{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T15:10:45Z","timestamp":1771168245499,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PCN Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The coronavirus disease 2019 (COVID\u201019) pandemic has had a significant psychological impact on children and adolescents, increasing depression, anxiety, and suicide\u2010related behaviors. In Japan, suicide remained the leading cause of death among individuals aged 10\u201319 years, with rates rising after the pandemic onset. However, few studies have examined these changes in psychiatric outpatient settings. We aimed to determine whether the prevalence of suicide\u2010related behaviors and associated psychiatric symptoms\u2014depression and anxiety\u2014differed pre\u2010 and post\u2010pandemic among elementary and junior high school students attending psychiatric outpatient clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective case\n                      <jats:bold>\u2013<\/jats:bold>\n                      control study, we analyzed registry data from a child and adolescent psychiatric outpatient clinic in Japan. Patients were classified into pre\u2010 and post\u2010COVID\u201019 groups based on the visit date (cutoff: March 2, 2020). Clinical characteristics were assessed at the initial visit through interviews and standardized rating scales: Depression Self\u2010Rating Scale for Children, Spence Children's Anxiety Scale, and Attention\u2010Deficit\/Hyperactivity Disorder Rating Scale\u2010IV. Group differences were examined using univariate and multivariate logistic regression analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 2016 and 2022, 2878 patients were included. The prevalence of suicide\u2010related behaviors increased post\u2010pandemic, from 3.0% to 6.9% among elementary school students and from 15.5% to 21.2% among junior high school students. In the post\u2010COVID\u201019 group, elementary students more often exhibited antisocial behaviors and hyperactivity\/conduct disorder diagnoses. Junior high students more often exhibited anxiety symptoms, particularly social anxiety, panic, and trauma\u2010related fear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Suicide\u2010related behaviors significantly increased after the COVID\u201019 pandemic, with distinct clinical characteristics observed across age groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pcn5.70263","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T14:29:42Z","timestamp":1764685782000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Increased suicide\u2010related behaviors, challenging behaviors, and anxiety symptoms in elementary and junior high school students after the coronavirus disease 2019 pandemic: A single\u2010center case\u2013control study"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7712-4966","authenticated-orcid":false,"given":"Masahiro","family":"Ishida","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine Fukuoka University Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0816-4355","authenticated-orcid":false,"given":"Yoshinori","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, National Kohnodai Medical Center Japan Institute for Health Security Chiba Japan"},{"name":"Department of Psychiatry and Behavioral Sciences Institute of Science Tokyo Graduate School of Medical and Dental Sciences Tokyo 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