{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:14:29Z","timestamp":1788268469393,"version":"build-2803163510"},"reference-count":60,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"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":["Child"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study examined psychiatric presentations among children and adolescents (C&amp;A) in Alberta, Canada, across pre\u2010pandemic, pandemic and post\u2010pandemic periods, with a focus on age, biological sex and urban\/rural status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Utilizing a retrospective cohort design, we analysed health administrative billing data from 1\u2009430\u2009441 psychiatric encounters among Albertans aged 0\u201317 between 2017 and 2022. Service utilization rates were compared across pandemic phases, and associations were evaluated using one\u2010way ANOVAs and generalized linear models stratified by healthcare setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Total psychiatric presentations increased significantly post\u2010pandemic, driven by a 21.3% surge in outpatient settings. One\u2010way ANOVA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014) and regression modelling confirmed that both pandemic phase (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014) and age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) significantly influenced utilization. Adolescents accounted for 64% of encounters and were the most heavily impacted cohort. Outpatient increases were primarily phase\u2010driven (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), whereas emergency and inpatient encounters were strongly influenced by age and sex (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with female adolescents experiencing the highest rates (significant age\u2009\u00d7\u2009sex interaction,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Conversely, rural presentations declined sharply during the pandemic (\u221235.2%) and only partially rebounded post\u2010pandemic (+17.4%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The psychological impacts of the pandemic were highly stratified by demographic factors and care settings, with adolescent females showing acute distress in acute care, and rural youth experiencing persistent service gaps. These findings underscore an urgent need for targeted mental health resources, equitable geographic access and tailored interventions across diverse youth cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cch.70303","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:16:37Z","timestamp":1782180997000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trends in Psychiatric Presentations Among Children and Adolescents in Alberta: A Pre\u2010\/Post\u2010Pandemic Analysis (2017\u20132022)"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5254-2379","authenticated-orcid":false,"given":"Jacquelyn","family":"Paquet","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine","family":"Hibbard","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9090-4174","authenticated-orcid":false,"given":"Pamela","family":"Brett\u2010MacLean","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.39549"},{"key":"e_1_2_12_3_1","unstructured":"Alberta Health Services.2018. \u201cOfficial Standard Geographic Areas.\u201d Government of Alberta. 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