Child Anxiety and Depression Symptom Trajectories and Predictors over 15 Months of the Coronavirus Pandemic

Multiple emergency department visits and suicidal behavior in children and adolescents

BACKGROUND

Suicidal behaviour is a growing problem in child and adolescents, and the Emergency Department (ED) is often where the first contact with Mental Health occurs. Here we factors associated with suicidal behaviour in this children and adolescents attended at the ED.

METHODS

Our sample consisted of children and adolescents who attended the ED of Hospital 12 de Octubre for psychiatric reasons between January 1st and December 31st, 2022. Inclusion criteria were age under 18 years. No restrictions by diagnosis, ethnicity, nationality, gender or any other variables. We conducted an initial interview with patients in the ED and reviewed patients' digital patient records for the six months following their first visit during 2022.

RESULTS

We found that the variables that were independently associated with a repeated visits for suicidal behaviour were eating problems, transgender identity, emotional dysregulation and previous mental health follow-up.

CONCLUSION

In our study, we found that ED revisits were concentrated in the first month after the first visit. Just as associated factors and approaches have historically been studied in the adult population, the child and adolescent population needs an even more in-depth study of this alarming situation.

Impact of mealtime social experiences on student consumption of meals at school: a qualitative analysis of caregiver perspectives

OBJECTIVE

To understand caregivers' perceptions about their children's mealtime social experiences at school and how they believe these social experiences impact their children's consumption of meals at school (both meals brought from home and school meals).

DESIGN

Qualitative data were originally collected as part of a larger mixed methods study using an embedded-QUAN dominant research design.

SETTING

Semi-structured interviews were conducted with United States (U.S.) caregivers over ZoomTM in English and Spanish during the 2021-2022 school year. The interview guide contained 14 questions on caregivers' perceptions about their children's experiences with school meals.

PARTICIPANTS

Caregivers of students in elementary, middle and high schools in rural, suburban and urban communities in California (n 46) and Maine (n 20) were interviewed. Most (60·6 %) were caregivers of children who were eligible for free or reduced-price meals.

RESULTS

Caregivers reported that an important benefit of eating meals at school is their child's opportunity to socialise with their peers. Caregivers also stated that their child's favourite aspect of school lunch is socialising with friends. However, some caregivers reported the cafeteria environment caused their children to feel anxious and not eat. Other caregivers reported that their children sometimes skipped lunch and chose to socialise with friends rather than wait in long lunch lines.

CONCLUSIONS

Socialising during school meals is important to both caregivers and students. Policies such as increasing lunch period lengths and holding recess before lunch have been found to promote school meal consumption and could reinforce the positive social aspects of mealtime for students.

Depression, anxiety, and development of obesity from childhood to young adulthood in China

OBJECTIVE

To examine the cross-sectional and longitudinal bidirectional associations of depression and anxiety symptoms with the development of obesity over time among children and adolescents in different age groups from childhood to young adulthood.

METHODS

This is a three-wave longitudinal study that included >200,000 school-aged children between 5 and 18 years. Participants were assessed at baseline, 6 months, and 12 months. Depression and anxiety symptoms, as well as participants' weight and height, were collected at each assessment. The cross-sectional associations between obesity and depression or anxiety were examined through ANOVA and Chi-square tests. Multivariable logistic regression analyses were performed to investigate their longitudinal bidirectional associations.

RESULTS

The prevalence of obesity reached a peak in the age group between 12 and 14 years. Concurrently, higher mean BMI and obesity prevalence were associated with more severe symptoms of depression and anxiety in each age group (ps < 0.001). Longitudinally, depression and anxiety significantly increased the risk of development of obesity over time (odds ratios [ORs] = 1.08 to 1.77). Moreover, obesity significantly aggravated the risk of development of depression (ORs = 1.17 to 1.68) and anxiety (ORs = 1.25 to 1.71) over time and hindered the alleviation of depressive (ORs = 0.68 to 0.79) and anxiety symptoms (ORs = 0.73 to 0.74).

CONCLUSION

Findings suggest that there were bidirectional associations between obesity and psychological distress. It may be important to continuously track BMI and psychological conditions for children and adolescents over time to avoid the reinforcement of their negative reciprocal interactions.

The course of children's mental health symptoms during and beyond the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic is associated with increases in child mental health problems, but the persistence of these changes in the post-pandemic era remains uncertain. Additionally, it is unclear whether changes in mental health problems during the pandemic exceed the anticipated increases as children age. This study controls for the linear effect of age in 1399 children, investigating the course of child-reported anxiety, depression, hyperactivity, and inattention symptoms during and after the pandemic, and identifies risk and protective factors that predict these mental health trajectories.

METHODS

Children (51% male; ages 9-11 at the first timepoint) provided mental health ratings at three pandemic timepoints (July-August 2020; March-April 2021; November 2021-January 2022) and one post-pandemic timepoint (January-July 2023). Mothers reported pre-pandemic mental health (2017-2019) and socio-demographic factors. Children reported socio-demographic factors, risk (e.g. screen time, sleep), and resilience (e.g. optimism) factors during the first timepoint.

RESULTS

Average mental health symptoms increased over time, with more children exceeding clinical cut-offs for poor mental health at each subsequent pandemic timepoint. Growth curve modeling, adjusting for age-related effects, revealed a curvilinear course of mental health symptoms across all domains. Examination of risk and protective factors revealed that pre-existing mental health symptoms and optimism were associated with the course of symptoms.

CONCLUSIONS

After considering age effects, children's mental health follows a curvilinear pattern over time, suggesting an initial decline followed by a rising trend in symptoms post-COVID. These findings underscore the continued need for additional resources and timely, evidence-based mental health prevention and intervention for children.

Exploring the Prevalence and Predictors of Anxiety among Lithuanian Adolescents during Times of Crisis: A Cross-Sectional Study

Recent events in Europe, like the COVID-19 pandemic and the 2022 Russo-Ukrainian War (RUW), might have sparked anxiety among adolescents. This study aimed to compare anxiety levels in Lithuanian adolescents post-COVID-19 peak (Study 1, October 2021) and during the onset of the RUW (Study 2, April-June 2022). Data from 459 participants in Study 1 and 6637 in Study 2, aged 11-17, were collected through HBSC pilot and national surveys in Lithuania. Self-reported questionnaires assessed anxiety, social media use, stress, loneliness, self-efficacy, and peer support factors. Analysis was conducted using multivariable logistic regressions. Notably, anxiety prevalence in Lithuanian adolescents showed no significant difference between Study 1 and Study 2, stabilizing around 24%. In 2021, stress (OR = 5.89, 95% CI 3.11-11.17), problematic social media use (OR = 4.58, 95% CI 1.89-10.58), and female gender (OR = 2.87, 95% CI 1.58-5.22) significantly predicted anxiety. By 2022, stress (OR = 3.68, 95% CI 3.14-4.30), loneliness (OR = 2.85, 95% CI 2.43-3.35), and lower self-efficacy (OR = 1.40, 95% CI 1.20-1.60) emerged as important predictors. This study enhances our understanding of adolescent anxiety during crises, emphasizing the urgency of addressing multiple factors to manage and support vulnerable youth.

Trajectories of child mental health, physical activity and screen-time during the COVID-19 pandemic considering different family situations: results from a longitudinal birth cohort

BACKGROUND

Many authors have described a significant mental health burden on children and adolescents during the COVID-19 pandemic, possibly moderated by social disparities. This analysis explores whether pre-pandemic family circumstances might be related to different aspects of child health during the pandemic.

METHODS

We analyzed trajectories of health-related outcomes in children aged 5 to 9 years (T7 to T11) using the Ulm SPATZ Health study, a population based birth cohort study (baseline 04/2012-05/2013) conducted in the South of Germany. Outcomes were children's mental health, quality of life, and lifestyle, such as screen time and physical activity. We conducted descriptive statistics of maternal and child characteristics before and throughout the pandemic. We defined three different groups of pre-pandemic family situations and used adjusted mixed models to estimate differences in means associated with the time during the pandemic vs. before the pandemic in (a) all children and in (b) children belonging to specific pre-pandemic family situations.

RESULTS

We analyzed data from n = 588 children from whom at least one questionnaire was completed between T7 and T11. When not considering the pre-pandemic family situation, adjusted mixed models showed statistically significant lower mean scores of health-related quality of life among girls during vs. before the COVID-19 pandemic (difference in means (b): - 3.9 (95% confidence interval (CI): - 6.4, - 1.4). There were no substantial differences in mental health, screen time, or physical activity in boys or girls. When considering pre-pandemic family situations, boys with mothers having symptoms of depression or anxiety showed a substantial loss of health-related quality of life on the subscale of friends (b: - 10.5 (95% CI: - 19.7, - 1.4)). Among girls in this group, 60% of the 15 assessed outcomes were negatively associated with a remarkable loss in health-related quality of life (e.g., KINDL-physical well-being difference in means: - 12.2 (95% CI: - 18.9, - 5.4)). Furthermore, a substantial increase in screen time was found (+ 2.9 h (95% CI: 0.3, 5.6)).

CONCLUSION

Our results suggest that the health (and behavior) of primary school-aged children is possibly impacted by the COVID-19 pandemic, with adverse consequences differing by gender and very likely by the pre-pandemic family situation. Especially in girls having a mother with depression or anxiety symptoms, the adverse consequences of the pandemic on mental health seem to be aggregated. Boys showed fewer adverse trajectories, and it needs to be further assessed which factors exactly are behind the (socio-economic) factors, such as maternal working habits and limited living space, when analyzing the effect of the pandemic on children's health.