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Cosmos Study

Adolescent Mental Health Visits Increased for Females During the Pandemic

Abstract: Adolescent females were seen more often than males for mental health concerns during the pandemic, notably for OCD and eating disorders.
June 3, 2021
Dual-Team Study
Team A:Johnston Thayer, RNEric Lindgren, JDAdrianna Teriakidis, PhD
Team B:Gregg Springan, MSN, RNDan GruettLily Rubin-Miller, MPH

During the COVID-19 pandemic, mental health diagnoses made up a greater proportion of pediatric visits than before the pandemic.1 As shown in Figure 1, outpatient mental health visits for adolescent females increased by 11.3% over predicted volumes during the COVID-19 pandemic. Mental health visits for adolescent males decreased by 0.4% from predicted volumes during the same time period.

Figure 1
Outpatient Adolescent Mental Health Visit Volumes by Sex
Outpatient Adolescent Mental Health Visit Volumes by Sex
Figure 1. Outpatient visit volumes for mental health visits versus predicted volumes for patients ages 12-18 from January 1, 2017, through February 28, 2021. The vertical lines for March 1, 2020, and February 28, 2021, indicate the time frame for which we predicted visit volumes.

Two groups of mental health diagnoses stood out for their prominent increase in adolescent females: obsessive-compulsive disorders and eating disorders. Visits with OCD diagnoses increased by 41.5% for females and by 10.8% for males over predicted volumes. Visits with eating disorder diagnoses increased by 37.7% for females and by 5.4% for males over predicted volumes.

Figure 2
Outpatient Visit Diagnoses for Obsessive-Compulsive Disorder for Adolescents by Sex
Outpatient Visit Diagnoses for Obsessive-Compulsive Disorder for Adolescents by Sex
Figure 2. The difference in monthly outpatient visit diagnoses versus predicted volumes for obsessive-compulsive disorder for patients ages 12-18 from January 1, 2017, through February 28, 2021. The vertical lines for March 1, 2020, and February 28, 2021, indicate the time frame for which we predicted visit volumes.
Figure 3
Outpatient Visit Diagnoses for Eating Disorder for Adolescents by Sex
Outpatient Visit Diagnoses for Eating Disorder for Adolescents by Sex
Figure 3. The difference in monthly outpatient visit diagnoses versus predicted for feeding and eating disorder for patients ages 12-18 from January 1, 2017, through February 28, 2021. The vertical lines for March 1, 2020, and February 28, 2021, indicate the time frame for which we predicted visit volumes.

This study was completed by two teams each comprised of a clinician and two research scientists who worked independently analyzing adolescent mental health visit volumes and diagnoses by sex. The two teams came to similar conclusions. These data come from Cosmos, a HIPAA-limited set of EHR data from over 107 million patients contributed by Epic customers. Data are pooled from 77 healthcare organizations representing 333 hospitals that span 46 states and cover 64 million patients of which 8.6 million are pediatric patients.

  1. Thayer J, Springan G, Gruett D, et al. Mental Health Make Up a Greater Proportion of Pediatric Visits During the COVID-19 Pandemic. Epic Health Research Network. https://ehrn.org/articles/pediatric-visits-more-likely-for-mental-health-than-other-conditions-during-the-covid-19-pandemic. Published May 21, 2021. Accessed May 24, 2021.