289 - Trends in Children's Mental Health During the Past Decade: A COSMOS Study

Publication Number: 3278.289

Angelina Ritson, Wright State University Boonshoft School of Medicine, Dayton, OH, United States; John Pascoe, Wright State University Boonshoft School of Medicine, Dayton, OH, United States

Background: The rates of diagnosed depression and anxiety among children and adolescents have significantly increased over the last decade. Following the COVID-19 pandemic, there have been increasing concerns about this observation among clinicians and public health professionals. While prior studies have demonstrated increasing rates of mental health diagnoses among children, few have compared diagnostic patterns in large samples before, during, and after the pandemic.

Objective: To compare rates of recorded depression and anxiety diagnoses among Ohio children and adolescents aged 10-17 years within the intervals of 2015-2019 and 2020-2024.

Design/Methods: Data were analyzed using the COSMOS dataset, which consists of de-identified patient information from U.S. health systems using the EPIC electronic health record. Diagnostic data from Ohio children and adolescents between the ages of 10 and 17 years old, inclusive, were analyzed. Two distinct time cohorts were included in the analysis: Cohort 1, 2015-2019, pre-COVID-19, and Cohort 2, 2020-2024, the COVID-19 and post-COVID-19 cohort. Rates were calculated as the proportion of patients with a documented diagnosis of depression or anxiety among all children and adolescents seen within each time period at participating health facilities. Both overall rates and rates stratified by gender were examined. Chi-square analyses compared diagnostic rates both within and between time periods.

Results: All reported comparisons were statistically significant at p < 0.0001. Across Ohio, the rate of anxiety and depression diagnoses increased from 1.9% in Cohort 1 (N = 2,194,380) to 3.0% in Cohort 2 (N = 1,998,376). Among girls, rates increased from 2.6% to 4.2%; among boys, from 1.3% to 1.8%. Within both cohorts, girls had significantly higher rates than boys. Furthermore, the gap between rates for girls versus boys widened from 1.5% in Cohort 1 to 2.4% in Cohort 2.

Conclusion(s): In this large sample (N = 4,192,756) of Ohio children and adolescents aged 10–17 years seen at health facilities over the past decade, there has been a notable rise in rates of children with a documented diagnosis of depression or anxiety within the COSMOS dataset. As compared to boys and young men, there was a higher rate of depression and anxiety among girls and young women. It is also noteworthy that the gender gap for rates widened between the two-time cohorts. These findings add to the rapidly accumulating evidence regarding the need for effective action that addresses the mental health of United States' youth, especially among girls and young women.