of anxiety, substance abuse, suicidal ideations, and depressive disorders across all ages, with a disproportionate prevalence amongst young adults (62.9% in 18-24yo vs 30.9% in all ages) and racial minorities.1 Data on children and teens is still being collected, but thus far points to similar increases in children and teens. As COVID continues to affect our communities, physicians must be on alert for these growing psychiatric concerns.  

One of the major changes for youth has been the closure of schools and subsequent shift to online education. Children of all ages across the state are now learning virtually and screen time is surpassing the limits recommended by AAP.  While public opinion often considers social media as having a negative impact on MH, the data around this is mixed.4,5   Rather than focusing on social media use itself, it may be more helpful to look at specific exposures to negative aspects of social media, such as online bullying, sexual exploitation, and trauma exposure.5,6  An example that has received considerable media attention this year is the prevalence across social media platforms of videos depicting police brutality of minorities.  The American Academy of Child and Adolescent Psychiatry (AACAP) recommends parents have an active, hands on role in helping children process information they have learned from the news about tragedies. When children view these images on social media, they often lack the parental support and context, and may experience higher stress related responses.7   As screen time increases, parents should be advised to remain engaged in what their children are viewing and how they are processing that information.  Physicians should also be ready to discuss in detail how patients are using their screen time and how it may be affecting their mood and thoughts. 

Updates on HIV non-occupational post-exposure prophylaxis (nPEP)


AMA PRA Category 1 Credit FOR EACH ISSUE (2 ARTICLES)!!!!!!

By Atsuko Koyama, MD, MPH and Lauren Middlebrooks, MD

According to the 2017 Youth Risk Behavior Survey (YRBS), almost 30% of 9th to 12th graders reported being “currently sexually active,” and only 54% used a condom at their last sexual encounter [1]. Despite improved antiretroviral regimens and HIV pre- and post-exposure prophylaxis (PrEP and PEP), adolescents and young adults continue to make up a quarter of new HIV diagnoses (21%, n=8,090), with the majority of these cases being secondary to male-to-male (MSM) sexual contact [2]. Given the prevalence of sexual activity amongst adolescents who present under a variety of circumstances disclosing past sexual activity, knowledge about non-occupational HIV PEP (nPEP) is relevant and important for all pediatricians.

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