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Döpfner M, von Wirth E, Adam J, Goldbeck C, Schulze-Husmann K, Herpertz-Dahlmann B, Simons M, Heuer F, Schwendowius J, Poustka L, Wegner C, Bender S. Feasibility, satisfaction, and goal attainment in routine telemedicine consultation in child and adolescent psychiatry and psychotherapy. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02477-9. [PMID: 38836920 DOI: 10.1007/s00787-024-02477-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/18/2024] [Indexed: 06/06/2024]
Abstract
Telehealth services were rapidly adopted during the COVID-19 pandemic, but evidence regarding the effectiveness and feasibility of telehealth services in child and adolescent mental healthcare is sparse. This study aims to investigate feasibility, satisfaction, and goal attainment in video-delivered consultations in routine care child and adolescent psychiatry and psychotherapy. A total of 1046 patients from four university child and adolescent outpatient psychiatric clinics and one university outpatient unit for child and adolescent psychotherapy were screened for study participation. We examined a) the percentage of patients considered eligible for video-delivered consultation, b) clinicians', parents' and patients' satisfaction with video consultation, c) clinicians' ratings of goal attainment in video consultation, and d) factors associated with satisfaction and goal attainment. 59% of the screening sample (n = 621) fulfilled eligibility criteria and were considered eligible for video consultation. A total of 267 patients consented to participate in the study and received a video consultation. Clinicians reported high levels of satisfaction with video consultation and high levels of goal attainment in video consultations, especially for patients scheduled for initial patient assessments. Parents and patients were also highly satisfied with the video consultations, especially if patients had less severe emotional and behavioral problems. The present findings suggest that video consultations are a feasible and well-accepted alternative to in-person consultations in child and adolescent mental health care, especially for children with less severe symptoms and for children in early phases of assessment and treatment. Limitations include the lack of a control group. The study was registered at the German Clinical Trials Registry (DRKS00023525).
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Affiliation(s)
- Manfred Döpfner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Elena von Wirth
- Department of Clinical Child and Adolescent Psychology and Psychotherapy, University of Trier, Trier, Germany
| | - Julia Adam
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Carolina Goldbeck
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Karen Schulze-Husmann
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Michael Simons
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Fabiola Heuer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Schwendowius
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Christiane Wegner
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Berger É, Larose MP, Capuano F, Letarte MJ, Geoffroy MC, Lupien S, Brendgen M, Boivin M, Vitaro F, Tremblay R, Masse B, Côté S, Ouellet-Morin I. Hair steroid before and after COVID-19 in preschoolers: the moderation of family characteristics. Psychoneuroendocrinology 2024; 166:107072. [PMID: 38733756 DOI: 10.1016/j.psyneuen.2024.107072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/01/2024] [Accepted: 05/05/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Frequent or prolonged exposure to stressors may jeopardize young children's health. The onset of the COVID-19 pandemic, coupled with disruptions in daily routines and social isolation resulting from public health preventive measures, have raised concerns about its potential impact on children' experienced stress, particularly for young children and vulnerable families. However, whether the pandemic was accompanied by changes in physiological stress remains unknown as perceived stress is not a good proxy of physiological stress. This study examined if preschoolers showed increasing hair steroid concentrations following the onset of the COVID-19 pandemic and whether family characteristics may have exacerbated or buffered these changes. METHODS 136 preschoolers (2-4 years) provided hair for steroid measurement (cortisol, dehydroepiandrosterone (DHEA), cortisone, cortisol-to-DHEA ratio, cortisol-to-cortisone ratio) in October-November 2019 (T0) and in July-August 2020 (T1). A 2-centimeter hair segment was analyzed, reflecting steroid production over the two months leading up to collection. Family income, conflict resolution and lack of cohesion, as well as parents' COVID-19 stress were reported by parents. Linear mixed models for repeated measures and Bayes factors were used. RESULTS No significant changes were noted from before to after the onset of the COVID-19 pandemic for most hair steroids. However, a moderating role of family conflict resolution was noted. Children living with parents with a better ability to resolve conflicts had lower levels of DHEA compared to those who had more difficulty managing conflicts. Additionally, lower levels of family cohesion and income were linked to some steroids, especially DHEA, suggesting that these factors may relate to children's physiological stress. Finally, boys had higher DHEA levels than girls. CONCLUSION Our findings suggest that stress biomarkers were comparable from before to during the COVID-19 pandemic. This observation holds true despite the pandemic being perceived by many as a novel, unpredictable, and potentially threatening event. Findings further suggest that family characteristics are associated with hair steroid, especially DHEA, which deserves further investigation.
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Affiliation(s)
- Éloise Berger
- School of Criminology, University of Montreal, Montreal, Canada; Research Center of the Montreal Mental Health University Institute, Montreal, Canada
| | - Marie-Pier Larose
- INVEST Flagship Research Center/Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - France Capuano
- Department of Education and Specialized Training, University of Quebec at Montreal, Montreal, Canada
| | | | - Marie-Claude Geoffroy
- Department of Psychiatry McGill University, Montreal, Canada; McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, Montreal, Canada
| | - Sonia Lupien
- Research Center of the Montreal Mental Health University Institute, Montreal, Canada; Centre for Studies on Human Stress, Department Psychiatry, University of Montreal, Montreal, Canada
| | - Mara Brendgen
- Department of Psychology, University of Quebec at Montreal, Montreal, Canada; Ste Justine Hospital Research Centre, Montreal, Canada
| | - Michel Boivin
- School of Psychology, Laval University, Quebec City, Canada
| | - Frank Vitaro
- School of Psychoeducation, University of Montreal, Montreal, Canada; Research Group on Child Maladjustment, Université de Montréal, Montreal, Canada
| | - Richard Tremblay
- Department of Pediatrics and Psychology, University of Montreal, Montreal, Canada
| | - Benoît Masse
- School of Public Health, University of Montreal, Montreal, Canada
| | - Sylvana Côté
- Research Group on Child Maladjustment, Université de Montréal, Montreal, Canada; School of Public Health, University of Montreal, Montreal, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal, Montreal, Canada; Research Center of the Montreal Mental Health University Institute, Montreal, Canada.
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Vaillant-Coindard E, Briet G, Lespiau F, Gisclard B, Charbonnier E. Effects of three prophylactic interventions on French middle-schoolers' mental health: protocol for a randomized controlled trial. BMC Psychol 2024; 12:204. [PMID: 38615007 PMCID: PMC11016224 DOI: 10.1186/s40359-024-01723-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/09/2024] [Indexed: 04/15/2024] Open
Abstract
Adolescence is a strategic developmental stage in terms of preventing later difficulties and ensuring good mental health. Prophylactic interventions, which are conducted before the onset, prolongation, or worsening of difficulties, and aim to prevent or reduce symptoms or to promote wellbeing, therefore appear particularly appropriate for adolescents. However, existing prophylactic interventions conducted with adolescents have several weaknesses, including sparse theoretical frameworks, ambivalent evidence of their efficacy, and implementation and dissemination difficulties. In addition, no data are currently available on the effectiveness of such interventions in France. To fill this gap, a four-arm randomized controlled trial will be performed to assess the effectiveness of three prophylactic interventions targeting reactive, proactive and interpersonal adaptation in fourth-grade middle-school students, together with participants' experience and perception of the interventions. Based on existing knowledge about adolescents, their learning mechanisms, and field constraints, these three interventions have been designed to promote their learning and receptiveness to interventions. Compared with baseline (i.e., before the intervention), we expect to observe a significant decrease in the level of distress (anxiety and depressive symptoms, functional impairment, and psychosocial difficulties) and a significant increase in the level of wellbeing after the intervention, across the three intervention groups, but not in the control group. In addition, we expect to observe post-intervention improvements in the processes targeted by the reactive adaptation intervention (operationalized as coping strategy use and flexibility), those targeted by the proactive adaptation intervention (operationalized as the tendency to engage in committed actions and general self-efficacy), and those targeted by the interpersonal adaptation intervention (operationalized as assertiveness in interactions), but only in the corresponding groups, with no change in any of these processes in the control group. The results of this research will not only enrich our knowledge of the processes involved in adolescents' distress and wellbeing, but also provide clues as to the best targets for intervention. Moreover, the material for these interventions will be freely available in French on request to the corresponding author, providing access to innovative and fully assessed interventions aimed at promoting adolescents' mental health in France.This clinical trial is currently being registered under no. 2023-A01973-42 on https://ansm.sante.fr/ . This is the first version of the protocol.
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Affiliation(s)
| | - Gaëtan Briet
- UNIV. NIMES, APSY-V, F-30021, Nîmes Cedex 1, France
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Hertz-Palmor N, Gothelf D. Unexpected mental health improvement in children and adolescents during COVID-19-who benefits from staying at home? Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02432-8. [PMID: 38592511 DOI: 10.1007/s00787-024-02432-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Affiliation(s)
- Nimrod Hertz-Palmor
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Doron Gothelf
- Child and Adolescent Psychiatry Division, Edmond & Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Ramat Gan, 5262000, Israel.
- The Faculty of Medical & Health Sciences, and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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Buechel C, Friedmann A, Eber S, Behrends U, Mall V, Nehring I. The change of psychosocial stress factors in families with infants and toddlers during the COVID-19 pandemic. A longitudinal perspective on the CoronabaBY study from Germany. Front Pediatr 2024; 12:1354089. [PMID: 38562139 PMCID: PMC10982396 DOI: 10.3389/fped.2024.1354089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Background Over nearly three years, the COVID-19 pandemic has had a lasting impact on people's lives and mental health worldwide with its far-reaching restrictions and concerns about infections and other personal consequences. Families were particularly affected and showed increased stress and psychological problems. Long-term effects cannot be ruled out. So far, data on young families are sparse. The present longitudinal analysis (n = 932) of the CoronabaBY study investigated the development of parenting stress, parental affective symptoms, and child's mental health in young families with children aged 0-3 years in Germany as well as potential influencing factors. Methods The observational study includes two measurement points over the course of the pandemic (baseline and follow-up). Data was collected by app using standardized questionnaires. Results N = 932 participants, mainly mothers (94.7%) born in Germany (93.1%) with higher education (61.3% with at least high school diploma) and a comfortable financial situation participated in the longitudinal study. Children were on average 14.7 months old at baseline (SD: 12, range: 1-39 months). While the proportion of parents who perceived the pandemic as stressful decreased significantly from baseline (60%) to follow-up (52.3%), the proportion with parenting stress increased significantly (from 40.1% to 45.4%). Both parental and child mental health problems remained constant over time, with infants crying/feeding/sleeping problems ranging above pre-pandemic comparative data. Most predictive for high parenting stress at follow-up was high parenting stress at baseline. This was also true for parental affective symptoms (depression/anxiety) and child mental health problems. Conclusions Despite faded pandemic restrictions, parents remained burdened. Support services do not appear to have been sufficient to help families out of their stressful situation. Our results indicate a need for action regarding low-threshold services that effectively reach affected families. Trial registration The study was pre-registered in OSF (https://osf.io/search/?q=tksh5&page=1).
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Affiliation(s)
- Catherine Buechel
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Anna Friedmann
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Stefan Eber
- Professional Association of Pediatricians in Bavaria (BVKJ) and PaedNetz Bayern, Munich, Germany
| | - Uta Behrends
- Children’s Hospital, School of Medicine, Technical University Munich, Munich, Germany
| | - Volker Mall
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Ina Nehring
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
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Ou W, Xiao C, Dong Q, Chen Y, Ke C, Liu B, Liu J, Ju Y, Zhang Y. Risk factors associated with depression and anxiety among the Chinese general population after retracting the dynamic zero-COVID policy: A network analysis. J Affect Disord 2024; 349:77-85. [PMID: 38199391 DOI: 10.1016/j.jad.2024.01.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/01/2024] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Recent studies have evidenced the negative psychological consequences of the COVID-19 pandemic and sociodemographic vulnerability among the general population, while limited information was available on which factors make the greatest contribution to psychological distress when these factors were considered concurrently. Herein, we aimed to investigate the pathways that underlie psychological distress in the context of retracting dynamic zero-COVID policy. METHODS We employed the mixed graphical model to construct the network of depression (PHQ-9), anxiety (GAD-7), and pandemic-related factors in a general population sample (N = 1610). Then, we re-examined the network by adding sociodemographic variables to further explore the influence of sociodemographic factors. Additionally, we repeated the analyses in the second sample (N = 620) collected in the same period to assess the replicability. RESULTS The relationships between the pandemic factors and anxiety and depressive symptoms exhibited a tendency to decrease after adding demographic variables, and income became the most important node and shared edge weights with all anxiety and depressive symptoms. These findings were replicable with the second sample. No significant difference in the network properties was detected between the two samples. LIMITATIONS The cross-sectional design limits the ability to observe longitudinal changes in these risk factors and their relationship with psychological distress. CONCLUSIONS Income level, rather than the pandemic-related factors, acted as a vital role in the psychological distress of the general population, implying that livelihood issues may be the critical intervention targets for mental health during the post-pandemic period.
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Affiliation(s)
- Wenwen Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Chuman Xiao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Qiangli Dong
- Department of Psychiatry, Lanzhou University Second Hospital, Lanzhou 730000, Gansu, China
| | - Yafei Chen
- Xiangya Medical School, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Chunxi Ke
- Xiangya Medical School, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jin Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yumeng Ju
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Reiß F, Behn S, Erhart M, Strelow L, Kaman A, Ottová-Jordan V, Bilz L, Moor I, Ravens-Sieberer U. Subjective health and psychosomatic complaints of children and adolescents in Germany: Results of the HBSC study 2009/10 - 2022. JOURNAL OF HEALTH MONITORING 2024; 9:7-22. [PMID: 38559686 PMCID: PMC10977472 DOI: 10.25646/11868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/14/2023] [Indexed: 04/04/2024]
Abstract
Background Subjective health and well-being are important health indicators in childhood and adolescence. This article shows current results and trends over time between 2009/10 and 2022. Methods The Health Behaviour in School-aged Children (HBSC) study examined subjective health, life satisfaction and psychosomatic complaints of N = 21,788 students aged 11 to 15 years in the school years 2009/10, 2013/14, 2017/18 and in the calendar year 2022. Multivariate regression analyses show the associations between sociodemographic characteristics and well-being in 2022, as well as trends since 2009/10. Results The majority of children and adolescents indicate a good subjective health and high life satisfaction. About half of the girls and one third of the boys report multiple psychosomatic health complaints, with a clear increase over time. Older adolescents, girls and gender diverse adolescents are at an increased risk of poor well-being. Subjective health and life satisfaction varied between 2009/10 and 2022, with a significant deterioration between 2017/18 and 2022. Conclusions The high proportion of children and adolescents with psychosomatic complaints, as well as the observed gender and age differences, underline the need for target group-specific prevention, health promotion and continuous health monitoring.
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Affiliation(s)
- Franziska Reiß
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Steven Behn
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Michael Erhart
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
- Alice Salomon University of Applied Sciences Berlin, Health and Rehabilitation Science, Berlin, Germany
| | - Lisa Strelow
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Anne Kaman
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Veronika Ottová-Jordan
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Ludwig Bilz
- Brandenburg University of Technology Cottbus-Senftenberg, Institute of Health, Cottbus, Germany
| | - Irene Moor
- Martin Luther University Halle-Wittenberg, Medical Faculty, Interdisciplinary Centre for Health Sciences (PZG), Institute of Medical Sociology, Halle (Saale), Germany
| | - Ulrike Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
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Sobotka M, Kern T, Haider K, Dale R, Wöhrer V, Pieh C, Probst T, Humer E, Jesser A. School students' burdens and resources after 2 years of COVID-19 in Austria: a qualitative study using content analysis. Front Public Health 2024; 12:1327999. [PMID: 38406498 PMCID: PMC10884163 DOI: 10.3389/fpubh.2024.1327999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/29/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction The mental health of young people has been severely affected by the COVID-19 pandemic and the measures associated with it. Mental health symptoms increased across various domains during the pandemic and subjective wellbeing decreased. Methods This study examined the burdens and resources of Austrian school students (M = 16.63 years old) in the third year of the pandemic and compared them descriptively with the burdens and resources identified in a comparative study in 2021. A cross-sectional online survey with open-ended questions from April to May 2022 provided data that was analyzed using qualitative content analysis. A sub-sample of N = 214 was selected from the larger sample. This sub-sample is representative for the Austrian population aged 15-19 in terms of gender and migrant background. Results Analysis of the open-ended questions showed that concerns about the pandemic and the burdens of the measures were no longer on young people's minds at the time of the survey in 2022. On the other hand, stress at school was increasing and the opening of schools and the resumption of face-to-face teaching were challenging for respondents. While resuming social contacts and leisure activities was mentioned as a resource by many respondents, some also expressed a desire for more time off and a retreat into coping strategies such as sleeping more or avoiding problems. Discussion Our findings suggest that there is a need for low-threshold support from teachers and parents to help students catch up on missed lessons and to empathize with the mas they make the transition back to "old normal".
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Affiliation(s)
- Marlies Sobotka
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems an der Donau, Austria
| | - Thomas Kern
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems an der Donau, Austria
| | - Katja Haider
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems an der Donau, Austria
| | - Rachel Dale
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems an der Donau, Austria
| | - Veronika Wöhrer
- Department of Education, University of Vienna, Vienna, Austria
| | - Christoph Pieh
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems an der Donau, Austria
| | - Thomas Probst
- Division of Psychotherapy, Department of Psychology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems an der Donau, Austria
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, Vienna, Austria
| | - Andrea Jesser
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems an der Donau, Austria
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, Vienna, Austria
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Orban E, Li LY, Gilbert M, Napp AK, Kaman A, Topf S, Boecker M, Devine J, Reiß F, Wendel F, Jung-Sievers C, Ernst VS, Franze M, Möhler E, Breitinger E, Bender S, Ravens-Sieberer U. Mental health and quality of life in children and adolescents during the COVID-19 pandemic: a systematic review of longitudinal studies. Front Public Health 2024; 11:1275917. [PMID: 38259801 PMCID: PMC10800626 DOI: 10.3389/fpubh.2023.1275917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Background The COVID-19 pandemic has significantly impacted the mental health of children and families, i.e., due to measures like social distancing and remote schooling. While previous research has shown negative effects on mental health and health-related quality of life (HRQoL), most studies have focused on pre-post comparisons in the early pandemic stages. This systematic review aims to examine longitudinal studies to understand the long-term impacts of the pandemic on children and adolescents. Methods This systematic review adhered to the PRISMA guidelines and was preregistered in the international prospective register of systematic reviews (Record ID: CRD42022336930). We systematically searched PubMed/MEDLINE, Web of Science, PsycINFO, PSYNDEX, and the WHO-COVID-19 database and included studies published up to August 30, 2022. Based on pre-defined eligibility criteria, longitudinal and prospective studies that assessed the mental health or quality of life of children or adolescents (0-19 years) in the general population over a longer time span (at two or more measurement points) during the COVID-19 pandemic were included in the review. The methodological quality of the included studies was assessed using an adapted version of the Effective Public Health Practice Project (EPHPP) checklist. Narrative data synthesis was used to summarize the findings. Results A total of 5,099 results were obtained from literature searches, with 4,935 excluded during title/abstract screening. After reviewing 163 full-text articles, 24 publications were included in the review. Sample sizes ranged between n = 86 and n = 34,038. The length of the investigated time periods and the number of assessment points, as well as outcomes, varied. The majority of studies were of moderate methodological quality. Mental health outcomes were more frequently studied compared to measures of HRQoL. The findings from these studies mostly suggest that children and adolescents experienced heightened mental health problems, specifically internalizing symptoms like anxiety and depression. Further, there was a decline in their overall HRQoL over the course of the COVID-19 pandemic that did not necessarily subside when lockdowns ended. Conclusion It is crucial to continue monitoring the mental health and well-being of children and adolescents following the pandemic to identify groups at risks and plan interventions. This should ideally be conducted by large systematic studies, using validated instruments, and encompassing representative samples to obtain reliable and comprehensive insights with the aim of improving youth mental health care.
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Affiliation(s)
- Ester Orban
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Li
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ann-Kathrin Napp
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sabine Topf
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maren Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Child and Adolescent Psychiatry, Child Neuropsychology Section, University Hospital RWTH Aachen, Aachen, Germany
| | - Janine Devine
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiß
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Flora Wendel
- Faculty of Medicine, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Caroline Jung-Sievers
- Faculty of Medicine, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Vanessa Sophie Ernst
- Institute for Community Medicine, Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Marco Franze
- Institute for Community Medicine, Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Eva Möhler
- Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Eva Breitinger
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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10
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Melchior M. The long shadow of the COVID-19 pandemic on children and adolescents' mental health. Eur Child Adolesc Psychiatry 2023; 32:2385-2386. [PMID: 37975934 DOI: 10.1007/s00787-023-02321-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, ERES, 27 rue Chaligny, 75012, Paris, France.
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11
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Teich P, Fühner T, Bähr F, Puta C, Granacher U, Kliegl R. Covid Pandemic Effects on the Physical Fitness of Primary School Children: Results of the German EMOTIKON Project. SPORTS MEDICINE - OPEN 2023; 9:77. [PMID: 37578660 PMCID: PMC10425322 DOI: 10.1186/s40798-023-00624-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/31/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND In spring of 2020, the Sars-CoV-2 incidence rate increased rapidly in Germany and around the world. Throughout the next 2 years, schools were temporarily closed and social distancing measures were put in place to slow the spread of the Covid-19 virus. Did these social restrictions and temporary school lockdowns affect children's physical fitness? The EMOTIKON project annually tests the physical fitness of all third-graders in the Federal State of Brandenburg, Germany. The tests assess cardiorespiratory endurance (6-min-run test), coordination (star-run test), speed (20-m sprint test), lower (powerLOW, standing long jump test), and upper (powerUP, ball-push test) limbs muscle power, and static balance (one-legged stance test with eyes closed). A total of 125,893 children were tested in the falls from 2016 to 2022. Primary analyses focused on 98,510 keyage third-graders (i.e., school enrollment according to the legal key date, aged 8 to 9 years) from 515 schools. Secondary analyses included 27,383 older-than-keyage third-graders (i.e., OTK, delayed school enrollment or repetition of a grade, aged 9 to 10 years), who have been shown to exhibit lower physical fitness than expected for their age. Linear mixed models fitted pre-pandemic quadratic secular trends, and took into account differences between children and schools. RESULTS Third-graders exhibited lower cardiorespiratory endurance, coordination, speed and powerUP in the Covid pandemic cohorts (2020-2022) compared to the pre-pandemic cohorts (2016-2019). Children's powerLOW and static balance were higher in the pandemic cohorts compared to the pre-pandemic cohorts. From 2020 to 2021, coordination, powerLOW and powerUP further declined. Evidence for some post-pandemic physical fitness catch-up was restricted to powerUP. Cohen's |ds| for comparisons of the pandemic cohorts 2020-2022 with pre-pandemic cohorts 2016-2019 ranged from 0.02 for powerLOW to 0.15 for coordination. Within the pandemic cohorts, keyage children exhibited developmental losses ranging from approximately 1 month for speed to 5 months for cardiorespiratory endurance. For powerLOW and static balance, the positive pandemic effects translate to developmental gains of 1 and 7 months, respectively. Pre-pandemic secular trends may account for some of the observed differences between pandemic and pre-pandemic cohorts, especially in powerLOW, powerUP and static balance. The pandemic further increased developmental delays of OTK children in cardiorespiratory endurance, powerUP and balance. CONCLUSIONS The Covid-19 pandemic was associated with declines in several physical fitness components in German third-graders. Pandemic effects are still visible in 2022. Health-related interventions should specifically target those physical fitness components that were negatively affected by the pandemic (cardiorespiratory endurance, coordination, speed).
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Affiliation(s)
- Paula Teich
- Division of Training and Movement Science, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany.
| | - Thea Fühner
- Division of Training and Movement Science, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
| | - Florian Bähr
- Division of Sports and Movement Sciences, Faculty of Educational Sciences, University of Erfurt, Erfurt, Germany
| | - Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University of Jena, Jena, Germany
- Center for Interdisciplinary Prevention of Diseases Related to Professional Activities, Jena, Germany
- Center for Sepsis Control and Care (CSCC), Jena University Hospital/ Friedrich-Schiller-University Jena, Jena, Germany
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany
| | - Reinhold Kliegl
- Division of Training and Movement Science, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
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12
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Fehkührer S, Humer E, Kaltschik S, Pieh C, Probst T, Diestler G, Jesser A. Young People and the Future: School Students' Concerns and Hopes for the Future after One Year of COVID-19 in Austria-Findings of a Mixed-Methods Pilot Study. Healthcare (Basel) 2023; 11:2242. [PMID: 37628439 PMCID: PMC10454506 DOI: 10.3390/healthcare11162242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/21/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
The COVID-19 pandemic resulted in enormous changes in everyday life and numerous burdens for adolescents. This pilot study focused on how young people look to the future in the face of these burdens. Responses to two open-ended questions on concerns and hopes for the future that were part of a larger online survey on the mental health of school students in Austria were analyzed using qualitative content analysis. Subsequently, differences in the experiences of boys and girls, young people with and without a migration background and psychologically stressed and non-stressed young people were examined by applying a mixed-methods approach. Data collection took place from 3 February to 28 February 2021. From a total survey sample of 3052 adolescents aged 14-20, a representative sample according to gender and migration background (N = 500) was drawn. Qualitative content analysis revealed several areas of concern about the future, including school-related concerns, concerns about the further development of the pandemic and the associated restrictions, concerns related to a lack of locus of control, health-related concerns and concerns about social relationships. The analysis also indicated young people's greatest hopes for the future, such as hopes related to further pandemic development, hopes regarding major life goals, school, social relationships and health. Young people's experiences differ according to gender, migration background and the extent of psychological distress. This study contributes to research on the psychological well-being of adolescents during the pandemic and provides important insights into the subjective experience of young people. It aims to gain a more comprehensive understanding of the concerns and hopes for the future of young people in a time marked by various challenges. The results of the study should be used to develop ideas for measures, such as the expansion of school psychological services and low-threshold support services for students, such as school social work and counseling.
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Affiliation(s)
- Sonja Fehkührer
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems, 3500 Krems, Austria; (S.F.); (E.H.); (S.K.); (C.P.); (T.P.)
| | - Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems, 3500 Krems, Austria; (S.F.); (E.H.); (S.K.); (C.P.); (T.P.)
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, 1020 Vienna, Austria
| | - Stefan Kaltschik
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems, 3500 Krems, Austria; (S.F.); (E.H.); (S.K.); (C.P.); (T.P.)
| | - Christoph Pieh
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems, 3500 Krems, Austria; (S.F.); (E.H.); (S.K.); (C.P.); (T.P.)
| | - Thomas Probst
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems, 3500 Krems, Austria; (S.F.); (E.H.); (S.K.); (C.P.); (T.P.)
| | - Gertraud Diestler
- Österreichischer Arbeitskreis für Gruppentherapie und Gruppendynamik, Fachsektion Integrative Gestalt Therapy Vienna, 1080 Vienna, Austria;
| | - Andrea Jesser
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems, 3500 Krems, Austria; (S.F.); (E.H.); (S.K.); (C.P.); (T.P.)
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13
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Barbieri V, Piccoliori G, Mahlknecht A, Plagg B, Ausserhofer D, Engl A, Wiedermann CJ. Adolescent Mental Health during the COVID-19 Pandemic: The Interplay of Age, Gender, and Mental Health Outcomes in Two Consecutive Cross-Sectional Surveys in Northern Italy. Behav Sci (Basel) 2023; 13:643. [PMID: 37622783 PMCID: PMC10451173 DOI: 10.3390/bs13080643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/27/2023] [Accepted: 07/30/2023] [Indexed: 08/26/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the mental health and well-being of adolescents. This study aimed to investigate the development of health-related quality of life (HRQoL) and mental health among adolescents in Northern Italy by comparing cross-sectional surveys conducted in 2021 and 2022, with a particular focus on the influence of age and gender. The sample included adolescents aged 11-19 years from public schools in South Tyrol. Validated psychometric instruments were used to assess HRQoL, anxiety and depression symptoms, and psychosomatic complaints. Sociodemographic variables, COVID-19 burden, and pandemic-related factors were measured. Statistical analyses included chi-square tests, correlation coefficients, and logistic regression analyses. The results indicated that while the self-reported burden of adolescents decreased significantly in 2022 (n = 1885) compared to 2021 (n = 1760), there were no significant differences in symptoms of anxiety, depressive symptoms, low HRQoL, and increased psychosomatic complaints between the two surveys for both early and late adolescents. Females consistently had higher percentages for all outcome variables, and symptoms of anxiety increased with age in females, but not in males. Both genders experienced an increase in depressive symptoms and low HRQoL with age. The co-occurrence of mental health outcomes was observed, suggesting overlapping patterns among anxiety, depression, low HRQoL, and psychosomatic complaints. These findings underscore the intricate relationship between age, gender, and mental health outcomes among adolescents during the pandemic. It is important to recognize that late adolescents may exhibit distinct vulnerabilities and may require tailored support approaches to address their specific mental health challenges, differing from those needed for early adolescents.
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Affiliation(s)
- Verena Barbieri
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Angelika Mahlknecht
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Barbara Plagg
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
- Faculty of Education, Free University of Bolzano, 39100 Bolzano, Italy
| | - Dietmar Ausserhofer
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Adolf Engl
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Christian J. Wiedermann
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology—Tyrol, 6060 Hall, Austria
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14
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Caqueo-Urízar A, Mena-Chamorro P, Henríquez D, Urzúa A, Irarrázaval M. The Effects of Social Determinants and Resilience on the Mental Health of Chilean Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1213. [PMID: 37508710 PMCID: PMC10378294 DOI: 10.3390/children10071213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
The aim of this research was to evaluate the effects of social determinants (i.e., gender, educational vulnerability, and socioeconomic status) and resilience on the mental health of Chilean adolescents in pre-, during, and post-COVID-19 pandemic contexts. The study included a group of 684 students, ranging in age from 12 to 18 years, who were attending educational institutions in the city of Arica. The Child and Adolescent Assessment System (SENA) was used to measure mental health problems, the Brief Resilience Scale for Children and Youth (CYRM-12) was used to measure resilience, and the Vulnerability Index of Educational Institutions was used to measure educational vulnerability. The results suggest increases in depressive, anxious, and social anxiety symptomatologies over time (wave by year, 2018, 2020, and 2021). In addition, multiple linear regression models showed predictive effects of the COVID-19 pandemic, gender, vulnerability index, socioeconomic status, and resilient behaviors on mental health problems. The worsening of mental health indicators over time requires the greater coordination and integration of mental health experts in the most vulnerable educational centers.
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Affiliation(s)
| | - Patricio Mena-Chamorro
- Centro de Justicia Educacional CJE, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile
| | - Diego Henríquez
- Centro de Justicia Educacional CJE, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile
| | - Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta 1270709, Chile
| | - Matías Irarrázaval
- Department of Psychiatry, Faculty of Medicine, Clinical Hospital, Universidad de Chile, Santiago 8380453, Chile
- Millennium Institute for Research in Depression and Personality, MIDAP, Santiago 8380453, Chile
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15
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Jeriček Klanšček H, Furman L. Socioeconomic Deprivation and Inequalities in Mental Well-Being during the COVID-19 Pandemic among Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6233. [PMID: 37444081 PMCID: PMC10341098 DOI: 10.3390/ijerph20136233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/26/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023]
Abstract
The COVID-19 pandemic highlighted the existing inequalities in education and mental health. The aim of this study was to examine socioeconomic disadvantages and mental well-being inequalities among Slovenian adolescents in October 2020. The study used nationally representative data from 3052 adolescents aged 14 and 18 (Mage = 14.4 and 18.4). The WHO-5 Well-Being Index (WHO-5) was used to measure mental well-being and risk for depression. Multinomial logistic regression was used to identify differences in the pattern of associations regarding sociodemographic characteristics and experiences during the pandemic with poor well-being and risk for depression. Our study found that adolescents from socially disadvantaged families faced poorer conditions as regards academic performance, had fewer opportunities to socialise with friends online, and were more likely to feel lonely; they reported lower levels of mental well-being and were at a higher risk for depression. The unemployment of both parents and adolescents' perceptions of family wealth were found to be the most important predictors of depression risk. In addition, experiencing deprivation and economic hardship during the pandemic was also identified as a significant predictor. The study concludes that social and economic conditions were critical determinants of adolescents' mental health during the pandemic and that effective intervention is needed to promote their well-being and reduce inequalities.
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