Associations Between Sleep and Adolescent Mental Health Before and During the COVID-19 Pandemic in a Partial Hospitalization Program

AI Summary

In female adolescents, increases in insomnia correlated with increases in depressive, anxiety, and irritability symptoms both before and during COVID-19.
Associations between insomnia and suicidal ideation were present among females pre COVID-19 but not during COVID-19.
Neither the pandemic period nor sex significantly moderated insomnia associations; the in-person partial hospitalisation programme was comparably effective before and during COVID-19.

JAACAP Open. 2026 Mar 14;4(3):454-463. doi: 10.1016/j.jaacop.2026.03.002. eCollection 2026 Jun.

ABSTRACT

OBJECTIVE: The impact of partial hospitalization programs (PHP) for adolescents with mental health difficulties has remained unclear, especially during the COVID-19 pandemic. This study examined changes in mental health symptomatology among youth in an in-person PHP. Specifically, this study examined whether the COVID-19 pandemic or sex moderated the effect of insomnia on irritability, anxiety, depression, and suicidality among youth in an in-person PHP.

METHOD: A retrospective study of 271 adolescents (aged 11-17 years) treated in a PHP before (n = 99) and during (n = 172) the COVID-19 pandemic from January 2019 through December 2021 was conducted. The conditional process moderation path analytic regression model assessed whether changes in insomnia symptoms were moderated by both COVID-19 (pre- COVID-19 and during COVID-19 time periods) and sex.

RESULTS: A significant positive linear relationship was observed between changes in insomnia symptoms and changes in depressive, anxiety, and irritability symptoms among female adolescents, both before and during the COVID-19 period. A similar relationship between insomnia and suicidal ideation was observed among female adolescents, albeit only in the pre-COVID period. However, no significant interaction effects were identified between insomnia and group (pre- vs during COVID-19) or between insomnia and sex, suggesting that neither the pandemic nor sex moderated these associations.

CONCLUSION: This study highlights the impact of sleep disturbance on mental health symptoms particularly among female adolescents, in the context of an in-person PHP, both before and during the COVID-19 pandemic. The PHP appeared to be equally effective in managing these symptoms in both the before and during the COVID-19 period. These findings provide a foundation for future research regarding the role of partial hospitalization programs in addressing adolescent mental health during global crises.

PMID:42220636 | PMC:PMC13221801 | DOI:10.1016/j.jaacop.2026.03.002

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