{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T14:02:58Z","timestamp":1789567378778,"version":"build-2803163510"},"reference-count":43,"publisher":"Hogrefe Publishing Group","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zeitschrift f\u00fcr Kinder- und Jugendpsychiatrie und Psychotherapie"],"abstract":"<jats:p>\n                    Abstract: Objectives: The coronavirus disease 2019 (COVID-19) pandemic affected the mental health of children and adolescents in Germany by increasing depressive symptoms and altering their access to treatment. However, representative data on pandemic-related changes in care for children and adolescents are scarce. This study examines the service utilization of children and adolescents with depressive disorders during the COVID-19 pandemic. Methods: We analyzed anonymized insurance data (outpatient and inpatient cases) for depressive disorders in children and adolescents during pre-COVID (01\/2018\u200a\u2013\u200a03\/2020; N\u2009=\u2009142,257) and intra-COVID (04\/2020\u200a\u2013\u200a12\/2021; N\u2009=\u2009139,690) periods, stratified by age (0.0\u200a\u2013\u200a9.9; 10.0\u200a\u2013\u200a13.9; 14.0\u200a\u2013\u200a17.9 years) and sex. We analyzed the differences between time periods descriptively (%-changes, odds ratios) and using \u03c7\u00b2 tests, Welch tests, and interrupted time series analysis. Results: The prevalence of depressive disorders decreased from pre-COVID to intra-COVID periods, particularly among males (female children: 2.8\u2009%, n\u2009=\u20091,932 vs. 2.8\u2009%, n\u2009=\u20091,964; female adolescents: 8.9\u2009%, n\u2009=\u20096,149 vs. 8.7\u2009%, n\u2009=\u20095,914; male children: 1.6\u2009%, n\u2009=\u20091,165 vs. 1.2\u2009%, n\u2009=\u2009914; male adolescents: 4.0\u2009%, n\u2009=\u20092,888 vs. 3.0\u2009%, n\u2009=\u20092,205). The quarterly incidence showed significant positive trends for female children (\u03b2\n                    <jats:sub>1<\/jats:sub>\n                    \u2009=\u2009+2.83, p\u2009&lt;\u2009.01; \u03b2\n                    <jats:sub>3<\/jats:sub>\n                    \u2009=\u2009+2.93, p\u2009=\u2009.030) and adolescents (\u03b2\n                    <jats:sub>3<\/jats:sub>\n                    \u2009=\u2009+5.52, p\u2009=\u2009.031) following the onset of the intra-COVID period (Q2\/2020). There were significant proportional increases in inpatient and outpatient cases for female and male adolescents in child and adolescent psychiatry as well as among specialized providers, i.e., pediatricians, child and adolescent psychiatrists\/psychotherapists. Conclusions: The data showed declines in the prevalence and incidence of depressive disorders, potentially reflecting care avoidance or reduced treatment capacities, particularly among boys. Differences emerged in service utilization by care provider, with proportionate increases for specialized providers and reductions for general practitioners. We need further research to address potential ongoing treatment gaps and to support at-risk children and adolescents.\n                  <\/jats:p>","DOI":"10.1024\/1422-4917\/a001096","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:59:08Z","timestamp":1789480748000},"source":"Crossref","is-referenced-by-count":0,"title":["Sex-Specific Changes in Outpatient and Inpatient Care for Depressive Disorders in Children and Adolescents in Germany During the COVID-19 Pandemic"],"prefix":"10.1024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7254-494X","authenticated-orcid":true,"given":"Stephan","family":"Zillmer","sequence":"first","affiliation":[{"name":"Department of Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Hildesheim, Germany"},{"name":"Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Campus Virchow-Klinikum (CVK), Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1415-3836","authenticated-orcid":true,"given":"Jule","family":"Leickert","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Campus Charit\u00e9 Mitte (CCM), Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Germany"},{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany"},{"name":"Department of Education and Psychology, Clinical Child and Adolescent Psychology and Psychotherapy, Freie Universit\u00e4t Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J.","family":"Bachmann","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, University of Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Vivirito","sequence":"additional","affiliation":[{"name":"InGef \u2013 Institute for Applied Health Research Berlin GmbH, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Enders","sequence":"additional","affiliation":[{"name":"InGef \u2013 Institute for Applied Health Research Berlin GmbH, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elianna","family":"Mitchnik","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Hildesheim, Germany"},{"name":"Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Campus Virchow-Klinikum (CVK), Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7254-5646","authenticated-orcid":true,"given":"Christoph U.","family":"Correll","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Campus Virchow-Klinikum (CVK), Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Germany"},{"name":"Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra\/Northwell, Hempstead, NY, USA"},{"name":"Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA"},{"name":"German Center for Mental Health (DZPG), Partner Site Berlin, Germany"},{"name":"German Center for Child and Adolescent Health (DZKJ), Partner Site Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Jaite","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Hildesheim, Germany"},{"name":"Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Campus Virchow-Klinikum (CVK), Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, 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(2023).\n                      DAK Kinder- und Jugendreport 2023: Sonderanalyse f\u00fcr die Jahre 2018\u200a\u2013\u200a2022 Station\u00e4re Behandlung psychischer Erkrankungen\n                      . [DAK Children and youth report 2023: special analysis for the years 2018\u200a\u2013\u200a2022 \u2013 Inpatient treatment of mental illnesses.]. DAK-Gesundheit. At: https:\/\/caas.content.dak.de\/caas\/v1\/media\/36764\/data\/4a4fc442c6a07cf511b898edd3b01ace\/dak-kinder-und-jugendreport-2023-sonderanalyse.pdf. 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