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

Objective: The impact of partial hospitalization programs (PHP) for adolescents with mental health difficulties remains 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 the COVID-19 pandemic (n=172) 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 prior to and during the COVID-19 period.A similar relationship between insomnia and suicidal ideation was observed among female adolescents, though 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 among female adolescents, in the context of an in-person PHP, both before J o u r n a l P r e -p r o o f and during the COVID-19 pandemic.The PHP appeared to be equally effective in managing these symptoms in both the pre-and during COVID-19 periods.These findings provide a foundation for future research regarding the role of partial hospitalization programs in addressing adolescent mental health during global crises.