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Peer-reviewedCC BY 4.0Psychiatry and Clinical Neurosciences

Newly recorded psychiatric diagnoses among 21 million youth before, during, and after COVID‐19 restrictions: A nationwide interrupted time‐series analysis

  • Naomi Matsumoto1
  • Hisashi Ishida2
  • Shunsaku Hayase3
  • Takahiro Asada4
  • Yoshie Shigeyasu2
  • Ayumi Okada5
  • Tomoya Hirota6
  • Takashi Yorifuji1
6 affiliations
  1. 1Department of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences Okayama University Okayama Japan
  2. 2Department of Pediatrics Okayama University Hospital Okayama Japan
  3. 3Department of Epidemiology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
  4. 4Department of Neuropsychiatry Okayama University Hospital Okayama Japan
  5. 5Department of Pediatrics Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
  6. 6Department of Child Development and Mental Health Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
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Abstract

Aim: The COVID‐19 pandemic had substantial effects on youth mental health. Most previous studies focused on the initial pandemic years, leaving the post‐restriction 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‐19 as an influenza‐equivalent Category V disease.

Methods: We conducted an interrupted time‐series analysis using the National Database of Health Insurance Claims, covering over 99% of the Japanese population. The study included 21 million individuals aged under 19 years 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.

Results: Following the 2020 closures, eating disorders showed sex‐specific patterns: males showed an immediate 28.8% decrease (IRR 0.712, 95% CI 0.619–0.819), whereas females showed a 28.4% increase (IRR 1.284, 95% CI 1.045–1.576). Newly recorded ADHD diagnoses showed an 8.1% immediate decrease (IRR 0.919, 95% CI 0.847–0.997). During the restriction period, anxiety/stress‐related 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 1.076–1.370). Neurodevelopmental disorders showed preliminary downward trends in the post‐restriction period.

Conclusion: This nationwide study of 21 million youths suggested differential diagnostic patterns across pandemic phases. These contrasting trajectories highlight the need for subgroup‐level post‐pandemic diagnostic surveillance.

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Cite

BibTeXRIS
BibTeX
@article{matsumoto2026newly,
  title = {{Newly recorded psychiatric diagnoses among 21 million youth before, during, and after COVID‐19 restrictions: A nationwide interrupted time‐series analysis}},
  author = {Naomi Matsumoto and Hisashi Ishida and Shunsaku Hayase and Takahiro Asada and Yoshie Shigeyasu and Ayumi Okada and Tomoya Hirota and Takashi Yorifuji},
  journal = {Psychiatry and Clinical Neurosciences},
  year = {2026},
  month = aug,
  doi = {10.1111/pcn.70117},
  url = {https://doi.org/10.1111/pcn.70117},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Newly recorded psychiatric diagnoses among 21 million youth before, during, and after COVID‐19 restrictions: A nationwide interrupted time‐series analysis
AU  - Naomi Matsumoto
AU  - Hisashi Ishida
AU  - Shunsaku Hayase
AU  - Takahiro Asada
AU  - Yoshie Shigeyasu
AU  - Ayumi Okada
AU  - Tomoya Hirota
AU  - Takashi Yorifuji
PY  - 2026
DA  - 2026/08/10
JO  - Psychiatry and Clinical Neurosciences
DO  - 10.1111/pcn.70117
UR  - https://doi.org/10.1111/pcn.70117
AB  - Aim: The COVID‐19 pandemic had substantial effects on youth mental health. Most previous studies focused on the initial pandemic years, leaving the post‐restriction 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‐19 as an influenza‐equivalent Category V disease.  Methods: We conducted an interrupted time‐series analysis using the National Database of Health Insurance Claims, covering over 99% of the Japanese population. The study included 21 million individuals aged under 19 years 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.  Results: Following the 2020 closures, eating disorders showed sex‐specific patterns: males showed an immediate 28.8% decrease (IRR 0.712, 95% CI 0.619–0.819), whereas females showed a 28.4% increase (IRR 1.284, 95% CI 1.045–1.576). Newly recorded ADHD diagnoses showed an 8.1% immediate decrease (IRR 0.919, 95% CI 0.847–0.997). During the restriction period, anxiety/stress‐related 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 1.076–1.370). Neurodevelopmental disorders showed preliminary downward trends in the post‐restriction period.  Conclusion: This nationwide study of 21 million youths suggested differential diagnostic patterns across pandemic phases. These contrasting trajectories highlight the need for subgroup‐level post‐pandemic diagnostic surveillance.
SN  - 1323-1316
SN  - 1440-1819
ER  -