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Butter S, Shevlin M, Gibson-Miller J, McBride O, Hartman TK, Bentall RP, Bennett K, Murphy J, Mason L, Martinez AP, Levita L. Psychological distress, wellbeing and resilience: modelling adolescent mental health profiles during the COVID-19 pandemic. DISCOVER MENTAL HEALTH 2024; 4:16. [PMID: 38780717 PMCID: PMC11116324 DOI: 10.1007/s44192-024-00071-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/21/2024] [Indexed: 05/25/2024]
Abstract
There has been concern about adolescent mental health during the pandemic. The current study examined adolescent mental health during the initial phase of the COVID-19 pandemic in the UK. Using indicator of psychological distress, wellbeing and resilience, latent profile analysis was used to identify homogeneous mental health groups among young people aged 13-24 (N = 1971). Multinomial logistic regression was then used to examine which sociodemographic and psychosocial variables predicted latent class membership. Four classes were found. The largest class (Class 1, 37.2%) was characterised by moderate symptomology and moderate wellbeing. Class 2 (34.2%) was characterised by low symptomology and high wellbeing, while Class 3 (25.4%) was characterised by moderate symptomology and high wellbeing. Finally, Class 4 was the smallest (3.2%) and was characterised by high symptomology and low wellbeing. Compared to the low symptomology, high wellbeing class, all other classes were associated with less social engagement with friends, poorer family functioning, greater somatic symptoms, and a less positive model of self. A number of unique associations between the classes and predictor variables were identified. Although around two-thirds of adolescents reported moderate-to-high symptomology, most of these individuals also reported concurrent moderate-to-high levels of wellbeing, reflecting resilience. Furthermore, these findings demonstrate how a more comprehensive picture of mental health can be gained through adopting a dual-continua conceptualisation of mental health that incorporates both pathology and well-being. In this way, at-risk youth can be identified and interventions and resources targeted appropriately.
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Affiliation(s)
- Sarah Butter
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland.
| | - Mark Shevlin
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland
| | | | - Orla McBride
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland
| | - Todd K Hartman
- Department of Social Statistics, University of Manchester, Manchester, England
| | - Richard P Bentall
- Department of Psychology, University of Sheffield, Sheffield, England
| | - Kate Bennett
- Department of Psychology, University of Liverpool, Liverpool, England
| | - Jamie Murphy
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland
| | - Liam Mason
- Division of Psychology and Language Sciences, University College London, London, England
| | - Anton P Martinez
- Department of Psychology, University of Sheffield, Sheffield, England
| | - Liat Levita
- School of Psychology, University of Sussex, Falmer, England
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2
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Ojio Y, Shiozawa T, Gregorio ER, Leynes MC, Hernandez PMR, Estrada CAM, Fuyama T, Kobayashi J, Satake N. An international interdisciplinary approach to developing video educational materials promoting mental health literacy among adolescents in the Philippines. Early Interv Psychiatry 2024. [PMID: 38772864 DOI: 10.1111/eip.13545] [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: 07/10/2023] [Revised: 04/18/2024] [Accepted: 05/06/2024] [Indexed: 05/23/2024]
Abstract
AIM Adolescent mental ill-health is a common international challenge affecting both high- and lower-middle-income countries. The Republic of the Philippines enacted its first mental health law in 2019, underlining the importance of the promotion of adolescent mental health education in schools. In Japan, course instructions about mental ill-health were formulated in a Course of Study that reflects governmental curriculum guidelines. Embedded since 2022, the Course of Study aimed to promote an understanding of current issues of adolescent health. The National Center for Global Health and Medicine in Japan has been sharing experience of promoting public health practices and advancing medical technology in low- and middle-income countries, especially in the Western Pacific region. This paper describes the development process and content of these resources by an interdisciplinary team from Japan and the Philippines. METHODS The interdisciplinary team created an embedded mental health education programme using animated videos for the Philippine school curriculum to improve mental health literacy in adolescents. RESULTS Two six-minute animated videos of age-relevant stories were created. The animation scenarios illustrate: 1) mental health problems and recovery; and 2) major symptoms of mental illnesses, including depression, anxiety, and schizophrenia. Each animated video presents several items for discussion among students and/or teachers, both in class and online for students unable to attend school. CONCLUSION Our efforts may provide good opportunities for enhancing adolescents' mental health activities in the Philippines. In the following steps, we should investigate the effectiveness of school-based MHL using these animated videos with rigorous evaluation methods.
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Affiliation(s)
- Yasutaka Ojio
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takuma Shiozawa
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Nursing Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
- Nursing Innovation Research Center (NIReC), Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ernesto R Gregorio
- Department of Health Promotion and Education, College of Public Health, Manila, Philippines
| | - Maria Cynthia Leynes
- Department of Psychiatry and Behavioral Medicine, College of Medicine, Manila, Philippines
| | - Paul Michael R Hernandez
- Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila, Manila, Philippines
| | | | - Taruto Fuyama
- Department of Animation, Graduate School of Film and New Media, Tokyo University of the Arts, Tokyo, Japan
| | - Jun Kobayashi
- Department of Global Health, Graduate School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Naoko Satake
- Department of Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
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Nolvi S, Paavonen EJ, Korja R, Pelto J, Karukivi M, Tuulari JJ, Karlsson H, Karlsson L. Course of child social-emotional and sleep symptoms, parental distress and pandemic-related stressors during COVID-19. Dev Psychopathol 2024; 36:518-532. [PMID: 36794405 DOI: 10.1017/s0954579422001377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Research on the longitudinal courses of child social-emotional symptoms and sleep during the COVID-19 pandemic within societies would be of key value for promoting child well-being in global crises. We characterized the course of children's social-emotional and sleep symptoms before and throughout the pandemic in a Finnish longitudinal cohort of 1825 5- to 9-year-old children (46% girls) with four follow-up points during the pandemic from up to 695 participants (spring 2020-summer 2021). Second, we examined the role of parental distress and COVID-related stressful events in child symptoms. Child total and behavioral symptoms increased in spring 2020 but decreased thereafter and remained stable throughout the rest of the follow-up. Sleep symptoms decreased in spring 2020 and remained stable thereafter. Parental distress was linked with higher child social-emotional and sleep symptoms. The cross-sectional associations between COVID-related stressors and child symptoms were partially mediated by parental distress. The findings propose that children can be protected from the long-term adverse influences of the pandemic, and parental well-being likely plays a mediating role between pandemic-related stressors and child well-being. Further research focusing on the societal and resilience factors underlying family and child responses to the pandemic is warranted.
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Affiliation(s)
- Saara Nolvi
- Turku Institute for Advanced Studies, Department of Psychology and Speech-Language Pathology, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku. Medisiina A (307), Kiinamyllynkatu 10, 20014 Turun yliopisto, Turku, Finland
| | - E Juulia Paavonen
- Department of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland; Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riikka Korja
- Department of Psychology and Speech-Language Pathology, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Juho Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine and Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine & Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Jetro J Tuulari
- Turku Collegium for Science, Medicine and Technology; FinnBrain Birth Cohort Study, Turku Brain and Mind Center & Department of Psychiatry, Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center & Department of Psychiatry & Center for Population Health Research, Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study & Center for Population Health Research, Psychiatry, Paediatrics and Adolescent Medicine, Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
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Wolf K, Schmitz J. Scoping review: longitudinal effects of the COVID-19 pandemic on child and adolescent mental health. Eur Child Adolesc Psychiatry 2024; 33:1257-1312. [PMID: 37081139 PMCID: PMC10119016 DOI: 10.1007/s00787-023-02206-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
The COVID-19 pandemic and associated containment measures have massively changed the daily lives of billions of children and adolescents worldwide. To investigate the global longitudinal effects on various mental health outcomes over a period of 1.5 years, we conducted a scoping review in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We included the peer-reviewed articles from PubMed, Web of Science, and APA PsycInfo that were published between December 2019 and December 2021, followed a longitudinal or repeated cross-sectional design, and quantitatively assessed with clinical questionnaires the effect of the COVID-19 pandemic or a related stressor on mental health indicators in community samples of children and adolescents.The results of our qualitative analysis of 69 studies indicate a general trend of less psychological well-being and more mental health problems, such as heightened stress, and depressive and anxiety symptoms during the pandemic. Data suggest that both protection measure intensity and infection dynamics were positively associated with severity of the psychopathology. The most reported influencing factors were age, gender, socio-economic status, previous state of mental and physical health, self-regulation abilities, parental mental health, parenting quality, family functioning, social support, isolation and loneliness, health-related worries, and consistent routines and structure. Our results demonstrate that children and adolescents worldwide have experienced more mental health problems due to the COVID-19 pandemic. They call for improved access to child and adolescent mental health care and prioritisation of child and adolescent welfare in political decision making.
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Affiliation(s)
- Kristin Wolf
- Department of Clinical Child and Adolescent Psychology, Wilhelm-Wundt-Institute for Psychology, University of Leipzig, Leipzig, Germany.
| | - Julian Schmitz
- Department of Clinical Child and Adolescent Psychology, Wilhelm-Wundt-Institute for Psychology, University of Leipzig, Leipzig, Germany
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Shoshani A, Kor A. The longitudinal impact of the COVID-19 pandemic on adolescents' internalizing symptoms, substance use, and digital media use. Eur Child Adolesc Psychiatry 2024; 33:1583-1595. [PMID: 37540475 DOI: 10.1007/s00787-023-02269-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/29/2023] [Indexed: 08/05/2023]
Abstract
The present study examined the long-term effects of the COVID-19 pandemic on adolescent internalizing symptoms, substance use, and digital media use before and during the pandemic. A nationally representative longitudinal cohort of 3718 Israeli adolescents aged 12-16 at baseline completed measures of internalizing symptoms (anxiety, depression, and somatization), the prevalence of substance use (i.e., previous 30-day use of tobacco, alcohol, and cannabis), and average daily use of internet/television, video games, and social media. Social support and daily routines were assessed as potential protective factors for mental health. Data were collected in 10 public schools at four measurement points: before the Covid-19 outbreak (September 2019), after the first wave lockdown (May 2020), after the third wave lockdown (May 2021), and after the fifth wave of the pandemic (May 2022). Multi-level mixed models were used to analyze the longitudinal data. The results showed significant increases in internalizing symptoms, substance use (tobacco, alcohol, and cannabis), and daily screen time from the start of the study to the 33-month follow-up. Social support and daily routines moderated the increases in internalizing symptoms and digital media use. These findings highlight the need for public and educational mental health services to address the continuing impact of the pandemic on adolescents.
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Affiliation(s)
- Anat Shoshani
- Baruch Ivcher School of Psychology, Reichman University (IDC Herzliya), P.O.Box 167, 46150, Herzliya, Israel.
| | - Ariel Kor
- Baruch Ivcher School of Psychology, Reichman University (IDC Herzliya), P.O.Box 167, 46150, Herzliya, Israel
- School of Medicine, Yale University, New Haven, CT, USA
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Yang X, Lawrence AJ, Harrison P, Liu Y, Chen L, Wang C, Yan C, Zahn R. Positive effects of the COVID-19 pandemic on depression and anxiety in Chinese adolescents. Eur Child Adolesc Psychiatry 2024; 33:1551-1561. [PMID: 37486386 PMCID: PMC11098867 DOI: 10.1007/s00787-023-02263-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
The potential impact on mental health of home schooling and social isolation due to COVID-19 lockdowns has led to widespread concern, particularly for adolescents. However, studies including pre-pandemic data from longitudinal cohorts with an assessment of the longer-term impact of the Covid-19 pandemic beyond the first months of 2020 are scarce. This longitudinal study of 1534 adolescents attending a secondary school in Hunan province investigated self-reported symptoms of anxiety and depression using two validated scales (Screen for Child Anxiety Related Disorders, Child Mood and Feelings Questionnaire) at six time points before, during, and after the 2020 national lockdown restrictions in China. Perceived COVID-related stress was assessed by an author-developed scale at two timepoints during the lockdown. We investigated trends in symptoms over time with a fixed effects model and multiple imputations of missing data. Counter to our expectations, depressive and anxiety symptoms were reduced during the 2020 lockdown relative to pre-lockdown (depression: b = - 3.37, SE = 0.345, Cohen's d = - 0.25, p < 0.0001; anxiety: b = - 4.55, SE = 0.382, Cohen's d = - 0.30, p < 0.0001). Symptoms remained significantly reduced even after lockdown restrictions eased. Higher symptom levels during lockdown were associated with greater self-reported COVID-related stress (depression: b = 0.11, SE = 0.026, p < 0.0001; anxiety: b = 0.11, SE = 0.036, p < 0.0001). Although COVID-related stresses correlated with higher levels of anxiety and depression, the lockdown period was associated with improved symptom levels in the adolescents taking part in our study. School closures may have improved the mental health of adolescents in China. We speculate this beneficial effect of lockdown can be explained by the adverse effects of attending school itself such as exposure to bullying and achievement pressures.
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Affiliation(s)
- Xinhua Yang
- Changning Mental Health Center, 299 Xiehe Road, Changning District, Shanghai, 200335, China.
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Andrew J Lawrence
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Phillippa Harrison
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yanlong Liu
- The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Liangliang Chen
- Changning Mental Health Center, 299 Xiehe Road, Changning District, Shanghai, 200335, China
| | - Chenglei Wang
- Changning Mental Health Center, 299 Xiehe Road, Changning District, Shanghai, 200335, China
| | - Chao Yan
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Roland Zahn
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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7
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Gotra M, Lindberg K, Jasinski N, Scarisbrick D, Reilly S, Perle J, Miller L, Mahoney Iii J. Changes in the Clinical Practice of Mental Health Service Providers Throughout the COVID-19 Pandemic: Longitudinal Questionnaire Study. JMIR Form Res 2024; 8:e50303. [PMID: 38683653 PMCID: PMC11060325 DOI: 10.2196/50303] [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: 06/26/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic impacted the practices of most mental health providers and resulted in a rapid transition to providing telemental health services, changes that were likely related to stay-at-home policies as well as increased need for services. OBJECTIVE The aim of this study was to examine whether these changes to practice have been sustained over time throughout the course of the COVID-19 pandemic and whether there are differences among mental health provider type and setting. We hypothesized that there would be an increase in the number of patients seen in person after the initial surge of the pandemic in spring 2020 and subsequent discontinuation of stay-at-home policies, though with continued implementation of telemental health services across settings. METHODS This study surveyed 235 of the 903 mental health providers who responded to a survey in spring 2020 (Time point 1) and at a 1-year follow-up in spring 2021 (Time point 2). Differences in practice adjustments, factors related to telemental health, and number of patients seen were examined across provider type (social worker, psychologist, neuropsychologist) and setting (academic medical center [AMC], community mental health, private practice, and Veterans Affairs hospital). RESULTS From Time point 1 to Time point 2, there was a small but significant increase in the overall number of providers who were implementing telehealth (191/235, 81% to 204/235, 87%, P=.01) and there was a significant decline in canceled or rescheduled appointments (25%-50% in 2020 to 3%-7% in 2021, P<.001). Psychologists and providers working at AMCs reported decreased difficulty with telehealth implementation (P<.001), and providers working at AMCs and in private practice settings indicated they were more likely to continue telehealth services beyond spring 2021 (P<.001). The percent of time working remotely decreased overall (78% to 59%, P<.001), which was most notable among neuropsychologists and providers working at an AMC. There was an overall increase in the average number of patients seen in person per week compared with earlier in the pandemic (mean 4.3 to 8.7, P<.001), with no change in the number of patients seen via telehealth (mean 9.7 to 9.9, P=.66). CONCLUSIONS These results show that the rapid transition to telemental health at the onset of the COVID-19 pandemic in spring 2020 was sustained over the next year, despite an overall increase in the number of patients seen in person. Although more providers reported returning to working on-site, over 50% of providers continued to use a hybrid model, and many providers reported they would be more likely to continue telemental health beyond spring 2021. This suggests the continued importance and reliance on telemental health services beyond the acute pandemic phase and has implications for future policies regulating the availability of telemental health services to patients.
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Affiliation(s)
- Milena Gotra
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | | | - Nicholas Jasinski
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - David Scarisbrick
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Shannon Reilly
- Department of Neurology, University of Virginia Health, Charlottesville, VA, United States
| | - Jonathan Perle
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Liv Miller
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - James Mahoney Iii
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
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Gutema BT, Tariku EZ, Melketsedik ZA, Levecke B, De Henauw S, Abubakar A, Abbeddou S. Assessing the influence of COVID-19 lockdown measures on cognition and behavior in school age children in Arba Minch Health and Demographic Surveillance site, Southern Ethiopia: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002978. [PMID: 38512931 PMCID: PMC10956753 DOI: 10.1371/journal.pgph.0002978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/07/2024] [Indexed: 03/23/2024]
Abstract
Ethiopian schools were closed for nearly 40 weeks as a measure to control the COVID-19 pandemic. The objective of the study was to evaluate the role of COVID-19 pandemic's restrictive measures on cognition and behavioral difficulties of schoolchildren in Arba Minch Health and Demographic Surveillance Site. Two cross-sectional surveys were conducted in November 2019 (pre-COVID-19-lockdown) and November 2020 (post-COVID-19 lockdown). Data were collected both at the school and homes of the children. Cognitive development of the children was assessed using digit span, Raven's coloured progressive matrices (RCPM) and Visual search using cancellation task. Behavioral difficulties score of the children was assessed using Strengths and Difficulties Questionnaire. Analysis of covariance (ANCOVA) was used to compare between the cognition outcomes and behavioral difficulties score pre- and post-COVID-19-lockdown. In a sub-group of children who provided data in both surveys, the difference in cognitive and behavioral outcomes was tested using a mixed effect model. Compared to the pre-COVID-19-lockdown, schoolchildren post-COVID-19-lockdown scored lower in the standardized performance index for the visual search task, which measures attention (0.27 SD, 95% confidence intervals (95%CI): -0.40, -0.13). However, they scored higher by 0.26 SD (95%CI: 0.13, 0.40) and 0.36 SD (95%CI: 0.22, 0.49) in digit span and RCPM, respectively, measuring working memory and non-verbal intelligence. There was no significant difference in total difficulties score between pre- and post-COVID-19-lockdown (0.01 SD, 95%CI: -0.12, 0.15). The subgroup analysis showed a significant increase in digit span among children post-COVID-19-lockdown while the other domains did not show a significant change. Factors contributing to the improvement of children's cognitive domains while away from the school environment should be explored and utilized to enhance child development. This study was registered at clinicaltrials.gov as NCT04137354 on October 14, 2019.
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Affiliation(s)
- Befikadu Tariku Gutema
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Eshetu Zerihun Tariku
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Bruno Levecke
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Amina Abubakar
- Kenya Medical Research Institute (KMRI)–Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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9
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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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10
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Borkett-Jones C, Thakur N, Roy P, Clayton-Payne A, Erdunast A, Wilkinson S, Mehta H, Jones AJ. A retrospective case review of young people referred for paediatric critical care transport following self-harm or a suicide attempt, 2015-2022. Arch Dis Child 2024; 109:262-263. [PMID: 38182267 DOI: 10.1136/archdischild-2023-326419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/07/2024]
Affiliation(s)
- Caroline Borkett-Jones
- Children's Acute Transport Service (CATS), Great Ormond Street Hospital for Children, London, UK
| | - Nitin Thakur
- Children's Acute Transport Service (CATS), Great Ormond Street Hospital for Children, London, UK
| | - Prithwish Roy
- Paediatric and Neonatal Decision Support and Retrieval Service (PaNDR), Addenbrooke's Hospital, Cambridge, UK
| | - Ali Clayton-Payne
- Children's Acute Transport Service (CATS), Great Ormond Street Hospital for Children, London, UK
| | - Anna Erdunast
- Children's Acute Transport Service (CATS), Great Ormond Street Hospital for Children, London, UK
| | - Simon Wilkinson
- Psychological and Mental Health Services (PAMHS), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Hiren Mehta
- Paediatric and Neonatal Decision Support and Retrieval Service (PaNDR), Addenbrooke's Hospital, Cambridge, UK
| | - Andrew J Jones
- Children's Acute Transport Service (CATS), Great Ormond Street Hospital for Children, London, UK
- Infection, Immunity and Inflammation Research and Teaching Department, University College London Institute of Child Health, London, UK
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11
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McCluskey CK, Black TR, Zee-Cheng J, Klein MJ, Lin A, Rogerson CM, Carroll CL, Remy KE, Scanlon MC, Shein SL, Wright M, Rotta AT. Suicide and Self-Harm in Adolescents During the COVID-19 Pandemic: A U.S. Virtual Pediatric Systems, LLC, Database Study of PICU Admissions, 2016-2021. Pediatr Crit Care Med 2024; 25:e73-e81. [PMID: 37812055 DOI: 10.1097/pcc.0000000000003381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
OBJECTIVES To characterize the epidemiology of suicide and self-harm among adolescents admitted to PICUs during the first 2 years of the COVID-19 pandemic in the United States. DESIGN Descriptive analysis of a large, multicenter, quality-controlled database (Virtual Pediatric Systems [VPS]), and of a national public health dataset (U.S. Centers for Disease Control and Prevention web-based Wide-ranging ONline Data for Epidemiology Research [CDC WONDER]). SETTING The 69 PICUs participating in the VPS database that contributed data for the entire the study period, January 1, 2016, to December 31, 2021. PATIENTS Adolescents older than 12 years to younger than 18 years old admitted to a participating PICU during the study period with a diagnosis involving self-harm or a suicide attempt (VPS sample), or adolescent suicide deaths over the same period (CDC WONDER sample). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We identified 10,239 suicide deaths and 7,692 PICU admissions for self-harm, including 5,414 admissions in the pre-pandemic period (Q1-2016 to Q1-2020) and 2,278 in the pandemic period (Q2-2020 to Q4-2021). Compared with the pre-pandemic period, there was no increase in the median (interquartile range) number of suicide deaths per quarter (429 [399-453] vs. 416 [390-482]) or PICU admissions for self-harm per quarter (315 [289-353] vs. 310 [286-387]) during the pandemic period, respectively. There was an increase in the ratio of self-harm PICU admissions to all-cause PICU admissions per quarter during the pandemic (1.98 [1.43-2.12]) compared with the pre-pandemic period per quarter (1.59 [1.46-1.74]). We also observed a significant decrease in all-cause PICU admissions per quarter early in the pandemic compared with the pre-pandemic period (16,026 [13,721-16,297] vs. 19,607 [18,371-20,581]). CONCLUSIONS The number of suicide deaths and PICU admissions per quarter for self-harm remained relatively constant during the pandemic, while the number of all-cause PICU admissions per quarter decreased compared with the pre-pandemic period. The resultant higher ratio of self-harm admissions to all-cause PICU admissions may have contributed to the perception that more adolescents required critical care for mental health-related conditions early in the pandemic.
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Affiliation(s)
- Casey K McCluskey
- Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV
| | - Tyler R Black
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | | - Margaret J Klein
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA
| | - Anna Lin
- Department of Pediatrics, Stanford University, Palo Alto, CA
| | - Colin M Rogerson
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Christopher L Carroll
- Department of Pediatrics, University of Florida, Wolfson Children's Hospital, Jacksonville, FL
| | - Kenneth E Remy
- Department of Pediatrics, Case Western University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH
| | - Matthew C Scanlon
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
| | - Steven L Shein
- Department of Pediatrics, Case Western University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH
| | - Melvin Wright
- Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV
| | - Alexandre T Rotta
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
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12
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Wright N, Hill J, Sharp H, Refberg-Brown M, Crook D, Kehl S, Pickles A. COVID-19 pandemic impact on adolescent mental health: a reassessment accounting for development. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-023-02337-y. [PMID: 38170282 DOI: 10.1007/s00787-023-02337-y] [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: 03/29/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024]
Abstract
Current prospective reports suggest a pandemic-related increase in adolescent mental health problems. We examine whether age-related change over 11-14 years accounts for this increase. Mothers and adolescents in a UK-based birth cohort (Wirral Child Health and Development Study; WCHADS; N = 737) reported on adolescent depression and behavioural problems pre-pandemic (December 2019-March 2020), mid-pandemic (June 2020-March 2021) and late pandemic (July 2021-March 2022). Analysis used repeated measures models for over-dispersed Poisson counts with an adolescent-specific intercept with age as a time-varying covariate. Maturational curves for girls, but not for boys, showed a significant increase in self-reported depression symptoms over ages 11-14 years. Behavioural problems decreased for both. After adjusting for age-related change, girls' depression increased by only 13% at mid-pandemic and returned to near pre-pandemic level at late pandemic (mid versus late - 12%), whereas boys' depression increased by 31% and remained elevated (mid versus late 1%). Age-adjusted behavioural problems increased for both (girls 40%, boys 41%) and worsened from mid- to late pandemic (girls 33%, boys 18%). Initial reports of a pandemic-related increase in depression in young adolescent girls could be explained by a natural maturational rise. In contrast, maturational decreases in boys' depression and both boys' and girls' behavioural problems may mask an effect of the pandemic.
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Affiliation(s)
- N Wright
- Department of Psychology, Manchester Metropolitan University, Manchester, UK.
| | - J Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - H Sharp
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - M Refberg-Brown
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - D Crook
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
| | - S Kehl
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - A Pickles
- Department of Biostatics & Health Informatics, King's College London, London, UK
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13
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Bertollo AG, Leite Galvan AC, Dama Mingoti ME, Dallagnol C, Ignácio ZM. Impact of COVID-19 on Anxiety and Depression - Biopsychosocial Factors. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:122-133. [PMID: 36809942 DOI: 10.2174/1871527322666230210100048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/16/2022] [Accepted: 12/16/2022] [Indexed: 02/17/2023]
Abstract
Anxiety and depression are prevalent mental disorders around the world. The etiology of both diseases is multifactorial, involving biological and psychological issues. The COVID-19 pandemic settled in 2020 and culminated in several changes in the routine of individuals around the world, affecting mental health. People infected with COVID-19 are at greater risk of developing anxiety and depression, and individuals previously affected by these disorders have worsened the condition. In addition, individuals diagnosed with anxiety or depression before being affected by COVID-19 developed the severe illness at higher rates than individuals without mental disorders. This harmful cycle involves several mechanisms, including systemic hyper-inflammation and neuroinflammation. Furthermore, the context of the pandemic and some previous psychosocial factors can aggravate or trigger anxiety and depression. Disorders are also risks for a more severe picture of COVID-19. This review discusses research on a scientific basis, which brings evidence on biopsychosocial factors from COVID-19 and the context of the pandemic involved in anxiety and depression disorders.
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Affiliation(s)
- Amanda Gollo Bertollo
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Agatha Carina Leite Galvan
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Maiqueli Eduarda Dama Mingoti
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Claudia Dallagnol
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
| | - Zuleide Maria Ignácio
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Chapecó, SC, Brazil
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14
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Mejova Y, Hommadova Lu A. Gender in the disclosure of loneliness on Twitter during COVID-19 lockdowns. Front Digit Health 2023; 5:1297983. [PMID: 38125758 PMCID: PMC10731375 DOI: 10.3389/fdgth.2023.1297983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/17/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Loneliness has been shown to affect both mental and physical health, and was a major concern even before the COVID-19 pandemic. During the COVID-19 distancing measures, millions of people took to social media to express their feelings and seek social support. Methods In this mixed-methods study, we examine the self-disclosure of loneliness by users identifying as male or female (via self-disclosed naming conventions) on Twitter before and during the COVID-19 "lockdowns." Results We show that in the first two months of COVID-19 restrictions, self-disclosure of loneliness on this platform rose dramatically, and also have changed qualitatively. We find that female accounts tend to post more loneliness self-disclosures compared to male ones, even before COVID. Female disclosures more often center around pregnancy, family, and close relationships, whereas those posted by the male ones are more related to leadership, video gaming and sex. During COVID lockdowns, female accounts turn to online messaging apps and hobbies, and male become increasingly vocal in seeking partners. Discussion The insights of this study have important implications for the design of interventions for lessening the burden of loneliness in the current digitized world.
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Affiliation(s)
| | - Anya Hommadova Lu
- Communication Studies, Sam Houston State University, Huntsville, TX, United States
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15
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Dabravolskaj J, Veugelers PJ, Mandour BA, Flynn J, Maximova K. Delivering health promotion during school closures in public health emergencies: building consensus among Canadian experts. Health Promot Int 2023; 38:daad172. [PMID: 38091618 PMCID: PMC10716908 DOI: 10.1093/heapro/daad172] [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] [Indexed: 12/18/2023] Open
Abstract
School-based health promotion is drastically disrupted by school closures during public health emergencies or natural disasters. Climate change will likely accelerate the frequency of these events and hence school closures. We identified innovative health promotion practices delivered during COVID-19 school closures and sought consensus among education experts on their future utility. Fifteen health promotion practices delivered in 87 schools across Alberta, Canada during COVID-19 school closures in Spring 2020, were grouped into: 'awareness of healthy lifestyle behaviours and mental wellness', 'virtual events', 'tangible supports' and 'school-student-family connectedness'. Two expert panels (23 school-level practitioners and 20 decision-makers at the school board and provincial levels) rated practices on feasibility, acceptability, reach, effectiveness, cost-effectiveness and other criteria in three rounds of online Delphi surveys. Consensus was reached if 70% or more participants (strongly) agreed with a statement, (strongly) disagreed or neither. Participants agreed all practices require planning, preparation and training before implementation and additional staff time and most require external support or partnerships. Participants rated 'awareness of healthy lifestyle behaviours and mental wellness' and 'virtual events' as easy and quick to implement, effective and cost-effective, sustainable, easy to integrate into curriculum, well received by students and teachers, benefit school culture and require no additional funding/resources. 'Tangible supports' (equipment, food) and 'school-student-family connectedness' were rated as most likely to reach vulnerable students and families. Health promotion practices presented herein can inform emergency preparedness plans and are critical to ensuring health remains a priority during public health emergencies and natural disasters.
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Affiliation(s)
- Julia Dabravolskaj
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria St, Toronto, ON M5B 1T8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada
| | - Paul J Veugelers
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, AB T6G 1K4, Canada
| | - Boshra A Mandour
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, AB T6G 1K4, Canada
| | - Jenn Flynn
- APPLE Schools, 206-A, 12227 – 107 Ave NW, Edmonton, AB T5M 1Y9, Canada
| | - Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria St, Toronto, ON M5B 1T8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada
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16
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Payne L, Goijen HJ, Cobham V, Bor W, Stathis SS, Coghill DC, Middeldorp CM. The impact of COVID-19 on children and adolescents attending Child and Youth Mental Health Services in Queensland, Australia. Early Interv Psychiatry 2023; 17:1180-1188. [PMID: 37051676 DOI: 10.1111/eip.13421] [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: 11/15/2022] [Revised: 01/27/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE This explorative study aims to provide insight into impacts of the COVID-19 pandemic and associated restrictions, on mental health of children and adolescents treated at Child and Youth Mental Health Services, and their parents. METHOD The COVID-19 Mental Health Survey was disseminated to parents of children and adolescents under treatment at community Child and Youth Mental Health Services (Brisbane, Australia) between July-November 2020 throughout different stages of COVID-19 related restrictions. Parents of 110 children participated. RESULTS Most reported child's symptoms were sadness (46%), anxiety (60%), lack of focus (61%), lack of joy in their usual activities (38%) and reduction in sleep (42%). Parental emotions were significantly correlated with their child's emotions. Parent's lack of enjoyment of usual activities had the overall strongest average correlation (0.27) but this was no longer significant once other variables were controlled for. Children who attended school remotely for some of the days had a significantly (p < .05) higher risk of having more reported symptoms. Interestingly, in later stages of the lockdown with further easing of restrictions, symptoms also tended to be more severe. CONCLUSION Cross-sectional data on children and adolescents in Queensland, Australia with pre-existing mental health issues suggests mental health continued to deteriorate through the pandemic even as restrictions eased. Changes in schooling seem to be an especially important risk factor.
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Affiliation(s)
- Leanne Payne
- Child Health Research Centre, University of Queensland, St Lucia, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Hedwig J Goijen
- Child Health Research Centre, University of Queensland, St Lucia, Australia
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Vanessa Cobham
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
- School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Australia
| | - William Bor
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Stephen S Stathis
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - David C Coghill
- Division of Clinical Science, Murdoch Children's Research Institute, Melbourne, Australia
- Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Division of Neuroscience, University of Dundee, Dundee, UK
- Department of Mental Health, Royal Children's Hospital Melbourne, Parkville, Australia
| | - Christel M Middeldorp
- Child Health Research Centre, University of Queensland, St Lucia, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
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17
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Romero C, Kupis L, Goodman ZT, Dirks B, Baez A, Beaumont AL, Cardona SM, Parlade MV, Alessandri M, Nomi JS, Perry LK, Uddin LQ. Pre-pandemic Executive Function Protects Against Pandemic Anxiety in Children with and Without Autism Spectrum Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-06175-4. [PMID: 38038873 DOI: 10.1007/s10803-023-06175-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/02/2023]
Abstract
The COVID-19 pandemic may have exacerbated depression, anxiety, and executive function (EF) difficulties in children with autism spectrum disorder (ASD). EF skills have been positively associated with mental health outcomes. Here, we probed the psychosocial impacts of pandemic responses in children with and without ASD by relating pre-pandemic EF assessments with anxiety and depression symptoms several months into the pandemic. We found that pre-pandemic inhibition and shifting difficulties, measured by the Behavior Rating Inventory of Executive Function, predicted higher risk of anxiety symptoms. These findings are critical for promoting community recovery and maximizing clinical preparedness to support children at increased risk for adverse psychosocial outcomes.
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Affiliation(s)
- Celia Romero
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA.
| | - Lauren Kupis
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Zachary T Goodman
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Bryce Dirks
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Adriana Baez
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Amy L Beaumont
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Sandra M Cardona
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Meaghan V Parlade
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Michael Alessandri
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Jason S Nomi
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Lynn K Perry
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Lucina Q Uddin
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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18
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Sayal K, Partlett C, Bhardwaj A, Dubicka B, Marshall T, Gledhill J, Ewart C, James M, Lang A, Sprange K, Montgomery A. Mental health in clinically referred children and young people before and during the Covid-19 pandemic. Eur Child Adolesc Psychiatry 2023; 32:2657-2666. [PMID: 36526804 PMCID: PMC9758019 DOI: 10.1007/s00787-022-02115-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022]
Abstract
The Covid-19 pandemic and mitigation approaches, including lockdowns and school closures, are thought to have negatively impacted children and young people's (CYP) mental health. However, the impact for clinically referred CYP is less clear. We investigated differences in the mental health of CYP referred to specialist Child and Adolescent Mental Health Services (CAMHS) before and since the onset of the pandemic. Using baseline data (self- and parent- completed Mood and Feelings Questionnaire and Strengths and Difficulties Questionnaire) from an ongoing RCT (STADIA; ISRCTN: 15748675) in England involving 5-17-year-olds with emotional difficulties recently referred to CAMHS (non-urgent referrals), with repeated cross-sectional comparisons of CYP (n = 1028) recruited during 5 different time periods: (1) Before schools were closed (Group 1 (pre-pandemic); n = 308; 27.08.2019-20.03.2020). (2) Early pandemic period until schools fully re-opened, which included the first national lockdown, its easing and the summer holidays (Group 2 (in-pandemic); n = 183; 21.03.2020-31.08.2020). (3) The following school-term-schools fully re-opened and remained open, including during the second national lockdown (Group 3 (in-pandemic); n = 204; 01.09.2020-18.12.2020). (4) Schools closed as part of the third national lockdown (Group 4 (in-pandemic); n = 101; 05.01.2021-07.03.2021). (5) Schools re-opened and remained open, until the school summer holidays (Group 5 (in-pandemic); n = 232; 08.03.2021-16.07.2021). Most CYP scored above cutoff for emotional problems and depression, with three-quarters meeting criteria for a probable disorder ('caseness'). The groups did not differ on parent-rated mental health measures. However, self-rated emotional problems, depression, functional impairment and caseness appeared to be higher amongst participants recruited in the two periods following school re-openings. In particular, functional impairment and caseness were greater in Group 5 compared with Group 2. Although symptom severity or impairment did not change in the initial pandemic period, self-reported difficulties were greater during the periods after schools re-opened. This suggests possible greater stresses in the adjustment to re-starting school following recurrent lockdowns and school closures.
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Affiliation(s)
- Kapil Sayal
- School of Medicine, University of Nottingham, Nottingham, UK.
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.
| | | | - Anupam Bhardwaj
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | | | | | - Julia Gledhill
- Central and North West London NHS Foundation Trust, London, UK
| | - Colleen Ewart
- School of Medicine, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Marilyn James
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Alexandra Lang
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Kirsty Sprange
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Alan Montgomery
- School of Medicine, University of Nottingham, Nottingham, UK
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19
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Miall N, Pearce A, Moore JC, Benzeval M, Green MJ. Inequalities in children's mental health before and during the COVID-19 pandemic: findings from the UK Household Longitudinal Study. J Epidemiol Community Health 2023; 77:762-769. [PMID: 37748928 PMCID: PMC10646900 DOI: 10.1136/jech-2022-220188] [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: 12/08/2022] [Accepted: 07/27/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND There are concerns that child mental health inequalities may have widened during the COVID-19 pandemic. We investigated whether child mental health inequalities changed in 2020/2021 compared with prepandemic. METHODS We analysed 16 361 observations from 9272 children in the population representative UK Household Longitudinal Study. Child mental health was measured using the Strengths and Difficulties Questionnaire (SDQ) at ages 5 and 8 years in annual surveys 2011-2019, and at ages 5-11 years in July 2020, September 2020 and March 2021. Inequalities in cross-sectional SDQ scores among 5 and 8 year olds, before and during the pandemic, were modelled using linear regression. Additionally, interactions between time (before/during pandemic) and: sex, ethnicity, family structure, parental education, employment, household income and area deprivation on mental health were explored. RESULTS A trend towards poorer mental health between 2011 and 2019 continued during the pandemic (b=0.12, 95% CI 0.08 to 0.17). Children with coupled, highly educated, employed parents and higher household income experienced greater mental health declines during the pandemic than less advantaged groups, leading to narrowed inequalities. For example, the mean difference in child SDQ scores for unemployed compared with employed parents was 2.35 prepandemic (1.72 to 2.98) and 0.02 during the pandemic (-1.10 to 1.13). Worse scores related to male sex and area deprivation were maintained. White children experienced worse mental health than other ethnicities, and greater declines during the pandemic. CONCLUSION Mental health among UK 5 and 8 year olds deteriorated during the pandemic, although several inequalities narrowed. Interventions are needed to improve child mental health while ensuring inequalities do not widen.
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Affiliation(s)
- Naomi Miall
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jamie C Moore
- Institute for Social and Economic Research (ISER), University of Essex, Colchester, UK
| | - Michaela Benzeval
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Institute for Social and Economic Research (ISER), University of Essex, Colchester, UK
| | - Michael J Green
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA
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20
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Brom C, Diviák T, Drbohlav J, Korbel V, Levínský R, Neruda R, Kadlecová G, Šlerka J, Šmíd M, Trnka J, Vidnerová P. Rotation-based schedules in elementary schools to prevent COVID-19 spread: a simulation study. Sci Rep 2023; 13:19156. [PMID: 37932281 PMCID: PMC10628146 DOI: 10.1038/s41598-023-45788-8] [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: 07/10/2022] [Accepted: 10/24/2023] [Indexed: 11/08/2023] Open
Abstract
Rotations of schoolchildren were considered as a non-pharmacological intervention in the COVID-19 pandemic. This study investigates the impact of different rotation and testing schedules.We built an agent-based model of interactions among pupils and teachers based on a survey in an elementary school in Prague, Czechia. This model contains 624 schoolchildren and 55 teachers and about 27 thousands social contacts in 10 layers. The layers reflect different types of contacts (classroom, cafeteria, etc.) in the survey. On this multi-graph structure we run a modified SEIR model of covid-19 infection. The parameters of the model are calibrated on data from the outbreak in the Czech Republic in spring 2020. Weekly rotations of in-class and distance learning are an effective preventative measure in schools reducing the spread of covid-19 by 75-81% . Antigen testing twice a week or PCR once a week significantly reduces infections even when using tests with a lower sensitivity. The structure of social contacts between pupils and teachers strongly influences the transmission. While the density of contact graphs for older pupils is 1.5 times higher than for younger pupils, the teachers' network is an order of magnitude denser. Teachers moreover act as bridges between groups of children, responsible for 14-18% of infections in the secondary school compared to 8-11% in the primary school. Weekly rotations with regular testing are a highly effective non-pharmacological intervention for the prevention of covid-19 spread in schools and a way to keep schools open during an epidemic.
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Affiliation(s)
- Cyril Brom
- Faculty of Mathematics and Physics, Charles University, Ke Karlovu 2027/3, 121 16, Praha 2, Czech Republic
| | - Tomáš Diviák
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- Department of Criminology and Mitchell Centre for Social Network Analysis, School of Social Sciences, University of Manchester, Oxford Rd, Manchester, UK
| | - Jakub Drbohlav
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
| | - Václav Korbel
- CERGE-EI, Politických vězňů 7, 11121, Praha 1, Czech Republic
- PAQ Research, 28. pluku 458/7, 101 00, Praha 10, Czech Republic
| | - René Levínský
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- CERGE-EI, Politických vězňů 7, 11121, Praha 1, Czech Republic
- New Media Studies, Faculty of Arts, Charles University, Na Příkopě 29, 110 00, Praha 1, Czech Republic
| | - Roman Neruda
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- Institute of Computer Science, The Czech Academy of Sciences, Pod Vodárenskou věží-2, 18200, Praha 8, Czech Republic
| | - Gabriela Kadlecová
- Faculty of Mathematics and Physics, Charles University, Ke Karlovu 2027/3, 121 16, Praha 2, Czech Republic
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- Institute of Computer Science, The Czech Academy of Sciences, Pod Vodárenskou věží-2, 18200, Praha 8, Czech Republic
| | - Josef Šlerka
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- New Media Studies, Faculty of Arts, Charles University, Na Příkopě 29, 110 00, Praha 1, Czech Republic
| | - Martin Šmíd
- Faculty of Mathematics and Physics, Charles University, Ke Karlovu 2027/3, 121 16, Praha 2, Czech Republic
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- Institute of Information Theory and Automation, The Czech Academy of Sciences, Pod Vodárenskou věží-4, 18200, Praha 8, Czech Republic
| | - Jan Trnka
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic.
- Department of Biochemistry, Cell and Molecular Biology, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Praha 10, Czech Republic.
| | - Petra Vidnerová
- Centre for Modelling of Biological and Social Processes, Na Břehu 497/15, 190 00, Praha 9, Czech Republic
- Institute of Computer Science, The Czech Academy of Sciences, Pod Vodárenskou věží-2, 18200, Praha 8, Czech Republic
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21
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Van de Velde J, Levecque K, Weijters B, Laureys S. Doing what matters in times of stress: No-nonsense meditation and occupational well-being in COVID-19. PLoS One 2023; 18:e0292406. [PMID: 37910465 PMCID: PMC10619828 DOI: 10.1371/journal.pone.0292406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/19/2023] [Indexed: 11/03/2023] Open
Abstract
While the COVID-19 pandemic challenged the general public's health and well-being, it exacerbated the pre-existing well-being issues in the educational sector in many countries. Mindfulness-based interventions are often applied to protect and promote occupational well-being. To investigate how the well-being benefits of these interventions arise, we selected one accessible technique that is used in most of them: focused attention meditation. In the middle of the COVID-19 pandemic, 199 teachers voluntarily practiced five to ten minutes of meditation together with their pupils, every morning for six months. We employed a three-wave longitudinal design to follow any changes in the meditating teachers' well-being and compared these changes to a waitlist control condition of 42 teachers. Three dimensions of well-being were measured at baseline, half-time, and post-intervention: emotional, cognitive, and physical well-being. Latent growth curve models revealed that the meditation technique not only improves well-being but also prevents the development of well-being problems. The practice of focused attention meditation resulted in improvements in emotional and physical well-being and prevented the development of cognitive well-being problems that were observed within the control condition. The effects were strongest for emotional and cognitive well-being and followed a linear trend. This paper shows that the well-being effects of mindfulness-based interventions are at least in part due to the focused attention meditation that is practiced in them. Occupational groups that experience emotional, cognitive, or physical well-being issues can benefit from a few minutes of focused attention meditation per day. Trial registration: ISRCTN ISRCTN61170784 (https://doi.org/10.1186/ISRCTN61170784).
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Affiliation(s)
| | - Katia Levecque
- Department of Work, Organization, and Society, Ghent University, Ghent, Belgium
| | - Bert Weijters
- Department of Work, Organization, and Society, Ghent University, Ghent, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness Research Unit, University and University Hospital of Liège, Liège, Belgium
- CERVO Brain Research Center, Laval University, Québec, Canada
- Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang, China
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22
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Moin JS, Vigod SN, Plumptre L, Troke N, Asaria M, Papanicolas I, Wodchis WP, Brail S, Anderson G. Sex differences among children, adolescents and young adults for mental health service use within inpatient and outpatient settings, before and during the COVID-19 pandemic: a population-based study in Ontario, Canada. BMJ Open 2023; 13:e073616. [PMID: 37914301 PMCID: PMC10626835 DOI: 10.1136/bmjopen-2023-073616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/28/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVES The pandemic and public health response to contain the virus had impacts on many aspects of young people's lives including disruptions to daily routines, opportunities for social, academic, recreational engagement and early employment. Consequently, children, adolescents and young adults may have experienced mental health challenges that required use of mental health services. This study compared rates of use for inpatient and outpatient mental health services during the pandemic to pre-pandemic rates. DESIGN Population-based repeated cross-sectional study. SETTING Publicly delivered mental healthcare in primary and secondary settings within the province of Ontario, Canada. PARTICIPANTS All children 6-12 years of age (n=2 043 977), adolescents 13-17 years (n=1 708 754) and young adults 18-24 years (n=2 286 544), living in Ontario and eligible for provincial health insurance between March 2016 and November 2021. PRIMARY OUTCOME MEASURES Outpatient mental health visits to family physicians and psychiatrists for: mood and anxiety disorders, alcohol and substance abuse disorders, other non-psychotic mental health disorders and social problems. Inpatient mental health visits to emergency departments and hospitalisations for: substance-related and addictive disorders, anxiety disorders, assault-related injuries, deliberate self-harm and eating disorders. All outcomes were analysed by cohort and sex. RESULTS During the pandemic, observed outpatient visit rates were higher among young adults by 19.01% (95% CI: 15.56% to 22.37%; 209 vs 175 per 1000) and adolescent women 24.17% (95% CI: 18.93% to 29.15%; 131 vs 105 per 1000) for mood and anxiety disorders and remained higher than expected. Female adolescents had higher than expected usage of inpatient care for deliberate self-harm, eating disorders and assault-related injuries. CONCLUSIONS Study results raise concerns over prolonged high rates of mental health use during the pandemic, particularly in female adolescents and young women, and highlights the need to better monitor and identify mental health outcomes associated with COVID-19 containment measures and to develop policies to address these concerns.
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Affiliation(s)
- John S Moin
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Simone N Vigod
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | | | | | - Miqdad Asaria
- Department of Health Policy, The London School of Economics and Political Science, London, UK
| | - Irene Papanicolas
- Brown University School of Public Health, Providence, Rhode Island, USA
| | - Walter P Wodchis
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Shauna Brail
- Institute for Management & Innovation, University of Toronto Mississauga, Toronto, Ontario, Canada
| | - Geoff Anderson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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23
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Daly M. Reexamining Quality Assessment and Effect Size Reporting Among Studies Showing Major Changes in Depressive Symptoms. JAMA Pediatr 2023; 177:1237-1238. [PMID: 37603357 DOI: 10.1001/jamapediatrics.2023.3046] [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] [Indexed: 08/22/2023]
Affiliation(s)
- Michael Daly
- Department of Psychology, Maynooth University, Maynooth, Co Kildare, Ireland
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24
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Nguyen T, Zillich L, Cetin M, Hall ASM, Foo JC, Sirignano L, Frank J, Send TS, Gilles M, Rietschel M, Deuschle M, Witt SH, Streit F. Psychological, endocrine and polygenic predictors of emotional well-being during the COVID-19 pandemic in a longitudinal birth cohort. Stress 2023; 26:2234060. [PMID: 37519130 DOI: 10.1080/10253890.2023.2234060] [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: 02/28/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
The COVID-19 pandemic severely affected the lives of families and the well-being of both parents and their children. Various factors, including prenatal stress, dysregulated stress response systems, and genetics may have influenced how the stress caused by the pandemic impacted the well-being of different family members. The present work investigated if emotional well-being during the COVID-19 pandemic could be predicted by developmental stress-related and genetic factors. Emotional well-being of 7-10 year-old children (n = 263) and mothers (n = 241) (participants in a longitudinal German birth cohort (POSEIDON)) was assessed during the COVID-19 pandemic using the CRISIS questionnaire at two time periods (July 2020-October 2020; November 2020-February 2021). Associations of the children's and mothers' well-being with maternal perceived stress, of the children's well-being with their salivary and morning urine cortisol at 45 months, and polygenic risk scores (PRSs) for depression, schizophrenia, loneliness were investigated. Lower emotional well-being was observed in both children and mothers during compared to before the pandemic, with the children's but not the mothers' emotional well-being improving over the course of the pandemic. A positive association between the child and maternal emotional well-being was found. Prenatally assessed maternal perceived stress was associated with a lower well-being in children, but not in mothers. Cortisol measures and PRSs were not significantly associated with the children's emotional well-being. The present study confirms that emotional well-being of children and mothers are linked, and were negatively affected by the COVID-19 pandemic, with differences in development over time.
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Affiliation(s)
- Thao Nguyen
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lea Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Metin Cetin
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Alisha S M Hall
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jerome C Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Institute for Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tabea S Send
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maria Gilles
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael Deuschle
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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25
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Pajek J, Mancini K, Murray M. COVID-19 and children's behavioral health: An overview. Curr Probl Pediatr Adolesc Health Care 2023; 53:101491. [PMID: 38040607 DOI: 10.1016/j.cppeds.2023.101491] [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] [Indexed: 12/03/2023]
Abstract
The paper reviews the impact of the COVID-19 pandemic on children's and adolescents' well-being. A trauma-informed framework is employed to discuss the emerging evidence of notable changes in youth's psychological, developmental, academic, and social well-being since the start of the COVID-19 pandemic. Children and adolescents have been uniquely affected based on their age at the start of the pandemic. Despite multiple resiliency factors, COVID-19 and its ramifications have had an adverse effect on youth in general and have exacerbated preexisting racial and socioeconomic disparities. This review concludes with recommendations for child health clinicians.
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Affiliation(s)
- Julie Pajek
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
| | - Kathryn Mancini
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Marsheena Murray
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
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26
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Fischer K, Tieskens JM, Luijten MAJ, Zijlmans J, van Oers HA, de Groot R, van der Doelen D, van Ewijk H, Klip H, van der Lans RM, De Meyer R, van der Mheen M, van Muilekom MM, Hyun Ruisch I, Teela L, van den Berg G, Bruining H, van der Rijken R, Buitelaar J, Hoekstra PJ, Lindauer R, Oostrom KJ, Staal W, Vermeiren R, Cornet R, Haverman L, Bartels M, Polderman TJC, Popma A. Internalizing problems before and during the COVID-19 pandemic in independent samples of Dutch children and adolescents with and without pre-existing mental health problems. Eur Child Adolesc Psychiatry 2023; 32:1873-1883. [PMID: 35616715 PMCID: PMC9133820 DOI: 10.1007/s00787-022-01991-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 04/09/2022] [Indexed: 01/25/2023]
Abstract
The aim of the study was to assess internalizing problems before and during the pandemic with data from Dutch consortium Child and adolescent mental health and wellbeing in times of the COVID-19 pandemic, consisting of two Dutch general population samples (GS) and two clinical samples (CS) referred to youth/psychiatric care. Measures of internalizing problems were obtained from ongoing data collections pre-pandemic (NGS = 35,357; NCS = 4487) and twice during the pandemic, in Apr-May 2020 (NGS = 3938; clinical: NCS = 1008) and in Nov-Dec 2020 (NGS = 1489; NCS = 1536), in children and adolescents (8-18 years) with parent (Brief Problem Monitor) and/or child reports (Patient-Reported Outcomes Measurement Information System®). Results show that, in the general population, internalizing problems were higher during the first peak of the pandemic compared to pre-pandemic based on both child and parent reports. Yet, over the course of the pandemic, on both child and parent reports, similar or lower levels of internalizing problems were observed. Children in the clinical population reported more internalizing symptoms over the course of the pandemic while parents did not report differences in internalizing symptoms from pre-pandemic to the first peak of the pandemic nor over the course of the pandemic. Overall, the findings indicate that children and adolescents of both the general and clinical population were affected negatively by the pandemic in terms of their internalizing problems. Attention is therefore warranted to investigate long-term effects and to monitor if internalizing problems return to pre-pandemic levels or if they remain elevated post-pandemic.
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Affiliation(s)
- Karen Fischer
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jacintha M Tieskens
- LUMC Curium-Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Michiel A J Luijten
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam University Medical Center, Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Josjan Zijlmans
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hedy A van Oers
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Rowdy de Groot
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Medical Informatics, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Daniël van der Doelen
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Hanneke van Ewijk
- LUMC Curium-Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Rikkert M van der Lans
- LUMC Curium-Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Malindi van der Mheen
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Maud M van Muilekom
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - I Hyun Ruisch
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lorynn Teela
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Hilgo Bruining
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Jan Buitelaar
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ramón Lindauer
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Kim J Oostrom
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Wouter Staal
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Robert Vermeiren
- LUMC Curium-Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Youz, Parnassia Psychiatric Institute, den Hague, The Netherlands
| | - Ronald Cornet
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Medical Informatics, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Lotte Haverman
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Meike Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Tinca J C Polderman
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
- LUMC Curium-Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Arne Popma
- Amsterdam University Medical Centres, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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27
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Heaton KG, Camacho NL, Gaffrey MS. Associations between pre-pandemic authoritative parenting, pandemic stressors, and children's depression and anxiety at the initial stage of the COVID-19 pandemic. Sci Rep 2023; 13:15592. [PMID: 37730878 PMCID: PMC10511718 DOI: 10.1038/s41598-023-42268-x] [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: 09/30/2022] [Accepted: 09/07/2023] [Indexed: 09/22/2023] Open
Abstract
Large-scale changes due to the Novel Coronavirus (COVID-19) pandemic negatively affected children's mental health. Prior research suggests that children's mental health problems during the pandemic may have been concurrently attenuated by an authoritative parenting style and exacerbated by family stress. However, there is a gap in the literature investigating these mechanisms and whether pre-pandemic authoritative parenting had a lasting positive influence on children's mental health while they were exposed to pandemic-related family stressors. The current study begins to fill this gap by investigating these unique relationships in a sample of 106 4-8 year old children (51% female). Before the pandemic, caregivers completed questionnaires on their parenting style and their children's depression and anxiety symptoms. Shortly after the onset of COVID-19's stay-at-home mandate, parents answered questionnaires about their children's depression and anxiety symptoms and pandemic-related family stressors. Child depression and anxiety symptom severity increased. Higher levels of pandemic-related family stress were associated with increases only in child anxiety scores. Further, greater endorsement of a pre-pandemic authoritative parenting style was associated with smaller changes only in child depression scores. Study findings elucidate unique and complex associations between young children's anxiety and depression symptoms severity and pre-pandemic parenting and pandemic-related family stressors.
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Affiliation(s)
- Karina G Heaton
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, NJ, USA.
| | - Nicolas L Camacho
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.
| | - Michael S Gaffrey
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.
- Children's Wisconsin, Milwaukee, WI, USA.
- Division of Pediatric Psychology and Developmental Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
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28
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Maximova K, Wu X, Khan MK, Dabravolskaj J, Sim S, Mandour B, Pabayo R, Veugelers PJ. The impact of the COVID-19 pandemic on inequalities in lifestyle behaviours and mental health and wellbeing of elementary school children in northern Canada. SSM Popul Health 2023; 23:101454. [PMID: 37334330 PMCID: PMC10260266 DOI: 10.1016/j.ssmph.2023.101454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/11/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives The COVID-19 pandemic has negatively affected children's lifestyle behaviours and mental health and wellbeing, and concerns have been raised that COVID-19 has also increased health inequalities. No study to date has quantified the impact of COVID-19 on health inequalities among children. We compared pre-pandemic vs. post-lockdown inequalities in lifestyle behaviours and mental health and wellbeing among children living in rural and remote northern communities. Methods We surveyed 473 grade 4-6 students (9-12 years of age) from 11 schools in rural and remote communities in northern Canada in 2018 (pre-pandemic), and 443 grade 4-6 students from the same schools in 2020 (post-lockdown). The surveys included questions on sedentary behaviours, physical activity, dietary intake, and mental health and wellbeing. We measured inequality in these behaviors using the Gini coefficient, a unitless measure ranging from 0 to 1 with a higher value indicating greater inequality. We used temporal changes (2020 vs. 2018) in Gini coefficients to assess the impact of COVID-19 on inequalities in lifestyle behaviours and mental health and wellbeing separately among girls and boys. Results Inequalities in all examined lifestyle behaviours increased between 2018 and 2020. Inequalities in watching TV, playing video games, and using a cell phone increased among girls, while inequalities in playing video games, using computers and tablets, and consumption of sugar, salt, saturated fat and total fat increased among boys. Changes in inequalities in mental health and wellbeing were small and not statistically significant. Conclusion The findings suggest that the COVID-19 pandemic has exacerbated inequalities in lifestyle behaviours among children living in rural and remote northern communities. If not addressed, these differences may translate into exacerbated inequalities in future health. The findings further suggest that school health programs can help mitigate the negative impact of the pandemic on lifestyle behaviours and mental health and wellbeing.
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Affiliation(s)
- Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria St, Toronto, Ontario, M5B 1T8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario, M5T 3M7, Canada
| | - Xiuyun Wu
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, Alberta, T6G 1K4, Canada
| | - Mohammed K.A. Khan
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario, M5T 3M7, Canada
| | - Julia Dabravolskaj
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, Alberta, T6G 1K4, Canada
| | - Shannon Sim
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, Alberta, T6G 1K4, Canada
| | - Boshra Mandour
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, Alberta, T6G 1K4, Canada
| | - Roman Pabayo
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, Alberta, T6G 1K4, Canada
| | - Paul J. Veugelers
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, Alberta, T6G 1K4, Canada
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Chen L, Yeung WJJ. Pre-pandemic family resources and child self-regulation in children's internalizing problems during COVID-19: a multi-level social-ecological framework for emotional resilience. Front Psychol 2023; 14:1203524. [PMID: 37564305 PMCID: PMC10410081 DOI: 10.3389/fpsyg.2023.1203524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/14/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction Children's psychological adjustment to adverse events can be determined by multiple risk and resilience factors. This study explored multi-level protective factors against children's internalizing problems and investigated the mechanism regarding how diverse environmental and child-level resources influence children's mental health in the context of COVID-19. Methods Our participants included a nationally representative sample of 2,619 young children (48.3% girls) and their primary caregivers (95.1% mothers) in Singapore. They were a subset of the participants in the Singapore Longitudinal Early Development Study (SG LEADS). Data were collected over two waves-before the outbreak of the COVID-19 pandemic (Wave 1) when these children aged 3 to 6, and during the second year of the pandemic (Wave 2). Primary caregivers completed measures of verbal cognitive ability, self-control, economic stress, and positive and negative parental control in Wave 1. Children's self-regulation was assessed by the Delay of Gratification task in Wave 1, and their internalizing problems were rated by their primary caregivers in both waves. Other pre-pandemic family and community characteristics were collected as covariates. Structural equation modeling was performed. Results Pre-pandemic parental resources (i.e., verbal cognitive ability, self-control, and low economic stress) predicted children's fewer internalizing problems during the pandemic and less aggravation of internalizing problems from before to during the pandemic, through more positive parental control (i.e., limit setting) and less negative parental control (i.e., harsh discipline). Moreover, children's self-regulation during early childhood was predicted by their primary caregivers' verbal cognitive ability and self-control, as well as positive parental control. Early childhood self-regulation further alleviated the aggravation of internalizing problems over time. Among the covariates, parental education, family income, parental psychological well-being, living with both parents, having a live-in domestic helper, and neighborhood quality also longitudinally predicted fewer child internalizing problems. Discussion Our findings underscore the importance of nurturing children's emotional resilience under adverse and uncertain circumstances by boosting protective factors in their social-ecological system, including community-, family-, parent-, and child-level resources.
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Affiliation(s)
- Luxi Chen
- Centre for Family and Population Research, National University of Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei-Jun Jean Yeung
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Sociology and Anthropology, National University of Singapore, Singapore, Singapore
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Hmidan A, Seguin D, Duerden EG. Media screen time use and mental health in school aged children during the pandemic. BMC Psychol 2023; 11:202. [PMID: 37430372 DOI: 10.1186/s40359-023-01240-0] [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: 12/09/2022] [Accepted: 06/30/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Children's screen time activity has increased significantly during the pandemic. Extended school closures and heightened parent stress are associated with children's behavioural difficulties and time spent watching screens. The primary aim of this study was to determine which school and household factors were associated with challenging behaviours in Canadian schoolchildren during the COVID-19 pandemic. METHODS This longitudinal survey study examined the association amongst screen time, internalizing and externalizing behaviours in school-aged children at two time points over the 2020-2021 academic school year. Parents completed survey measures on their parental involvement, stress levels, and their child's screen time use as well as their emotional and behavioural difficulties. RESULTS Children's average daily screen time was 4.40 h (SE = 18.45) at baseline and 3.89 h (SE = 16.70) at 1-year follow up, with no significant change across the school year (p = .316). Increased screen time use was associated with a greater incidence of internalizing behaviours in children (p = .03). Children who spent more time on screens and who were in households with parents reporting higher stress levels had increased internalizing behaviours (p < .001). No association between screen time use and externalizing behaviours was evident; however, parent stress was positively associated with children's externalizing behaviours (p < .001). CONCLUSIONS Children's screen time use has remained high during the pandemic and is associated with anxious and depressive symptoms. Children who spent more time on screens and who were in households with parents reporting higher stress levels had increased internalizing behaviours. Parent stress was positively associated with children's externalizing behaviours. Targeted family intervention plans focused on reducing parent stress and screen time use may aid in improving children's mental health during the ongoing pandemic.
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Affiliation(s)
- Amira Hmidan
- Applied Psychology, Faculty of Education, Western University, 1137 Western Rd, London, ON, N6G 1G7, Canada
- Department of Psychology, Western University, N6A 3K7, London, Canada
| | - Diane Seguin
- Applied Psychology, Faculty of Education, Western University, 1137 Western Rd, London, ON, N6G 1G7, Canada
- Physiology & Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Emma G Duerden
- Applied Psychology, Faculty of Education, Western University, 1137 Western Rd, London, ON, N6G 1G7, Canada.
- Children's Health Research Institute, London, Canada.
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Ludwig-Walz H, Dannheim I, Pfadenhauer LM, Fegert JM, Bujard M. Anxiety increased among children and adolescents during pandemic-related school closures in Europe: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health 2023; 17:74. [PMID: 37344892 DOI: 10.1186/s13034-023-00612-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/10/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Considering the heterogenous evidence, a systematic review of the change in anxiety in European children and adolescents associated with the COVID-19 pandemic is lacking. We therefore assessed the change compared with pre-pandemic baselines stratified by gender and age as well as evaluated the impact of country-specific restriction policies. METHODS A registration on the 'International Prospective Register of Systematic Reviews' (PROSPERO) occurred and an a priori protocol was published. We searched six databases (PubMed, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, WHO COVID-19) using a peer-reviewed search string with citation tracking and grey literature screening. Primary outcomes were: (1) general anxiety symptoms; and (2) clinically relevant anxiety rates. We used the Oxford COVID-19 Stringency Index as an indicator of pandemic-related restrictions. Screening of title/abstract and full text as well as assessing risk of bias (using the 'Risk of Bias in Non-randomized Studies of Exposure' [ROBINS-E]) and certainty of evidence (using the 'Grading of Recommendations Assessment, Development and Evaluation' [GRADE]) was done in duplicate. We pooled data using a random effects model. Reporting is in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. RESULTS Of 7,422 non-duplicate records, 18 studies with data from 752,532 pre-pandemic and 763,582 pandemic participants met full inclusion criteria. For general anxiety symptoms the total change effect estimate yielded a standardised mean difference (SMD) of 0.34 (95% confidence interval [CI], 0.17-0.51) and for clinically relevant anxiety rates we observed an odds ratio of 1.08 (95%-CI, 0.98-1.19). Increase in general anxiety symptoms was highest in the 11-15 years age group. Effect estimates were higher when pandemic-related restrictions were more stringent (Oxford Stringency Index > 60: SMD, 0.52 [95%-CI, 0.30-0.73]) and when school closures (School Closure Index ≥ 2: SMD, 0.44 [95%-CI, 0.23-0.65]) occurred. CONCLUSION General anxiety symptoms among children and adolescents in Europe increased in a pre/during comparison of the COVID-19 pandemic; particularly for males aged 11-15 years. In periods of stringent pandemic-related restrictions and/or school closures a considerable increase in general anxiety symptoms could be documented. PROSPERO registration: CRD42022303714.
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Affiliation(s)
| | - Indra Dannheim
- Regional Innovative Centre of Health and Quality of Live Fulda (RIGL), Fulda University of Applied Sciences, Fulda, Germany
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | - Lisa M Pfadenhauer
- Chair of Public Health and Health Services Research, IBE, Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Jörg M Fegert
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Competence Domain Mental Health Prevention, Ulm, Germany
| | - Martin Bujard
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
- Institute of Medical Psychology, Medical Faculty, University Heidelberg, Heidelberg, Germany
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Muhajarine N, Pisolkar V, Hinz T, Adeyinka DA, McCutcheon J, Alaverdashvili M, Damodharan S, Dena I, Jurgens C, Taras V, Green K, Kallio N, Palmer-Clarke Y. Mental Health and Health-Related Quality of Life of Children and Youth during the First Year of the COVID-19 Pandemic: Results from a Cross-Sectional Survey in Saskatchewan, Canada. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1009. [PMID: 37371243 DOI: 10.3390/children10061009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
For children and youth, the COVID-19 pandemic surfaced at a critical time in their development. Children have experienced extended disruptions to routines including in-person schooling, physical activities, and social interactions-things that bring meaning and structure to their daily lives. We estimated the prevalence of anxiety and depression symptoms of children and youth and their experiences of health-related quality of life (HRQoL), during the first year of the pandemic, and identified factors related to these outcomes. Further, we examined these effects among ethnocultural minority families. We conducted an online survey (March-July 2021) with 510 children and youth aged 8-18 years and their parents/caregivers. The sample was representative of the targeted population. We modelled the relationship between anxiety, depression (measured using the Revised Child Anxiety and Depression Scale), HRQoL (measured using KIDSCREEN-10), and sociodemographic, behavioural, and COVID-19-contributing factors using binary logistic regression. A priori-selected moderating effects of sociodemographic characteristics and self-identified ethnocultural minority groups on the outcomes were tested. The point-in-time prevalence of medium-to-high anxiety symptoms and depression symptoms was 10.19% and 9.26%, respectively. Almost half (49.15%) reported low-to-moderate HRQoL. Children reporting medium-to-high anxiety symptoms, depression symptoms, and low-to-moderate HRQoL were more likely to be aged 8-11 years, 16-18 years, ethnocultural minority participants, living in rural/urban areas, having good/fair MH before COVID-19, experiencing household conflicts, having less physical activity, and having ≥3 h of recreational screen time. Those who had more people living at home and ≥8 h of sleep reported low anxiety and depression symptoms. Ethnocultural minority 16-18-year-olds were more likely to report low-to-moderate HRQoL, compared to 12-15-year-olds. Additionally, 8-11-year-olds, 16-18-year-olds with immigrant parents, and 16-18-year-olds with Canadian-born parents were more likely to report low-moderate HRQoL, compared to 12-15-year-olds. Children and youth MH and HRQoL were impacted during the pandemic. Adverse MH outcomes were evident among ethnocultural minority families. Our results reveal the need to prioritize children's MH and to build equity-driven, targeted interventions.
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Affiliation(s)
- Nazeem Muhajarine
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Vaidehi Pisolkar
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Tamara Hinz
- Department of Psychiatry, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
- Saskatchewan Health Authority, 701 Queen Street, Saskatoon, SK S7K 0M7, Canada
| | - Daniel A Adeyinka
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Jessica McCutcheon
- Canadian Hub for Applied and Social Research (CHASR), University of Saskatchewan, 9 Campus Drive, Saskatoon, SK S7N 5A5, Canada
| | - Mariam Alaverdashvili
- Department of Psychiatry, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Senthil Damodharan
- Department of Psychiatry, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Isabelle Dena
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Christa Jurgens
- EGADZ Saskatoon Downtown Youth Centre Inc., 1st Avenue North, Saskatoon, SK S7K 1X5, Canada
| | - Victoria Taras
- Saskatchewan Teachers' Federation, 2317 Arlington Avenue, Saskatoon, SK S7J 2H8, Canada
| | - Kathryn Green
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Natalie Kallio
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Yolanda Palmer-Clarke
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
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Madigan S, Racine N, Vaillancourt T, Korczak DJ, Hewitt JMA, Pador P, Park JL, McArthur BA, Holy C, Neville RD. Changes in Depression and Anxiety Among Children and Adolescents From Before to During the COVID-19 Pandemic: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:567-581. [PMID: 37126337 PMCID: PMC10152379 DOI: 10.1001/jamapediatrics.2023.0846] [Citation(s) in RCA: 42] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/04/2023] [Indexed: 05/02/2023]
Abstract
Importance There is a growing body of high-quality cohort-based research that has examined changes in child and adolescent mental health during the COVID-19 pandemic vs before the pandemic. Some studies have found that child and adolescent depression and anxiety symptoms have increased, while others have found these symptoms to have remained stable or decreased. Objective To synthesize the available longitudinal cohort-based research evidence to estimate the direction and magnitude of changes in depression and anxiety symptoms in children and adolescents assessed before and during the pandemic. Data Sources Medline, Embase, and PsycInfo were searched for studies published between January 1, 2020, and May 17, 2022. Study Selection Included studies reported on depression and/or anxiety symptoms, had cohort data comparing prepandemic to pandemic estimates, included a sample of children and/or adolescents younger than 19 years, and were published in English in a peer-reviewed journal. Data Extraction and Synthesis In total, 53 longitudinal cohort studies from 12 countries with 87 study estimates representing 40 807 children and adolescents were included. Main Outcomes and Measures Standardized mean changes (SMC) in depression and anxiety symptoms from before to during the pandemic. Results The analysis included 40 807 children and adolescents represented in pre-COVID-19 studies and 33 682 represented in during-COVID-19 studies. There was good evidence of an increase in depression symptoms (SMC, 0.26; 95% CI, 0.19 to 0.33). Changes in depression symptoms were most conclusive for study estimates among female individuals (SMC, 0.32; 95% CI, 0.21 to 0.42), study estimates with mid to high income (SMC, 0.35; 95% CI, 0.07 to 0.63), and study estimates sourced from North America (SMC, 0.25; 95% CI, 0.15 to 0.36) and Europe (SMC, 0.35; 95% CI, 0.17 to 0.53). There was strong evidence that anxiety symptoms increased slightly during the pandemic (SMC, 0.10; 95% CI, 0.04 to 0.16), and there was some evidence of an increase in study estimates with mid to high income. Conclusions This systematic review and meta-analysis of longitudinal studies including children and adolescents found an increase in depression symptoms during the COVID-19 pandemic, particularly among female individuals and those from relatively higher-income backgrounds.
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Affiliation(s)
- Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Nicole Racine
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Tracy Vaillancourt
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Counselling Psychology, Faculty of Education University of Ottawa, Ontario, Canada
| | - Daphne J. Korczak
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Jackson M. A. Hewitt
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Paolo Pador
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Joanne L. Park
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Celeste Holy
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Ross D. Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Kauhanen L, Wan Mohd Yunus WMA, Lempinen L, Peltonen K, Gyllenberg D, Mishina K, Gilbert S, Bastola K, Brown JSL, Sourander A. A systematic review of the mental health changes of children and young people before and during the COVID-19 pandemic. Eur Child Adolesc Psychiatry 2023; 32:995-1013. [PMID: 35962147 PMCID: PMC9373888 DOI: 10.1007/s00787-022-02060-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
There is increasing knowledge that the COVID-19 pandemic has had an impact on mental health of children and young people. However, the global evidence of mental health changes before compared to during the COVID-19 pandemic focusing on children and young people has not been systematically reviewed. This systematic review examined longitudinal and repeated cross-sectional studies comparing before and during COVID-19 pandemic data to determine whether the mental health of children and young people had changed before and during the COVID-19 pandemic. The Web of Science, PubMed, Embase and PsycINFO databases were searched to identify peer-reviewed studies that had been published in English and focused on children and young people between 0 and 24 years of age. This identified 21 studies from 11 countries, covering more than 96,000 subjects from 3 to 24 years of age. Pre-pandemic and pandemic data were compared. Most studies reported longitudinal deterioration in the mental health of adolescents and young people, with increased depression, anxiety and psychological distress after the pandemic started. Other findings included deteriorated negative affect, mental well-being and increased loneliness. Comparing data for pandemic and pre-pandemic periods showed that the COVID-19 pandemic may negatively impact the mental health of children and young people. There is an urgent need for high-quality research to address the impact, risks and protective factors of the pandemic on their mental health, as this will provide a good foundation for dealing with future health emergencies and other crises.
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Affiliation(s)
- Laura Kauhanen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Wan Mohd Azam Wan Mohd Yunus
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
- Department of Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Johor, Malaysia
| | - Lotta Lempinen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Kirsi Peltonen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - David Gyllenberg
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Kaisa Mishina
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Sonja Gilbert
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Kalpana Bastola
- National Institute for Health and Welfare, Helsinki, Finland
| | - June S L Brown
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, England, London, UK
| | - Andre Sourander
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland.
- INVEST Research Flagship, University of Turku, Turku, Finland.
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland.
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Barbieri V, Wiedermann CJ, Piccoliori G, Mahlknecht A, Plagg B, Ausserhofer D, Ravens-Sieberer U, Engl A. Evolution of Youth's Mental Health and Quality of Life during the COVID-19 Pandemic in South Tyrol, Italy: Comparison of Two Representative Surveys. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050895. [PMID: 37238443 DOI: 10.3390/children10050895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/08/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic has led to an increase in youth mental health problems worldwide. Studies have revealed substantial variation in the incidence of these problems across different regions. Longitudinal studies of children and adolescents in Italy are lacking. This study aimed to investigate the development of health-related quality of life (HRQoL) and mental health in Northern Italy by comparing surveys conducted in June 2021 and in March 2022. METHODS A representative, large cross-sectional, online survey investigated HRQoL, psychosomatic complaints, and symptoms of anxiety and depression among 5159 and 6675 children and adolescents in 2021 and 2022, respectively, using the KIDSCREEN-10 index, HBSC symptom checklist, SCARED, CES-DC, and PHQ-2 instruments. Statistical analyses included a multivariate linear regression analysis. RESULTS Baseline characteristics showed significant differences in demographic variables between the two surveys. Girls and their parents reported a significantly lower HRQoL in 2021 than in 2022. Psychosomatic complaints differed significantly between sexes, and the results showed no decrease in psychosomatic complaints, anxiety, or depression between 2021 and 2022. Predictors of HRQoL, anxiety, depressive symptoms, and psychosomatic complaints in 2022 differed from those in 2021. CONCLUSIONS The characteristics of the 2021 pandemic, including lockdowns and home schooling, may have contributed to the differences between the two surveys. As most pandemic restrictions ended in 2022, the results confirm the need for measures to improve the mental and physical health of children and adolescents after the pandemic.
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Affiliation(s)
- Verena Barbieri
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
| | - Christian J Wiedermann
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology, 6060 Hall, Austria
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
| | - Angelika Mahlknecht
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
| | - Barbara Plagg
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
- 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
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Adolf Engl
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
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Kästner A, Ernst VS, Hoffmann W, Franze M. Changes in social behavioral developmental risks in preschool children after the first COVID-19 wave: a prospective longitudinal cohort study. Sci Rep 2023; 13:5615. [PMID: 37024603 PMCID: PMC10078017 DOI: 10.1038/s41598-023-32877-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
The impact of the COVID-19 pandemic on social-emotional developmental risks (SE-DR) of preschool children is largely unknown. Therefore, the aim of this prospective longitudinal dynamic cohort study was to assess changes in preschoolers' SE-DR from before the pandemic to after the first COVID-19 wave. SE-DR were assessed annually with the instrument "Dortmund Developmental Screening for Preschools" (DESK). Longitudinal DESK data from 3- to 4-year-old children who participated both in survey wave (SW) three (DESK-SW3, 2019) and SW four (DESK-SW4, 2020) from August 1 to November 30 were used, respectively. Additionally, data from previous pre-pandemic SW were analyzed to contextualize the observed changes (SW1: 2017; SW2: 2018). A total of N = 786 children were included in the analysis. In the pre-pandemic DESK-SW3, the proportion of children with SE-DR was 18.2%, whereas in DESK-SW4 after the first COVID-19 wave, the proportion decreased to 12.4% (p = 0.001). Thus, the prevalence rate ratio (PRR) was 0.68. Compared to data from previous SW (SW1-SW2: PRR = 0.88; SW2-SW3: PRR = 0.82), this result represents a notable improvement. However, only short-term effects were described, and the study region had one of the highest preschool return rates in Germany. Further studies are needed to examine long-term effects of the pandemic on preschoolers' SE-DR.
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Affiliation(s)
- Anika Kästner
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany.
| | - Vanessa Sophie Ernst
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany
| | - Marco Franze
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany
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Sundaram N, Abramsky T, Oswald WE, Cook S, Halliday KE, Nguipdop‐Djomo P, Sturgess J, Ireland G, Ladhani SN, Mangtani P, Langan SM, Hargreaves JR, Bonell C. Implementation of COVID-19 Preventive Measures and Staff Well-Being in a Sample of English Schools 2020-2021. THE JOURNAL OF SCHOOL HEALTH 2023; 93:266-278. [PMID: 36450450 PMCID: PMC9877738 DOI: 10.1111/josh.13264] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/12/2022] [Accepted: 11/02/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND We examined fidelity and feasibility of implementation of COVID-19 preventive measures in schools, and explored associations between adherence to these measures and staff well-being, to inform policy on sustainable implementation and staff wellbeing. METHODS Surveys were conducted across 128 schools in England with 107 headteachers and 2698 staff-members with reference to autumn term 2020, examining school-level implementation of preventive measures, adherence, and teacher burnout (response rates for headteacher and staff surveys were 84% and 59%, respectively). RESULTS The median number of measures implemented in primary and secondary schools was 33 (range 23-41), and 32 (range 22-40), respectively; most measures presented challenges. No differences were found regarding number of measures implemented by school-level socio-economic disadvantage. High adherence was reported for staff wearing face-coverings, staff regularly washing their hands, (secondary only) desks facing forwards, and (primary only) increased cleaning of surfaces and student hand-washing. Adherence to most measures was reported as higher in primary than secondary schools. Over half of school leaders and 42% (517/1234) of other teaching staff suffered from high emotional exhaustion. Higher teacher-reported school-wide adherence with measures was consistently associated with lower burnout for leaders and other teaching staff. CONCLUSIONS Findings indicate a tremendous effort in implementing preventive measures and an urgent need to support investments in improving teacher wellbeing.
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Affiliation(s)
- Neisha Sundaram
- Department of Public Health, Environments and SocietyLondon School of Hygiene & Tropical MedicineWC1H 9SHLondonUK
| | - Tanya Abramsky
- Department of Global Health and DevelopmentLondon School of Hygiene & Tropical MedicineWC1H 9SHLondonUK
| | - William E Oswald
- Department of Disease ControlLondon School of Hygiene & Tropical MedicineWC1E 7HTLondonUK
| | - Sarah Cook
- Department of Non‐communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT; National Heart and Lung Institute, Imperial College LondonLondonUK
| | - Katherine E Halliday
- Department of Disease ControlLondon School of Hygiene & Tropical MedicineWC1E 7HTLondonUK
| | - Patrick Nguipdop‐Djomo
- Department of Infectious Disease EpidemiologyLondon School of Hygiene & Tropical MedicineWC1E 7HTLondonUK
| | - Joanna Sturgess
- Department of Medical StatisticsLondon School of Hygiene & Tropical MedicineWC1E 7HTLondonUK
| | | | - Shamez N Ladhani
- Public Health Programmes, UK Health Security Agency; Paediatric Infectious Diseases Research Group, St George's University of LondonLondonUK
| | - Punam Mangtani
- Department of Infectious Disease EpidemiologyLondon School of Hygiene & Tropical MedicineWC1E 7HTLondonUK
| | - Sinéad M Langan
- Department of Non‐communicable Disease EpidemiologyLondon School of Hygiene & Tropical MedicineWC1E 7HTLondonUK
| | - James R Hargreaves
- Department of Public Health, Environments and SocietyLondon School of Hygiene & Tropical MedicineWC1H 9SHLondonUK
| | - Chris Bonell
- Department of Public Health, Environments and SocietyLondon School of Hygiene & Tropical MedicineWC1H 9SHLondonUK
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Newlove‐Delgado T, Russell AE, Mathews F, Cross L, Bryant E, Gudka R, Ukoumunne OC, Ford TJ. Annual Research Review: The impact of Covid-19 on psychopathology in children and young people worldwide: systematic review of studies with pre- and within-pandemic data. J Child Psychol Psychiatry 2023; 64:611-640. [PMID: 36421049 PMCID: PMC10952503 DOI: 10.1111/jcpp.13716] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The high volume and pace of research has posed challenges to researchers, policymakers and practitioners wanting to understand the overall impact of the pandemic on children and young people's mental health. We aimed to search for and review the evidence from epidemiological studies to answer the question: how has mental health changed in the general population of children and young people? METHODS Four databases (Medline, CINAHL, EMBASE and PsychINFO) were searched in October 2021, with searches updated in February 2022. We aimed to identify studies of children or adolescents with a mean age of 18 years or younger at baseline, that reported change on a validated mental health measure from prepandemic to during the pandemic. Abstracts and full texts were double-screened against inclusion criteria and quality assessed using a risk of bias tool. Studies were narratively synthesised, and meta-analyses were performed where studies were sufficiently similar. RESULTS 6917 records were identified, and 51 studies included in the review. Only four studies had a rating of high quality. Studies were highly diverse in terms of design, setting, timing in relation to the pandemic, population, length of follow-up and choice of measure. Methodological heterogeneity limited the potential to conduct meta-analyses across studies. Whilst the evidence suggested a slight deterioration on some measures, overall, the findings were mixed, with no clear pattern emerging. CONCLUSIONS Our findings highlight the need for a more harmonised approach to research in this field. Despite the sometimes-inconsistent results of our included studies, the evidence supports existing concerns about the impact of Covid-19 on children's mental health and on services for this group, given that even small changes can have a significant impact on provision at population level. Children and young people must be prioritised in pandemic recovery, and explicitly considered in planning for any future pandemic response.
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Affiliation(s)
| | | | - Frances Mathews
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Lauren Cross
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - Eleanor Bryant
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Rebecca Gudka
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Obioha C. Ukoumunne
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
- NIHR Applied Research Collaboration South West Peninsula (PenARC)ExeterUK
| | - Tamsin J. Ford
- Department of PsychiatryUniversity of CambridgeCambridgeUK
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Astle DE, Moore A, Marryat L, Viding E, Mansfield KL, Fazel M, Pierce M, Abel KM, Green J, John A, Broome MR, Upthegrove R, Bould H, Minnis H, Gajwani R, Groom MJ, Hollis C, Liddle E, Sayal K, Berry V, Collishaw S, Dawes H, Cortese S, Violato M, Pollard J, MacCabe JH, Blakemore SJ, Simonoff E, Watkins E, Hiller RM, Townsend E, Armour C, Geddes JR, Thompson L, Schwannauer M, Nicholls D, Hotopf M, Downs J, Rahman A, Sharma AN, Ford TJ. We need timely access to mental health data: implications of the Goldacre review. Lancet Psychiatry 2023; 10:242-244. [PMID: 36931773 DOI: 10.1016/s2215-0366(23)00030-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 03/17/2023]
Affiliation(s)
- Duncan E Astle
- Department of Psychiatry, University of Cambridge, Cambridge CB2 1TN, UK; MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 1TN, UK.
| | - Anna Moore
- Department of Psychiatry, University of Cambridge, Cambridge CB2 1TN, UK
| | - Louise Marryat
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, UK
| | | | - Mina Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Matthias Pierce
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Kathryn M Abel
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Jonathan Green
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Ann John
- Population Data Science, Swansea University, Swansea, UK
| | - Matthew R Broome
- Institute for Mental Health, University of Birmingham, Birmingham, UK; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Helen Bould
- Population Health Science, Centre for Academic Mental Health and Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Helen Minnis
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Ruchika Gajwani
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Madeleine J Groom
- Academic Unit of Mental Health & Clinical Neurosciences School of Medicine, University of Nottingham, Nottingham, UK; Centre for ADHD & Neurodevelopmental Disorders Across the Lifespan, University of Nottingham, Nottingham, UK
| | - Chris Hollis
- NIHR MindTech MIC & NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - Elizabeth Liddle
- Centre for ADHD & Neurodevelopmental Disorders Across the Lifespan, University of Nottingham, Nottingham, UK
| | - Kapil Sayal
- Academic Unit of Mental Health & Clinical Neurosciences School of Medicine, University of Nottingham, Nottingham, UK; Centre for ADHD & Neurodevelopmental Disorders Across the Lifespan, University of Nottingham, Nottingham, UK
| | - Vashti Berry
- Children & Young People's Mental Health Research Collaboration, University of Exeter, Exeter, UK
| | - Stephan Collishaw
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Helen Dawes
- NIHR Exeter Biomedical Research Centre, University of Exeter, Exeter, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK
| | - Mara Violato
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jack Pollard
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - James H MacCabe
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | | | - Emily Simonoff
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | | | - Rachel M Hiller
- Division of Psychology and Language Sciences, University College London, London, UK; Anna Freud National Centre for Children and Families, University College London, London, UK
| | - Ellen Townsend
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Cherie Armour
- School of Psychology, Queen's University Belfast, Belfast, UK
| | - John R Geddes
- NIHR Oxford Health Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Lucy Thompson
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Matthias Schwannauer
- Centre for Applied Developmental Psychology, University of Edinburgh, Edinburgh, UK
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, London, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Johnny Downs
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Atif Rahman
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Aditya Narain Sharma
- Translational and Clinical Research Institute, University of Newcastle, Newcastle, UK; Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Tamsin J Ford
- Department of Psychiatry, University of Cambridge, Cambridge CB2 1TN, UK
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Lakshmi RKRR, Oinam E, Gazalaxmi Devi K. Yogic Spirituality and Positive Psychology vis-à-vis the Mental Health of Adolescents During COVID-19. PASTORAL PSYCHOLOGY 2023:1-7. [PMID: 37359495 PMCID: PMC9989573 DOI: 10.1007/s11089-023-01061-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 06/28/2023]
Abstract
COVID-19 ushered in a period of uncertainty and insecurity. It has affected the mental well-being of all, but certain groups are more vulnerable, including adolescents. Adolescence is a period of transition from childhood to adulthood in which the mental domain is still developing. The pandemic has had an adverse effect on the mental well-being of adolescents. Their normal routines are severely affected by the pandemic and related restrictions. There is a need for a coping mechanism or resources to empower this group of people. Spirituality has salubrious effect on all dimensions of health. The concept of spirituality is closely related to yoga and positive psychology. The article describes the similarities between yoga and positive psychology. It further posits that spirituality is closely related to yoga and positive psychology. The article also argues that both yoga and positive psychology could be useful in improving the mental dimension of health in adolescents in the COVID-19 era. A thorough study of the literature helped the authors to conclude that yoga and positive psychology definitely enhance mental well-being. The tenets of yoga and positive psychology can be incorporated into the daily regimen of children and adolescents to increase their resilience and mental strength. Further studies with robust study designs could ascertain the benefits of such measures.
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Affiliation(s)
| | - Elizabeth Oinam
- Faculty of Naturopathy, Shree Guru Gobind Singh Tricentenery University, Gurugram Badli Road, Haryana, India
| | - Khwairakpam Gazalaxmi Devi
- Guest Faculty, Department of Yoga, Manipur University, Canchipur, Manipur 795003 India
- Department of Yoga, Manipur University, Imphal, India
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Murray J, Bauer A, Loret de Mola C, Martins RC, Blumenberg C, Esposti MD, Stein A, Barros FC, Hallal PC, Silveira MF, Bertoldi AD, Domingues MR. Child and Maternal Mental Health Before and During the COVID-19 Pandemic: Longitudinal Social Inequalities in a Brazilian Birth Cohort. J Am Acad Child Adolesc Psychiatry 2023; 62:344-357. [PMID: 36075481 PMCID: PMC9441217 DOI: 10.1016/j.jaac.2022.07.832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/18/2022] [Accepted: 08/29/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has caused major stress for families and children, particularly in the context of prolonged school closures. Few longitudinal studies are available on young children's mental health, including data both before and during the pandemic. This study examined experiences that might increase risk for mental health problems among caregivers and young children during the COVID-19 pandemic and inequalities driven by pre-pandemic disadvantage. METHOD This prospective, population-based birth cohort study in Pelotas, Brazil, analyzed 2,083 children and caregivers with data from before the pandemic in 2019, when children were 4 years old, and again in 2020, when schools were closed for a long period during the pandemic. Child conduct problems, emotional problems, and hyperactivity-inattention problems were assessed using the Strengths and Difficulties Questionnaire. Family financial hardship, relationship difficulties, caregiver mental health, parenting practices, and child fears and isolation were considered as potential risk factors. RESULTS Across the whole population, the only significant increase in mental health problems from before to during the pandemic was found for maternal depression. However, poorer families were at far greater risk of experiencing serious financial problems, food shortages, increased conflict in adult relationships, parenting problems, and child worries about food availability during the pandemic. In turn, these difficulties were associated with increases in multiple mental health problems for both caregivers and children. Increased child mental health problems were most strongly associated with concurrent maternal anxiety (β > 0.20, p < .001, for each of child conduct, emotional, and hyperactivity problems), maternal depression (β = 0.26, p < .001, for child emotional problems), partner criticism (β = 0.21, p < .001, for child conduct problems), and harsh parenting (β > 0.20, p < .001, for both child conduct and hyperactivity problems). Child worry about COVID-19 was associated with increased emotional problems (β = 0.14, p < .001), but children's isolation was not associated with their mental health. CONCLUSION Overall, the impact of the COVID-19 pandemic on mental health is a mixed picture, but for families in poverty, marked material and interpersonal difficulties were associated with increases in mental health problems among children and caregivers.
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Affiliation(s)
- Joseph Murray
- Federal University of Pelotas, Brazil; Human Development and Violence Research Centre, Brazil.
| | - Andreas Bauer
- Federal University of Pelotas, Brazil; Human Development and Violence Research Centre, Brazil
| | - Christian Loret de Mola
- Federal University of Pelotas, Brazil; Human Development and Violence Research Centre, Brazil; University of Rio Grande, Brazil, and Universidad Científica del Sur Lima-Peru, Peru
| | - Rafaela Costa Martins
- Federal University of Pelotas, Brazil; Human Development and Violence Research Centre, Brazil
| | | | - Michelle Degli Esposti
- Federal University of Pelotas, Brazil; Human Development and Violence Research Centre, Brazil
| | - Alan Stein
- University of Oxford, United Kingdom, the University of the Witwatersrand, South Africa, and the African Health Research Institute, South Africa
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Barendse ME, Flannery J, Cavanagh C, Aristizabal M, Becker SP, Berger E, Breaux R, Campione‐Barr N, Church JA, Crone EA, Dahl RE, Dennis‐Tiwary TA, Dvorsky MR, Dziura SL, van de Groep S, Ho TC, Killoren SE, Langberg JM, Larguinho TL, Magis‐Weinberg L, Michalska KJ, Mullins JL, Nadel H, Porter BM, Prinstein MJ, Redcay E, Rose AJ, Rote WM, Roy AK, Sweijen SW, Telzer EH, Teresi GI, Thomas AG, Pfeifer JH. Longitudinal Change in Adolescent Depression and Anxiety Symptoms from before to during the COVID-19 Pandemic. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2023; 33:74-91. [PMID: 35799311 PMCID: PMC9349954 DOI: 10.1111/jora.12781] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
This study aimed to examine changes in depression and anxiety symptoms from before to during the first 6 months of the COVID-19 pandemic in a sample of 1,339 adolescents (9-18 years old, 59% female) from three countries. We also examined if age, race/ethnicity, disease burden, or strictness of government restrictions moderated change in symptoms. Data from 12 longitudinal studies (10 U.S., 1 Netherlands, 1 Peru) were combined. Linear mixed effect models showed that depression, but not anxiety, symptoms increased significantly (median increase = 28%). The most negative mental health impacts were reported by multiracial adolescents and those under 'lockdown' restrictions. Policy makers need to consider these impacts by investing in ways to support adolescents' mental health during the pandemic.
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Deborah Omoleye D, Olubukola Abidakun O, Oluwadamilola Akinje R, Hannah Ademuyiwa O, Mofoluwaso Fasogbon B. A Review of the Effects of the COVID-19 Pandemic on Children and Adolescents' Mental Health. Curr Pediatr Rev 2023; 20:CPR-EPUB-129438. [PMID: 36788690 DOI: 10.2174/1573396319666230213104546] [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: 07/07/2022] [Revised: 09/23/2022] [Accepted: 12/23/2022] [Indexed: 02/16/2023]
Abstract
Disaster poses a huge threat to physical health as much as mental health, and Covid-19 is not any different. Understanding that physical and social factors can all contribute to mental health disruptions explains the rising concern of the global community about the impacts of Covid-19 on mental health, especially among the vulnerable, including children and adolescents. It is imperative to explore the diverse impacts of Covid-19 on the paediatric age group, especially to better address its effect and adequately strategize for its resulting conditions. This narrative review, therefore, explores literature reports on the effect of the pandemic on the mental health of children and adolescents. As observed in the literature, Covid-19 did not only threaten the physical health of children and adolescents but also their mental health, especially in terms of anxiety, depression, sleep alteration, etc. In this paper, we have discussed interventions, such as adequate sleep, healthy lifestyles, and nutritious foods, to improve paediatric mental health even after the pandemic.
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Stänicke LI, Kurseth PO, Bekkhus M. 'Everything turned upside down': A thematic analysis of adolescents' experiences of everyday life during COVID-19 restrictions. Scand J Public Health 2023:14034948231152272. [PMID: 36765465 PMCID: PMC9922644 DOI: 10.1177/14034948231152272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND At the beginning of the COVID-19 pandemic, people were encouraged to practice social distancing, and schools and leisure venues closed. AIMS We aimed to explore the everyday experiences of Norwegian adolescents during COVID-19 restrictions, when in-person contact with peers was severely limited. METHODS A total of 622 high-school students (16-18 years of age) replied to an online survey containing open-ended questions about the changes they experienced in everyday life during the first three months of the pandemic. RESULTS Reflexive thematic analysis resulted in four themes: (a) 'Everyday life turned upside down - everything is on hold'; (b) 'Alone with my thoughts - new concerns'; (c) 'A loss of social life - a fear of wasting important time'; and (d) 'Gratitude - new perspectives in life'. The results are discussed according to mental-health concerns and psychological developmental challenges during adolescence, such as social exploration of roles with peers, autonomy and identity formation during a crisis. CONCLUSIONS
The results underline individual variations and positive experiences among adolescents during the COVID-19 pandemic, despite social restrictions. Still, the lack of in-person contact with friends is related to an increased experience of loneliness and mental-health concerns for many adolescents.
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Affiliation(s)
- Line Indrevoll Stänicke
- Department of Psychology, University of
Oslo, Norway,Lovisenberg Hospital, Nic Waals
Institute, Norway,Line Indrevoll Stänicke, University of
Oslo, Pb 1094 Blindern, 0317 Oslo, Norway.
| | | | - Mona Bekkhus
- Promenta Research Centre, Department of
Psychology, University of Oslo, Norway
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Jamison JM, Egger D, Vazquez CE, McBride MJ, Pauling SN, Hess KE, Calzada EJ, Bearman SK. Mental Health Trajectories of Latinx Female Caregivers and Young Children During COVID-19: A Longitudinal Analysis. JOURNAL OF CHILD AND FAMILY STUDIES 2023; 32:571-585. [PMID: 36788947 PMCID: PMC9911948 DOI: 10.1007/s10826-023-02545-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Studies of the impact of COVID-19 on mental health symptoms suggest that there may be a unique impact of COVID-19 on minoritized individuals, young children (children five and younger), and their caregivers. Longitudinal studies with representative samples including minoritized populations are needed to accurately reflect the experience of families during COVID-19. The current study used a longitudinal design to assess trajectories of mental health among Latinx female caregivers and their young children over time, beginning prior to the onset of the COVID-19 pandemic and over the course of 12 months. In fall of 2019, Latinx female caregivers (N = 213; 93.0% biological mother) of young children (M age = 5.38, SD = 0.34) reported on their own and their child's (52.6% female) mental health symptoms, as well as parenting stress, at three time points through Fall of 2020. Growth curve models showed that self-report of caregiver global mental health worsened over time, though caregiver depression and parenting stress did not change significantly, nor did caregiver-report of their children's mental health. Results suggest that while female caregiver well-being was adversely affected by COVID-19, caregivers showed resilience in the face of this pandemic, which in turn may have buffered the impact of the pandemic on Latinx child mental health. Methodological and contextual implications of these results are considered.
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Affiliation(s)
- Jesslyn M. Jamison
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
| | - Dominique Egger
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
| | - Christian E. Vazquez
- School of Social Work, The University of Texas at Arlington, 211S Cooper St, Arlington, TX 76019 USA
| | - Megan J. McBride
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
| | - Sydney N. Pauling
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
| | - Katherine E. Hess
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
| | - Esther J. Calzada
- The Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712 USA
| | - Sarah Kate Bearman
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
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McArthur BA, Racine N, McDonald S, Tough S, Madigan S. Child and family factors associated with child mental health and well-being during COVID-19. Eur Child Adolesc Psychiatry 2023; 32:223-233. [PMID: 34302530 PMCID: PMC8302979 DOI: 10.1007/s00787-021-01849-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/16/2021] [Indexed: 12/23/2022]
Abstract
Understanding the implications of the COVID-19 pandemic on the current generation of youth is critical for post-pandemic recovery planning. This study aimed to identify the most salient child (i.e., connectedness to caregivers, screen time, sleep, physical activity, peer relationships, and recreational activities) and family (i.e., COVID-19 financial impact, maternal depression and anxiety) factors associated with children's mental health and well-being during the COVID-19 pandemic, after controlling for pre-pandemic mental health. This study included 846 mother-child dyads (child age 9-11) from the All Our Families cohort. Mothers reported on the child's pre-pandemic mental health at age 8 (2017-2019) and during COVID-19 (May-July 2020), the family's financial impact due to COVID-19, and maternal depression and anxiety. During COVID-19 (July-August 2020), children reported on their screen time, sleep, physical activity, peer and family relationships, and recreational activities, as well as their happiness, anxiety and depression. After controlling for pre-pandemic anxiety, connectedness to caregivers (B - 0.16; 95% CI - 0.22 to - 0.09), child sleep (B - 0.11; 95% CI - 0.19 to - 0.04), and child screen time (B 0.11; 95% CI 0.04-0.17) predicted child COVID-19 anxiety symptoms. After controlling for pre-pandemic depression, connectedness to caregivers (B - 0.26; 95% CI - 0.32 to - 0.21) and screen time (B 0.09; 95% CI 0.02-0.16) predicted child COVID-19 depressive symptoms. After controlling for covariates, connectedness to caregivers (B 0.36; 95% CI 0.28-0.39) predicted child COVID-19 happiness. Fostering parent-child connections and promoting healthy device and sleep habits are critical modifiable factors that warrant attention in post-pandemic mental health recovery planning.
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Affiliation(s)
- Brae Anne McArthur
- Department of Psychology, Faculty of Arts, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Dr. NW., Calgary, AB T2N 1N4 Canada
| | - Nicole Racine
- Department of Psychology, Faculty of Arts, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Dr. NW., Calgary, AB T2N 1N4 Canada
| | - Sheila McDonald
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 2500 University Dr. NW., Calgary, AB T2N 1N4 Canada
| | - Suzanne Tough
- Department of Pediatrics and Community Health Sciences, Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Dr. NW., Calgary, AB T2N 1N4 Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, Alberta Children's Hospital Research Institute, University of Calgary, 2500 University Dr. NW., Calgary, AB, T2N 1N4, Canada.
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Dalhof M(G, Rost K, Ziegenhain U, Fegert JM, Köhler-Dauner F. SARS-CoV-2 pandemic as a catalyst? Development of emotional problems of preschool children of mothers with childhood maltreatment experiences in the course of the pandemic-a longitudinal analysis. Front Pediatr 2023; 11:1156282. [PMID: 37063662 PMCID: PMC10098205 DOI: 10.3389/fped.2023.1156282] [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: 02/01/2023] [Accepted: 03/13/2023] [Indexed: 04/18/2023] Open
Abstract
Background SARS-CoV-2 pandemic have posed great challenges for all families and children. Health risks and fears associated with SARS-CoV-2 negatively affect the parental mental health and perceived stress, which in turn influence parental coping and thereby impairs the mental health and well-being of their children. Additional risk factors within the parents, such as maternal childhood maltreatment (CM) experiences, may increase the risk of children to develop emotional problems during the pandemic. Objective The purpose of this longitudinal study is to determine whether preschool children of mothers with CM are at higher risk of developing emotional problems during the pandemic than preschool children of mothers without CM. Method 74 mothers from a birth cohort examining pathways to resilience or vulnerability in the transgenerational transmission of CM, provided information on emotional problems of their children (aged 3-7 years) at two measurement time points (t1: May 2020, t2: March 2021) as part of an online "SARS-CoV-2 pandemic" survey. In addition, parents were asked for a retrospective assessment of their children's emotional problems before the pandemic at time t1. Children's emotional problems were assessed using the "emotional problems" scale of the German version of the Strengths and Difficulties Questionnaire (SDQ) and linked to previously collected data on mothers' childhood maltreatment experiences, which were collected using the German short version of the Trauma in Childhood Questionnaire (CTQ). Results Our analyses showed that children's emotional problems increased significantly over the SARS-CoV-2 pandemic [F(1.86, 116.88) = 3.72, p = 0.030 η 2 = 0.06] and were rated significantly higher in the group of children of mothers with CM, than in the group of mothers without CM [F(1, 63) = 126.06, p < 0.001 η 2 = 0.67]. Furthermore children's emotional problems of mothers with CM increased significantly more and reached a clinically significant value during the pandemic than for children of mothers without CM [F(1.86, 116.88) = 8.89, p < 0.001, η 2 = 0.12]. Conclusions Children of mothers with CM appear to be at increased risk of developing emotional problems during the pandemic. CM therefore needs to be considered as an additional risk factor in the impact of the pandemic on children.
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Hughes C, Ronchi L, Heng J, Basile C, Del Sette P, Lecce S. What Mediates the Effect of Family Disruption in the COVID-19 Pandemic on Children’s Prosocial Behavior. SOCIAL PSYCHOLOGY 2023. [DOI: 10.1027/1864-9335/a000485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract. At the start of the COVID-19 pandemic, unprecedented social distancing rules (including mass school closures) dramatically constrained children’s social lives, jeopardizing human connections that foster prosocial development. This study of 2,516 families of 3–8-year-olds from six countries (China, Sweden, Australia, Italy, the USA, and the United Kingdom) examined whether children’s understanding or feelings about COVID-19 regulations mediated the expected association between COVID-19-related family disruption and children’s prosocial behavior, as indexed by parental ratings. For all six sites, family disruption indirectly predicted reduced prosocial behavior. Negative feelings about COVID-19 regulations mediated this association in all sites except China. Contrariwise, understanding of COVID-19 regulations was not implicated in the link between family disruption and reduced prosocial behavior.
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Affiliation(s)
- Claire Hughes
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Luca Ronchi
- Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy
| | - Jean Heng
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Chiara Basile
- Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy
| | - Paola Del Sette
- Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy
| | - Serena Lecce
- Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy
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Ludwig-Walz H, Dannheim I, Pfadenhauer LM, Fegert JM, Bujard M. Increase of depression among children and adolescents after the onset of the COVID-19 pandemic in Europe: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health 2022; 16:109. [PMID: 36587221 PMCID: PMC9805372 DOI: 10.1186/s13034-022-00546-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/13/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Research points to a high depression burden among youth during the COVID-19 pandemic; however, a lack of systematic evidence exists. We determine the change in depression symptoms among children and adolescents during COVID-19 compared to pre-pandemic baselines. By using country differences in pandemic-related restrictions and school closures in Europe as quasi-experimental design, we evaluate policy impacts on depression. METHODS In this systematic review and meta-analysis, following the PRISMA statement, we searched six databases (MEDLINE, EMBASE, PsycINFO, Cochrane Central, Web of Science, WHO COVID-19) using a peer-reviewed search string up until March 18, 2022 with citation tracking and grey literature searches. No limitations regarding language and effect measures existed. We included studies that compared (1) general depression symptoms or (2) clinically relevant depression rates in children and adolescents (≤ 19 years) before and during the COVID-19 pandemic in Europe. The validated Oxford Stringency Index was used as indicator for pandemic-related restrictions. Screening for eligibility, extracting data from published reports and from unpublished data requested directly from study authors, assessing the study risk of bias and grading certainty of evidence using the GRADE approach, were all done in duplicate. Data were pooled in a random-effects model. PROSPERO CRD42022303714. RESULTS Of 7,422 nonduplicate records, 22 studies with data from 868,634 participants pre-pandemic and 807,480 during pandemic, met full inclusion criteria. For the comparison of depression symptoms before and during the COVID-19 pandemic, moderate certainty of evidence was observed for general depression symptoms (standardized mean difference, 0.21 [95%CI, 0.12-0.30]; I2 = 94%) and low certainty of evidence for clinically relevant depression rates (odds ratio, 1.36 [95%CI, 1.05-1.76]; I2 = 95%) for total population. Increase in general depression symptoms was higher for male adolescents, whereas increase in clinically relevant depression rates was higher for females. Effect estimates were significantly higher when pandemic-related restrictions were more stringent or school closure occurred. CONCLUSION An increase in depression symptoms occurred in a pre-pandemic vs. during-pandemic comparison within the COVID-19 pandemic, whereby pandemic-related restrictions (such as school closures) resulted in a considerable effect increase. Ensuring adequate supply of mental health recovery services and long-term monitoring is of high public health relevance.
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Affiliation(s)
| | - Indra Dannheim
- grid.430588.2Regional Innovative Centre of Health and Quality of Live Fulda (RIGL), Fulda University of Applied Sciences, Fulda, Germany ,grid.430588.2Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | - Lisa M. Pfadenhauer
- grid.5252.00000 0004 1936 973XInstitute for Medical Information Processing, Biometry and Epidemiology-IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany ,Pettenkofer School of Public Health, Munich, Germany
| | - Jörg M. Fegert
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Competence Domain Mental Health Prevention, Ulm, Germany
| | - Martin Bujard
- grid.506146.00000 0000 9445 5866Federal Institute for Population Research (BiB), Wiesbaden, Germany ,grid.7700.00000 0001 2190 4373 Institute for Medical Psychology, Medical Faculty, University Heidelberg, Heidelberg, Germany
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Hagan MJ, Roubinov DR, Cordeiro A, Lisha N, Bush NR. Young children's traumatic stress reactions to the COVID-19 pandemic: The long reach of mothers' adverse childhood experiences. J Affect Disord 2022; 318:130-138. [PMID: 36030995 PMCID: PMC9420002 DOI: 10.1016/j.jad.2022.08.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 04/22/2022] [Accepted: 08/21/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic has negatively impacted parental and child mental health; however, it is critical to examine this impact in the context of parental histories of adversity. We hypothesized that maternal adverse childhood experiences (ACEs) and pandemic-related negative life events would predict child traumatic stress symptoms (TSS) and tested potential mediating pathways through maternal pandemic-related TSS and/or poorer maternal sensitivity during the pandemic. METHODS Data were collected from a longitudinal sample of low-income, racially/ethnically diverse mothers and their children. Between May and November 2020, mothers (n = 111) of young children (M age = 7.42 years, SD = 0.45) completed questionnaires to assess their own and their child's pandemic-related TSS, exposure to pandemic-related negative events, and parent-child relationship quality. Maternal ACEs, maternal depression, parent-child relationship quality, and child internalizing symptoms had been assessed approximately 1-3 years prior. RESULTS Structural equation analyses revealed that pandemic negative life events were indirectly associated with child TSS via greater maternal TSS. For mothers, recent pandemic-related negative events were associated with their own TSS, whereas maternal ACEs were not. Maternal ACEs directly predicted greater child TSS, with no evidence of mediation by either maternal TSS or maternal sensitivity. LIMITATIONS All measures were parent report, and pandemic-related measures were collected at the same time point. CONCLUSIONS Findings underscore the long reach of mothers' own adverse childhood experiences, highlighting the negative consequences of these prior traumatic exposures alongside current pandemic-related maternal trauma symptoms for children's adjustment during the pandemic.
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