Background: The COVID-19 Pandemic is an unprecedented time that has impacted people across the world, with a particularly devastating impact on elderly populations and child and adolescent populations. As schools switched to virtual teaching models to decrease SARs-COV2 spread, children and adolescents were forced to isolate at home and abruptly make the transition to virtual learning. This meant an increase in the daily hours spent at home, on a computer, and a decrease in social peer engagement. This change happened quickly, despite efforts by schools to translate academic accommodations in a virtual setting. Many children and adolescents, including those with attention deficit hyperactivity disorder (ADHD), were left with ineffective or insufficient accommodations as schools and families struggled to adapt. Furthermore, this created ample opportunities for new strain on parent-child relationships. Academic, family, and social stability are core factors in the lives of children and adolescents. Any disruptions to this equilibrium make this population vulnerable to decline, especially in regards to their psychiatric conditions.
Methods: This report describes 2 cases of adolescent patients with ADHD, whom secondary to difficulty in school, developed worsening discord with parents and development of major depressive disorder (MDD) which led to their first acute inpatient psychiatric hospitalization.
Results: The first case was of a 15-year-old male with no significant past medical history and recently diagnosed ADHD. The second case was of a 16-year-old female with no significant past medical history and previously diagnosed psychiatric history of ADHD and alcohol use disorder. Both these patients required intensive DBT therapy and medication adjustments in order to address challenges that presented after transition to the virtual education format.
Conclusions: The clinical history described in our cases highlights the importance of providing supportive models and educational resources for this vulnerable population, not only during the pandemic, but also in the future as they transition back to in-person schooling.