Review: The mental health implications for children and adolescents impacted by infectious outbreaks - a systematic review

Post-traumatic Reactions and Social-Emotional Competence Among Chinese High School Students Experiencing COVID-19 Lockdown: A Network Analysis

In the post-pandemic era, psychological traumas have emerged as major mental health issues. However, the post-traumatic reactions and their connections with social-emotional competence among high school students experiencing COVID-19 lockdown have not been adequately explored. This study aimed to reveal the characteristics of their positive and negative post-traumatic reactions, and their connections with social-emotional competence. Network analysis was used on data from 1096 Chinese high school students who experienced COVID-19 lockdown. Measures included the DSECS-S, the PTGI and the PC-PTSD-5. The results revealed that "Valuing life" and "Recalling unwillingly" were identified as core factors of post-traumatic reactions, while "Having close friendships", "Getting along well with others" and "Respecting others' emotions" played a bridging role in connecting the communities of social-emotional competence and post-traumatic reactions. This study enriches research on post-traumatic reactions, emphasizing the importance of implementing social-emotional competence programs to tackle mental health crises.

Prevalence of depression, anxiety and stress and their risk and protective factors among secondary students in Rwanda during the first wave of COVID-19 pandemic

INTRODUCTION

Compelling evidence shows that the COVID-19 pandemic has detrimental effects on the mental health of university students. However, little is known about the psychological distress experienced by students from high schools during the pandemic. This study, therefore, sought to examine the prevalence of depression, anxiety and stress and their associated factors among students from high schools in Rwanda.

METHODS AND MATERIALS

A retrospective, cross-sectional study was conducted on 384 students randomly selected from high schools. Data were collected using standardized measures of mental disorders and their associated factors. Bivariate and multivariate analyses based on the odds ratio were used to indicate the associated factors of anxiety, depression, and stress.

RESULTS

The results indicated that slightly above half of the participants (51%, n = 195) had clinically significant symptoms of depression, 30.3% (n = 116) had stress and 67.3% (n = 259) had anxiety. Our analyses identified several key risk factors associated with increased odds of these mental disorders. These include exposure to domestic violence, COVID-19 symptoms like cough and myalgia, eating twice per day, having one of the three mental disorders, gender, with females showing higher susceptibility, and direct contact with the people who positively tested covid-19. Conversely, protective factors such as heightened awareness about Covid-19, positive mental health, social support, eating three times, belonging to the third Ubudehe category, and a high resilience emerged as significant elements mitigating the risks of these mental health challenges within our sample. Intriguingly, religious affiliation emerged as a notable factor, with students affiliated with the Witness of Jehovah and Adventist denominations exhibited lower risks for depression and anxiety.

CONCLUSION

Our findings highlighted a high prevalence of depression, anxiety, and stress among students from secondary schools. Interestingly, this study also revealed the associated risk and protective factors of depression, anxiety, and stress in Rwandan students in high schools. Therefore, mental health interventions targeting the impact of COVID-19 on students, as young people are needed.

A latent class analysis of dissociative PTSD subtype among Chinese adolescents following the COVID-19 pandemic and lockdown

BACKGROUND

The COVID-19 pandemic and related policies have amplified the vulnerability of adolescents to the development of posttraumatic stress disorder (PTSD) and dissociation symptoms. This study sought to explore the profile patterns and psychopathological characteristics of co-occurring PTSD and dissociation symptoms in Chinese adolescents.

METHODS

A total of 57,984 junior and senior high school students in Deyang City, China were recruited between July 13 and July 19, 2020. PTSD and dissociation symptoms, risk factors, and functional impairment variables were assessed using the Global Psychotrauma Screen for Teenagers (GPS-T) instrument. Latent class analysis (LCA) was employed to examine the phenomenology and risk factors of co-occurring PTSD and dissociation symptoms. Analysis of Variance (ANOVA) was utilized to investigate differences in COVID-19 pandemic-related exposure and functional impairment across distinct symptom profiles.

RESULTS

A 4-class model was selected as the optimal solution, comprising subgroups of low symptom, predominant PTSD symptom, predominant dissociation symptom, and PTSD-dissociation symptom. Class membership could be significantly predicted by other stressful experiences, social support, childhood maltreatment and psychiatric histories. The PTSD-dissociation symptom class exhibited the most severe COVID-19 pandemic-related exposure and functional impairment among all classes.

LIMITATIONS

The cross-sectional design, Chinese cultural background, online survey method and oversimple measurements were the limitations.

CONCLUSIONS

Our findings extend existing knowledge about the coexisting patterns of PTSD and dissociation symptoms in adolescents, which could assist in identifying high-risk youths. Furthermore, our findings offer recommendations for shaping public health policies and formulating effective clinical interventions for adolescents following the COVID-19 pandemic and lockdown.

The Up-Side of the COVID-19 Pandemic: Are Core Belief Violation and Meaning Making Associated with Post-Traumatic Growth?

The negative impact of the COVID-19 pandemic on mental health has been extensively documented, while its possible positive impact on the individual, defined as Post-Traumatic Growth (PTG), has been much less investigated. The present study examines the association between PTG and socio-demographic aspects, pre-pandemic psychological adjustment, stressors directly linked to COVID-19 and four psychological factors theoretically implicated in the change processes (core belief violation, meaning-making, vulnerability and mortality perception). During the second wave of the pandemic 680 medical patients completed an online survey on direct and indirect COVID-19 stressors, health and demographic information, post-traumatic growth, core belief violation, meaning-making capacity, feelings of vulnerability and perceptions of personal mortality. Violation of core beliefs, feelings of vulnerability and mortality, and pre-pandemic mental illness positively correlated with post-traumatic growth. Moreover, the diagnosis of COVID-19, stronger violation of core beliefs, greater meaning-making ability, and lower pre-existing mental illness predicted greater PTG. Finally, a moderating effect of meaning-making ability was found. The clinical implications were discussed.

The Resilience of Caregivers and Children in the Context of COVID-19: A Systematic Review

The COVID-19 pandemic has necessitated caregivers and school-aged children to adapt to ongoing changes and uncertainty. Understanding why some caregivers and school-aged children area able to adapt and others are not could be attributed to resilience. The relationships between caregiver or child resilience and socioeconomic status (SES) in the context of COVID-19 remain largely un-explored. Therefore, the purpose of this qualitative systematic review was to explore (1) what is currently known about the relationship between caregiver and child resilience in the context of COVID-19; and (2) the role of SES on caregiver or child resilience throughout the COVID-19 pandemic. Four databases (i.e., MEDLINE, Scopus, PsycINFO, and CINAHL) were systematically searched, title/abstract and full-text screening were conducted, and 17 articles met the inclusion criteria (i.e., discussed resilience of caregivers/children during COVID-19, mean age of children between 7-10, primary research/grey literature, English), including 15 peer-reviewed and two grey literature sources. Thematic analysis revealed five themes: (1) the mitigating effects of child resilience; (2) overcoming the psychological toll of the pandemic; (3) the unknown relationship: caregiver and child resilience; (4) family functioning during COVID-19; and (5) the perfect storm for socioeconomic impacts. Results from this review provide the first synthesis of the impact of the COVID-19 pandemic on the resilience of caregivers and school-aged children. Future research should conduct longitudinal data collection to understand the possible long-term impacts of the pandemic on these populations' resilience. Understanding these impacts will be integral to assisting families in bouncing back from the long-lasting adverse circumstances caused by the COVID-19 pandemic.

The relationship between fear of COVID-19 and psychological resilience according to personality traits of university students: A PATH analysis

PURPOSE

The purpose of the current research was to identify the influence of university students' personality traits on their fear of COVID-19 and psychological resilience levels.

DESIGN AND METHODS

A cross-sectional trial was completed with 690 students. Descriptive statistics and correlations were calculated, and a path analysis was employed with the objective of assessing the model fit and investigating direct and indirect impacts.

FINDINGS

Among personality traits, conscientiousness and neuroticism were observed to affect fear of COVID-19, and conscientiousness, neuroticism, and openness to experience had an effect on psychological resilience. The tested model has a good fit and explains the direct effects of the study variables.

PRACTICE IMPLICATIONS

Nurses should improve university students' psychological resilience by supporting them with protective and improving factors. The role of the psychiatric nurse is important in providing conscious and need-oriented support in extraordinary events such as pandemics.

Implementation of a Transdiagnostic Universal Prevention Program on Anxiety in Junior High School Students After School Closure During the COVID-19 Pandemic

School closures due to the coronavirus disease 2019 (COVID-19) pandemic have worsened mental health problems for children and adolescents worldwide. We aimed to examine the follow-up effectiveness of a transdiagnostic universal prevention program for anxiety of junior high school students after a nationwide school closure during the COVID-19 outbreak in Japan. A total of 117 junior high school students were included in the analysis. We used the Unified Universal Prevention Program for Diverse Disorders (Up2-D2) program; the Up2-D2 comprises cognitive-behavioral and positive psychological interventions provided over twelve 45-minute sessions. The program was originally implemented between June and July 2020, immediately after pandemic-related school closures had ended in Japan. The program assessments were based on students' responses to a questionnaire incorporating five scales to measure indicators such as internalizing and externalizing problems. Assessments were carried out before, immediately after, two-month, and six-month after implementing the program. Mixed models for the whole sample showed small anxiety improvement effects immediately post-intervention and two-month, and six-month assessments (g = -0.25, g = -0.44, and g = -0.30, respectively). The anxiety reducing effects were even greater for the higher-anxiety group at the post-, 2-month, and 6-month assessments (g = -1.48; g = -1.59; g = -1.06, respectively). Although there was no control group, these results indicate that the transdiagnostic universal prevention intervention reduce only anxiety, but not other outcomes (depression, anger, and self-efficacy) in junior high students returning to school following school closures related to the COVID-19 pandemic in Japan.

Role of emotion regulation capacities in affective state among Chinese high school students in the post-pandemic era of COVID-19

Objective

Psychological wellbeing and emotion regulation skills of vulnerable adolescents have been severely threatened by the long-term impact of the ongoing COVID-19 pandemic. The aim of this study was to seek out the potentially effective emotion regulation strategies to minimize the mental health risk of adolescents during the COVID-19 post-pandemic era.

Methods

A total of 436 high school students aged 16.07 ± 1.08 years were included in this cross-sectional study to complete questionnaires to self-report socio-demographic information, positive and negative affect state, and emotional regulation abilities. Student's t-test and one-way analysis of variance (ANOVA) were used for intergroup comparisons among socio-demographic variables. Pearson's correlation analysis was used for evaluating the association between each emotion regulation strategy and positivity or negativity. Multiple stepwise linear regression analysis was used for the determination of the predictors for adolescents' positivity and negativity.

Results

Adolescents' affect was influenced by multiple emotion regulation strategies, including cognitive reappraisal, acceptance and engagement, difficulty in awareness, acceptance, and modification of emotions after adjusting for a range of socio-demographic variables.

Conclusion

Overall, our findings highlight the importance of emotional regulation strategies in the modulation of the mental health of the vulnerable youth population in China during the COVID-19 crisis. In view of the continuous, multifaceted influence on adolescents' mental health of the ongoing pandemic, more effort should be made to leverage emotion regulation strategies to benefit their coping abilities.

The Trap of the COVID-19 Pandemic: Italian Adolescents Fare Well at First, Maybe Thanks to Protective Trait Expression

Abundant research indicates that the COVID-19 pandemic has been negatively affecting mental health in adolescence. Few works, however, benefit from data from the same sample before and after the onset of the pandemic. The present longitudinal study involved a non-clinical group of 136 Italian adolescents (Mage = 16.3 years ± 1.08, 67% girls) to investigate their psychological response to the first lockdown and explore the role of a protective trait (i.e., Positivity) in moderating the effect of Intolerance of Uncertainty (IU) on internalizing symptoms before and during the COVID-19 outbreak. Participants completed self-report questionnaires assessing psychopathological symptoms, psychological well-being, IU, and Positivity on three separate occasions: October 2019 (T1), January 2020 (T2), and April 2020 (T3). The results showed that internalizing and externalizing symptoms as well as psychological well-being did not vary significantly over time. Positivity was found to significantly moderate the relationship between IU and internalizing symptoms at T3 (i.e., during the COVID-19 lockdown) only. Overall, our findings suggest that the teenagers' good adjustment to the initial phase of the pandemic might have been associated with the enhanced weight of the Positivity trait, which may have encouraged a positive attitude towards self, life, and the future.

A meta-review of psychological resilience during COVID-19

Psychological resilience has emerged as a key factor in mental health during the global COVID-19 pandemic. However, no work to date has synthesised findings across review work or assessed the reliability of findings based on review work quality, so as to inform public health policy. We thus conducted a meta-review on all types of review work from the start of the pandemic (January 2020) until the last search date (June 2021). Of an initial 281 papers, 30 were included for review characteristic reporting and 15 were of sufficient review quality for further inclusion in strategy analyses. High-level strategies were identified at the individual, community, organisational, and governmental levels. Several specific training and/or intervention programmes were also identified. However, the quality of findings was insufficient for drawing conclusions. A major gap between measuring the psychological resilience of populations and evaluating the effectiveness of strategies for those populations was revealed. More empirical work, especially randomised controlled trials with diverse populations and rigorous analyses, is strongly recommended for future research.

COVID-19 and Australian school psychology: Qualitative perspectives for enhancing future practice

The challenges and changes driven by the Coronavirus Disease 2019 (COVID-19) pandemic in the education sector have been linked to high rates of anxiety, depression, and post-traumatic symptoms in school-aged populations. Despite this, it is also acknowledged that children and young people can be resilient and adaptable, with the right support in place. In schools, psychologists play an important role in supporting students' learning, behavior, wellbeing, and mental health. The aim of this study is to investigate the practices of Australian school psychologists during COVID-19 related school closures, focusing on their experiences and challenges and how they adapted their practices. Twelve Australian school psychologists were interviewed and, after member checks were undertaken, interview transcripts were analyzed using thematic analysis. Six interrelated themes were identified including: (a) heightened student psychological stress, (b) alternative delivery modes and associated challenges, (c) close collaboration with families, (d) participants personal challenges during COVID-19, (e) assessment during COVID-19, and (f) possible long-term practice changes post pandemic. The results of this study have implications for policies to support students in future pandemics or where physical school attendance is disrupted (e.g., natural disasters).

Hiding and seeking: Children's lived experiences during COVID-19

A qualitative study explored the perspectives and lived experiences of school-age children during COVID-19 using a child rights lens. Twenty children between the ages of 7 and 12 participated in open-ended, virtual interviews. Our hermeneutic analysis found children's right to play and education were severely compromised leaving children to navigate between two worlds: the adult world of public health restrictions and that of their childhood. Despite challenges and lost childhood opportunities, children emerged as competent social agents and responsible citizens. Planning for future pandemics should include policies and practices that balance public health needs with the protection of children's rights.

'We can play tag with a stick'. Children's knowledge, experiences, feelings and creative thinking during the COVID-19 pandemic

Using a relational approach, we draw on repeated interviews with a group of 30 diverse children from Ontario to share and reflect on their knowledge, experiences and feelings early in the COVID-19 pandemic. Prioritising relational interdependence and relational agency, this paper illustrates our participants' embedded engagements with the pandemic and their contribution to the co-production of knowledge. We emphasise their thoughtful responses to the pandemic; their creative, self-reflexive strategies for managing a difficult time; and their advice to others. We thus prioritise children's viewpoints and emphasise their relational interconnections with others during a time that was marked by social isolation.

Potential indirect impacts of the COVID-19 pandemic on children: a narrative review using a community child health lens

▪In this narrative review, we summarise the vast and burgeoning research on the potential and established indirect impacts on children of the COVID-19 pandemic. We used a community child health lens to organise our findings and to consider how Australia might best respond to the needs of children (aged 0-12 years). ▪We synthesised the literature on previous pandemics, epidemics and natural disasters, and the current COVID-19 pandemic. We found clear evidence of adverse impacts of the COVID-19 pandemic on children that either repeated or extended the findings from previous pandemics. ▪We identified 11 impact areas, under three broad categories: child-level factors (poorer mental health, poorer child health and development, poorer academic achievement); family-level factors that affect children (poorer parent mental health, reduced family income and job losses, increased household stress, increased abuse and neglect, poorer maternal and newborn health); and service-level factors that affect children (school closures, reduced access to health care, increased use of technology for learning, connection and health care). ▪There is increasing global concern about the likely disproportionate impact of the current pandemic on children experiencing adversity, widening existing disparities in child health and developmental outcomes. ▪We suggest five potential strategy areas that could begin to address these inequities: addressing financial instability through parent financial supplements; expanding the role of schools to address learning gaps and wellbeing; rethinking health care delivery to address reduced access; focusing on prevention and early intervention for mental health; and using digital solutions to address inequitable service delivery.

Adolescents, Suicide, and the COVID-19 Pandemic

The coronavirus disease 2019 pandemic has vastly disrupted the lives of youth. Stressors related to the pandemic and related lockdown measures have increased the prevalence of adolescent depression, suicidal ideation, and suicide attempts, with their mental and psychosocial development making them highly vulnerable to isolating restrictions. Research has demonstrated increased loneliness and decreased social support among adolescents during the pandemic. Increased social media usage has further affected depression among adolescents. Pandemic-related stressors such as fear of illness or life changes have negatively affected adolescent mental well-being. Health care use during the pandemic has involved disruption in primary care suicide screening, patterns of suicide-related presentations in emergency departments, and access to mental health services. Health care providers can support adolescent mental health through consistent screening, effectively coordinating referral for mental health evaluation, and providing family guidance on resiliency, pandemic-related mental health risks, and suicide prevention. [Pediatr Ann. 2022;51(4):e144-e149.].

Impact of COVID-19 on School Populations and Associated Factors: A Systematic Review

Apart from the severe impact on public health and well-being, the chain effect resulting from the COVID-19 health crisis is a profound disruption for various other sectors, notably in education. COVID-19 has driven massive transformation in many aspects of the educational landscape, particularly as teaching and learning shifted online due to school closure. Despite the many impacts of the health crises on school populations, a systematic review regarding this particular issue has yet to be conducted. This study, therefore, attempts to comprehensively review the impact of health crises on school populations (student, teacher, parent, and school administration). An extensive literature search guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting checklist was performed in two selected databases, namely Web of Science (WoS) and Scopus to identify how this particular topic was previously studied. Exclusion and inclusion criteria were set to ensure that only research papers written in English from the year 2000 to the present (April 2021) were included. From a total of 457 studies screened, only 41 of them were deemed eligible to be included for qualitative synthesis. The findings revealed that the COVID-19 pandemic was the only health crisis discussed when it comes to investigating the impact of health crises on school populations. This study found four notable consequences of health crises on school populations, which are impacts on mental health, teaching and learning, quality of life, and physical health. Among factors associated with the impact of the health crises are; demographic factors, concerns about the pandemic, education-related factors, health-related factors, geographic factors, economic concerns, teaching challenges, and parenting in the pandemic. This study is expected to be a reference for future works in formulating crises mitigation strategies to reduce the impact of health crises on schools by exploring the contexts of the crises.

Early childhood educators' psychological distress and wellbeing during the COVID-19 pandemic

There is growing awareness of the impacts of COVID-19 on children, families, and more recently, early childhood educators. This study aimed to add to this research and explore Australian early childhood educators' psychological distress and wellbeing in relation to COVID-19. Accordingly, 205 educators (117 early childhood educators, 86 leaders and 2 others) completed the Impact of Event Scale-Revised, measuring levels of post-traumatic distress, and an open-ended question on wellbeing, both in relation to COVID-19. Educators' responses to the open-ended question were matched to those who scored high, medium, and low on the Impact of Events Scale-Revised. Results demonstrated 66.8% of educators scored in the low range for post-traumatic distress, 11.7% scored in the moderate range, and 21.5% scored in the high range for post-traumatic distress on the Impact of Events Scale-Revised. Participants scoring in the low range on the Impact of Events Scale-Revised provided fewer comments regarding the emotional impacts of COVID-19. There were no differences between the groups in terms of fear of COVID-19 infection, challenges related to increased workload during the pandemic, and frustration with the Australian government response to COVID-19. Educators and early childhood leaders reported comparable wellbeing challenges during the pandemic. This research has implications for the types of support provided to educators during future pandemics.

It Takes a Village to Raise a Child: Understanding and Expanding the Concept of the “Village”

This perspective article defines and discusses the concept of the “village” when working with families who are experiencing multiple adversities. The article starts with a discussion on what is meant generally by a village approach, followed by a historical overview of how families living in adversity have been defined and positioned. The need to move past a siloed, professional centric approach when working with families is then presented. Using a model of social connections, based on Bronfenbrenner's ecological theory, we then identify who the “villagers” might be. Some potential principles for how the village might work with families living with adversity are presented, along with two case studies, to demonstrate how these principles might be enacted. This perspective article provides an overview and discussion of “the village” concept, rather than present a definitive set of guidelines or recommendations.

Anxiety, depression, and PTSD symptoms among high school students in china in response to the COVID-19 pandemic and lockdown

AIMS

This study aimed to investigate the prevalence of anxiety, depression and PTSD symptoms, and associated risk factors among a large-scale sample of adolescents from China after the pandemic and lockdown.

METHOD

A total of 57,948 high school students took part in an online survey from July 13 to 29, 2020. The mental health outcomes included anxiety, depression and PTSD symptoms. Risk factors included negative family relationships, COVID-19 related exposure, and a lack of social support.

RESULTS

The prevalence of anxiety, depression and PTSD symptoms was 7.1%, 12.8%, and 16.9%, respectively. COVID-19 related exposure significantly linked to the mental health outcomes (all p < .001). The most important predictors for the mental health outcomes were family relationship and social support (all p < .001).

CONCLUSION

The pandemic may have long-term adverse mental health consequences among adolescents. Adverse family relationships and lack of social support could be the major risk factors for the post-pandemic mental health outcomes of adolescents.

Repercussions of the COVID-19 pandemic on child and adolescent mental health: A matter of concern-A joint statement from EAP and ECPCP

COVID-19 pandemic and the consequent rigid social distancing measures implemented, including school closures, have heavily impacted children's and adolescents' psychosocial wellbeing, and their mental health problems significantly increased. However, child and adolescent mental health were already a serious problem before the Pandemic all over the world. COVID-19 is not just a pandemic, it is a syndemic and mentally or socially disadvantaged children and adolescents are the most affected. Non-Communicable Diseases (NCDs) and previous mental health issues are an additional worsening condition. Even though many countries have responded with decisive efforts to scale-up mental health services, a more integrated and community-based approach to mental health is required. EAP and ECPCP makes recommendations to all the stakeholders to take action to promote, protect and care for the mental health of a generation.

Investigating the Impact of Isolation During COVID-19 on Family Functioning - An Australian Snapshot

This study explored possible changes in family functioning from the perspective of parents during the COVID-19 pandemic. Thirty-four parents/guardians of children under 18 years completed a semi-structured interview, average length 47 min. Interviews focussed on changes in different aspects of family functioning including family roles, routines, and rules; parenting practices; communication and relationships; and strengths, challenges, and tensions. Data were analysed using reflexive thematic analysis applied in an idiographic and inductive manner to reduce the loss of individual experiences and perspectives. Four superordinate themes were identified: shifting family roles and boundaries throughout the pandemic; impacts on routines and relationships; opportunities and resourcing; and, experiences of support and unity. Gender differences were evident across some themes, particularly changing roles, workload and work-home boundaries. Challenges and tensions were frequently highlighted, particularly by "vulnerable" family groups such as those with children with disabilities. Parents also described a renewed sense of family and community that underpinned adaptive coping responses. The results highlight the importance of family connectedness in times of need.

The Ecology of Youth Psychological Wellbeing in the COVID-19 Pandemic

The consequences of profound disruption to everyday life caused by the COVID-19 pandemic will only emerge over time. Guided by ecological systems (Pitchik et al., 2021) and developmental psychopathology (Masten & Cicchetti, 2010) frameworks, I review evidence that points to parents at home with children as particularly vulnerable to increased psychological difficulties, particularly in contexts of poverty. Resultant compromised parenting may reduce children's opportunities for the kinds of everyday interactions that promote cognitive and socioemotional development and expose them to increases in coercive, avoidant, and other problematic caregiving behaviours. I discuss three evidence-based strategies that parents could adopt to buffer their child's mental health: building positive discipline strategies, talking with the child about the pandemic and its consequences, and conversing about the past. I conclude, however, that approaches to supporting parents and their children at this time must also address multisystem factors that compromise caregivers' ability to provide nurturing care.

Increase in depression and anxiety disorder diagnoses during the COVID-19 pandemic in children and adolescents followed in pediatric practices in Germany

The coronavirus pandemic and related restrictions impacted the daily lives of children and youth, partly due to the closure of schools and the absence of outdoor activities. The aim of this study was to investigate, quantify, and critically discuss the effect of the pandemic and related restrictions on consultations pertaining to depression and anxiety disorders in children and adolescents. This retrospective cross-sectional study was based on medical record data from the Disease Analyzer database (IQVIA) and included all children and adolescents aged 2-17 years with at least one visit to one of 168 German pediatric practices between April 2019 and December 2019 (n = 454,741) or between April 2020 and December 2020 (n = 417,979). The number of children and adolescents with depression and anxiety disorder diagnoses per practice and the prevalence of these diagnoses were compared for April 2020-December 2020 versus April 2019-December 2019. The number of children and adolescents with depression and anxiety diagnoses per practice increased in April 2020-December 2020 compared to the same period in 2019 (anxiety: + 9%, depression: + 12%). The increase was much greater in girls than in boys (anxiety: + 13% vs. + 5%; depression + 19% vs. + 1%). The prevalence of anxiety disorder increased from 0.31 to 0.59% (p < 0.001), and that of depression from 0.23 to 0.47% (p < 0.001). The biggest increases were observed for girls (anxiety from 0.35 to 0.72% (+ 106%, p < 0.001), depression from 0.28 to 0.72% (+ 132%, p < 0.001). This study shows an increase in the number of pediatric diagnoses of depression and anxiety disorders in the pandemic year 2020 compared to the previous year.

COVID-19 and mental health in children and adolescents: a diagnostic panel to map psycho-social consequences in the pandemic context

Since the beginning of the COVID-19 pandemic, much research has been done on the psycho-social consequences, especially for children, adolescents and families. In the long run, there is a large set of quantitative data available. However, these still seem to be not well understood. Theoretical classifications of the evidence also diagnostic tools still seem to be open. This paper elaborates a possible systematisation based on theoretical models of systemic self-organisation theories. This leads to a model for a comprehensive psycho-social child-in-environment diagnostic to map potential problem areas. Such a theoretical framing should enable both: a deeper understanding of the impact of pandemics on young people and hypotheses for intervention strategies in the context of pandemic management as well as in the context of diagnostic-systemic interventions in psycho-social working settings. In the coming months and years, it will be essential to be able to understand and describe psychosocial disabilities that have developed in the context of the pandemic in a differentiated way in order to establish targeted interventions.

The COVID-19 pandemic: an opportunity to make mental health a higher public health priority

Coronavirus disease 2019 (COVID-19) was first recognised in December 2019. The subsequent pandemic has caused 4.3 million deaths and affected the lives of billions. It has increased psychosocial risk factors for mental illness including fear, social isolation and financial insecurity and is likely to lead to an economic recession. COVID-19 is associated with a high rate of neuropsychiatric sequelae. The long-term effects of the pandemic on mental health remain uncertain but could be marked, with some predicting an increased demand for psychiatric services for years to come. COVID-19 has turned a spotlight on mental health for politicians, policy makers and the public and provides an opportunity to make mental health a higher public health priority. We review longstanding reasons for prioritising mental health and the urgency brought by the COVID-19 pandemic, and highlight strategies to improve mental health and reduce the psychiatric fallout of the pandemic.

Consequences of the COVID-19 Pandemic on Children's Mental Health: A Meta-Analysis

Background: The COVID-19 pandemic has exacerbated mental health problems in many individuals, including children. Children with pre-existing socio-demographic or developmental risk factors may be particularly vulnerable to the negative effects of the pandemic and associated public health preventive measures. Objective: This systematic review and meta-analysis explored the impacts of the COVID-19 pandemic on the mental health of children aged 5-13 years-old, while highlighting the specific difficulties experienced by children with neurodevelopmental issues or chronic health conditions. Methods: A systematic search of the published literature was conducted in Medline, ERIC, PsycINFO, and Google Scholar, followed by a quantitative meta-analysis of the eligible studies. Results: Out of the 985 articles identified, 28 empirical studies with prospective or retrospective longitudinal data were included in the quantitative synthesis. COVID-19 lockdown measures were associated with negative general mental health outcomes among children (g = 0.28, p < 0.001, and k = 21), but of small magnitude. Sleep habits were also changed during the pandemic, as sleep duration significantly increased in children (g = 0.32; p = 0.004, and k = 9). Moreover, results did not differ between children from the general population and those from clinical populations such as children with epilepsy, oncology, neurodevelopmental disorders, or obesity. Effect sizes were larger in European vs. Asian countries. Conclusions: Studies included in this review suggest that children's mental health was generally negatively impacted during the COVID-19 pandemic. More research is needed to understand the long-term effects of the COVID-19 pandemic on children's mental health and the influence of specific risks factors as they evolve over time.