Salud mental infantojuvenil en atención primaria en tiempos de COVID: ¿qué ha cambiado?
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Derechos de autor 2025 Revista de Psiquiatría Infanto-Juvenil
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
DOI:
https://doi.org/10.31766/revpsij.v42n1a4Palabras clave:
virus del SARS, infecciones por coronavirus, atención primaria de salud, pediatría, salud mentalResumen
Introducción: La pandemia por SARS-CoV-2 ha podido precipitar el deterioro de la Salud Mental Infantojuvenil (SMIJ), su manejo y tratamiento, por lo que este estudio trata de comparar el número de consultas relativas a la SMIJ atendidas en Atención Primaria (AP), así como la derivación a Atención Especializada (AE) y la prescripción farmacológica. Metodología: Estudio descriptivo y retrospectivo en pacientes pediátricos de AP en la provincia de Zaragoza por patología relacionada con la SMIJ en dos periodos: “prepandemia” y “pandemia”. Resultados: La muestra total fue de 6854 consultas (56,9% en "prepandemia" y 43,1% en "pandemia";p<0,001). En "pandemia" disminuyeron consultas por trastornos del sueño (N=541 vs N=420; p<0,001), enuresis (N=85 vs N=43; p<0,001), trastornos del comportamiento (N=918 vs N=671 ;p<0,001), trastorno del déficit de atención e hiperactividad (TDAH) (N=612 vs N=330;p<0,001) y alteraciones del desarrollo psicomotor (N=1004 vs N=765; p<0,001); se incrementaron las derivaciones a SMIJ por trastornos del sueño (N=34 vs N=138;p<0,001) y alteraciones del desarrollo psicomotor (N=52 vs N=236;p<0,001 con reducción de TDAH (N=198 vs N=81;p<0,001) y trastornos del comportamiento (N=580 vs N=233;p<0,001). La edad media de derivación fue inferior en "pandemia" (9,89 vs 7,64 años; p<0,001), con aumento de la ratio Psiquiatría/Psicología (de 5,2 a 5,9; p=0,018). Tras el subperiodo 2a se aumentó prescripción de psicofármacos del 2,6% al 4,4% (p<0,001). Conclusiones: Las consultas totales de SMIJ en AP han disminuido en "pandemia". Sin embargo, han cobrado mayor relevancia los trastornos del sueño y alteraciones del desarrollo psicomotor respecto a las consultas totales. Es posible que la telemedicina haya propiciado el sobretratamiento farmacológico y mayores tasas de derivación a SMIJ.
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