Children and young people’s consultation rates for psychosocial problems between 2016 and 2021 in the Netherlands

Figures & data

Table 1. Study population demographics.

Year	N Population size	Sex (% Female)	Median age (IQR)	Deprivation status (% registered in deprived postal code)
2016	64801	49.3%	12.5 (6.5–18.5)	19.2%
2017	74788	49.2%	13 (6.5–19)	20.6%
2018	80501	49.1%	13 (6.5–19)	20.0%
2019	79210	49.1%	13 (6.5–19)	20.5%
2020	82802	49.1%	13 (6.5–19)	20.4%
2021	96635	49.1%	12.5 (6.5–18.5)	21.9%

The RPCD is a dynamic cohort and the study population differed per month. Numbers represent the month January of each year.

Figure 1. Consultation rates per age and sex categories over time.

Figure 2. Expected and observed consultation rates over time.

Figure 2a shows the observed monthly psychosocial consultation rates and the expected rates based on Model 1.

Figure 2b shows the observed non-psychosocial rates and the expected rates based on Model 2. The shaded area indicates the pandemic period with the first wave in dark grey.

Table 2. Regression table of model 3 estimating the effect of COVID-19 indices on consultation rates.

Variables	Estimate of relative rate (RR) (95% CI)	p Value
Trend over time (RR per subsequent month)	1.010 (1.008–1.011)	p < 0.001
School closure^a	0.786 (0.706–0.875)	p < 0.001
COVID-19 infection rate^b	1.010 (1.002–1.018)	p = 0.010

Only significant variables were kept in the final model. We adjusted for effects of seasonality. For the complete model including seasonality variables see Supplementary Material Table 3.

^aSchool closure is a levelled index, transformed to a scale from 0 to 1, averaged per month. 0 represents a complete month without restrictions, 1 represents a month with complete school closure.

^bCOVID-19 infection rate represents the national number of daily new cases per 1000 inhabitants, averaged per month.

Table 3. Regression table of model 4 estimating the effect of COVID-19 indices in different age categories.

Variable	Estimate of relative rate (RR) (95% CI)	p Value
Trend over time (RR per subsequent month)	1.009 (1.007–1.010)	p < 0.001
Age 7–12	1.862 (1.725–2.010)	p < 0.001
Age 13–17	2.513 (2.329–2.712)	p < 0.001
Age 18–24	3.361 (3.116–3.626)	p < 0.001
School closure^a in: Age 0–6 Age 7–12 Age 13–17 Age 18–24	0.563 (0.459–0.692) 0.693 (0.565–0.848) 0.951 (0.777–1.163) 0.891 (0.729–1.089)	p < 0.001^c
COVID-19 infection rate^b	1.013 (1.003–1.023)	p = 0.009

The reference group is the consultation rate for children aged 0–6. Only significant variables and interactions were kept in the final model. Sex was no significant predictor. The effect of the different months (seasonality) is not shown in this table (Supplementary Material Table 5 for complete model). ^aSchool closure is a levelled index, transformed to a scale from 0 to 1, averaged per month. 0 represents a full month without restrictions, 1 represents a month with complete school closure. ^bCOVID-19 infection rate represents the national number of daily new cases per 1000 inhabitants, averaged per month. ^cThere was a significant interaction between school closure and the different age categories, the effect is shown per age category, the presented p value derived from likelihood-ratio test of the interaction components.