{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:28:39Z","timestamp":1786426119053,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP23K16329"],"award-info":[{"award-number":["JP23K16329"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP26K20581"],"award-info":[{"award-number":["JP26K20581"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Clin Neurosci"],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The COVID\u201019 pandemic had substantial effects on youth mental health. Most previous studies focused on the initial pandemic years, leaving the post\u2010restriction period underexplored. We examined trajectories of newly recorded psychiatric diagnoses among Japanese youths across two policy shifts: March 2020 school closures and May 2023 reclassification of COVID\u201019 as an influenza\u2010equivalent Category V disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an interrupted time\u2010series analysis using the National Database of Health Insurance Claims, covering over 99% of the Japanese population. The study included 21\u2009million individuals aged under 19\u2009years to analyze monthly trends in first recorded psychiatric diagnoses from January 2018 to March 2024. Segmented negative binomial regression was used to estimate shifts in levels and trends following both policy interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Following the 2020 closures, eating disorders showed sex\u2010specific patterns: males showed an immediate 28.8% decrease (IRR 0.712, 95% CI 0.619\u20130.819), whereas females showed a 28.4% increase (IRR 1.284, 95% CI 1.045\u20131.576). Newly recorded ADHD diagnoses showed an 8.1% immediate decrease (IRR 0.919, 95% CI 0.847\u20130.997). During the restriction period, anxiety\/stress\u2010related and mood disorders showed apparent surge patterns following infection waves. After restrictions were lifted in 2023, eating disorders among males showed an upward level shift (IRR 1.214, 95% CI 1.076\u20131.370). Neurodevelopmental disorders showed preliminary downward trends in the post\u2010restriction period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This nationwide study of 21\u2009million youths suggested differential diagnostic patterns across pandemic phases. These contrasting trajectories highlight the need for subgroup\u2010level post\u2010pandemic diagnostic surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pcn.70117","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:47:27Z","timestamp":1786423647000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Newly recorded psychiatric diagnoses among 21 million youth before, during, and after\n                    <scp>COVID<\/scp>\n                    \u201019 restrictions: A nationwide interrupted time\u2010series analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9980-6092","authenticated-orcid":false,"given":"Naomi","family":"Matsumoto","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences Okayama University  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Okayama University Hospital  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsaku","family":"Hayase","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Asada","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry Okayama University Hospital  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshie","family":"Shigeyasu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Okayama University Hospital  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayumi","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Hirota","sequence":"additional","affiliation":[{"name":"Department of Child Development and Mental Health Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yorifuji","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences Okayama University  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1001\/jamapediatrics.2021.2482","article-title":"Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID\u201019: A meta\u2010analysis","volume":"175","author":"Racine N","year":"2021","journal-title":"JAMA Pediatr."},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/S2215-0366(23)00036-6","article-title":"Comparison of paediatric emergency department visits for attempted suicide, self\u2010harm, and suicidal ideation before and during the COVID\u201019 pandemic: A systematic review and meta\u2010analysis","volume":"10","author":"Madigan S","year":"2023","journal-title":"Lancet Psychiatry"},{"key":"e_1_2_10_4_1","first-page":"1","article-title":"Incidence and outcomes of eating disorders during the COVID\u201019 pandemic","volume":"220","author":"Taquet M","year":"2021","journal-title":"Br. 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Child Psychol. Psychiatry"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.25829","article-title":"COVID\u201019 pandemic school disruptions and acute mental health in children and adolescents","volume":"7","author":"Davico C","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.46106","article-title":"Mental health of children with special educational needs and the return to in\u2010person learning after the COVID\u201019 pandemic","volume":"6","author":"Tso WWY","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2026.5683","article-title":"Neurodevelopmental diagnoses before, during, and after the COVID\u201019 pandemic","volume":"9","author":"Freeman SJ","year":"2026","journal-title":"JAMA Netw. 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Epidemiol."},{"key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1016\/j.acap.2013.08.002","article-title":"Use of interrupted time series analysis in evaluating health care quality improvements","volume":"13","author":"Penfold RB","year":"2013","journal-title":"Acad. Pediatr."},{"key":"e_1_2_10_19_1","unstructured":"Ministry of Education Culture Sports Science and Technology (MEXT).Measures against COVID\u201019 in schools following the transition to the Category V infectious diseases (Notification). Available from URL:https:\/\/www.mext.go.jp\/content\/20230427-mxt_ope01-000004520_1.pdf."},{"key":"e_1_2_10_20_1","unstructured":"Ministry of Education Culture Sports Science and Technology (MEXT).Hygiene management manual for COVID\u201019 in schools. [Cited 2 January 2026.] Available from URL:https:\/\/www.mext.go.jp\/a_menu\/coronavirus\/mext_00029.html."},{"key":"e_1_2_10_21_1","unstructured":"Population Estimates Monthly Report Monthly.Portal site of official statistics of Japan. [Cited 3 January 2026.] Available from URL:https:\/\/www.e-stat.go.jp\/en\/stat-search\/files?page=1&layout=datalist&toukei=00200524&tstat=000000090001&cycle=1&tclass1=000001011678&tclass2val=0."},{"key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"703","DOI":"10.2307\/1913610","article-title":"A simple, positive semi\u2010definite, Heteroskedasticity and autocorrelation consistent covariance matrix","volume":"55","author":"Newey WK","year":"1987","journal-title":"Econometrica"},{"key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the false discovery rate: A practical and powerful approach to multiple testing","volume":"57","author":"Benjamini Y","year":"1995","journal-title":"J. R. Stat. Soc. Series B Stat. Methodol."},{"key":"e_1_2_10_24_1","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s13104-023-06336-9","article-title":"Research note changes in the number of outpatient visits in Japan during the COVID\u201019 pandemic","volume":"16","author":"Machida M","year":"2023","journal-title":"BMC. Res. Notes"},{"key":"e_1_2_10_25_1","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19148810","article-title":"Changes in health care access during the COVID\u201019 pandemic: Estimates of national Japanese data, June 2020\u2010October 2021","volume":"19","author":"Tanoue Y","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"e_1_2_10_26_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2025.53150","article-title":"Telemedicine uptake during and after pandemic\u2010era deregulation in Japan","volume":"9","author":"Ohashi K","year":"2026","journal-title":"JAMA Netw. 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Dev."},{"key":"e_1_2_10_29_1","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/S2352-4642(23)00126-8","article-title":"Temporal trends in eating disorder and self\u2010harm incidence rates among adolescents and young adults in the UK in the 2\u2009years since onset of the COVID\u201019 pandemic: A population\u2010based study","volume":"7","author":"Trafford AM","year":"2023","journal-title":"Lancet Child Adolesc. Health."},{"key":"e_1_2_10_30_1","doi-asserted-by":"crossref","DOI":"10.3390\/medicina61030445","article-title":"Association of COVID\u201019 pandemic with newly diagnosed anorexia nervosa among children and adolescents in Japan","volume":"61","author":"Fukuya Y","year":"2025","journal-title":"Medicina (Kaunas)"},{"key":"e_1_2_10_31_1","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1002\/erv.2964","article-title":"What do we know about the epidemiology of avoidant\/restrictive food intake disorder in children and adolescents? 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Resour."},{"key":"e_1_2_10_34_1","doi-asserted-by":"crossref","DOI":"10.1192\/bjo.2025.10903","article-title":"Changes in psychotropic medication prescription patterns during the COVID\u201019 pandemic among Japanese children, adolescents and young adults: Interrupted time\u2010series study using a national claims database","volume":"11","author":"Huang W","year":"2025","journal-title":"BJPsych Open."},{"key":"e_1_2_10_35_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.rasd.2023.102202","article-title":"Uncertainty, sensory processing, and stress in autistic children during the COVID\u201019 pandemic","volume":"106","author":"Cardon G","year":"2023","journal-title":"Res. Autism Spectr. Disord."},{"key":"e_1_2_10_36_1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1177\/20965311231210310","article-title":"\u201cSuspending classes without stopping learning\u201d: An initiative to ensure learning in Japan during the pandemic","volume":"7","author":"Yu P","year":"2024","journal-title":"ECNU Rev. Educ."},{"key":"e_1_2_10_37_1","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.je.2016.09.009","article-title":"Validity of diagnoses, procedures, and laboratory data in Japanese administrative data","volume":"27","author":"Yamana H","year":"2017","journal-title":"J. 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