Mental health and quality of life in children and adolescents during the COVID-19 pandemic: a systematic review of longitudinal studies

Anxiety and depressive symptoms among youth in Italy, Spain, and Portugal: A three-year post-pandemic study

The COVID-19 pandemic disrupted the population's lives. Stressful conditions during the lockdown and the reintroduction to a changed social environment emotionally affected children and adolescents. The aim of this work was to study anxiety and depressive symptoms in Italian, Spanish, and Portuguese children and adolescents aged 3 to 18 years at different moments of the COVID-19 pandemic: April 2020 (during confinement), September 2020 (with the schools' reopening), and September 2023 (with the situation restored). Parents of 1,097 children participated in at least one assessment, completing measures of child emotional symptoms online. Cases with subclinical symptoms of anxiety and depression were higher compared to pre-pandemic studies. Overall, anxiety increased from April 2020 to September 2020, decreasing in September 2023 with no differences compared to the first assessment. Depression was high in April 2020 but decreased in September 2020, with no significant differences three years later, in September 2023. Cross-country comparisons at each point are discussed. Moreover, boys showed higher levels of depression during the pandemic compared to girls. Older children, compared to younger ones, had more anxiety and depressive symptoms throughout all the moments. These findings highlight the emotional impact of the pandemic and its conditions on children and adolescents.

[Mental health of children and adolescents in times of global crises: findings from the longitudinal COPSY study from 2020 to 2024]

BACKGROUND

The mental health of children and adolescents is increasingly affected by global crises, but so far there are only limited longitudinal studies on this topic. This longitudinal, population-based study aimed to explore changes in mental health during global crises.

METHODS

The study analyzed data from 2865 families with children and adolescents aged 7 to 22 years who participated in at least one wave of the COPSY (COvid-19 and PSYchological health) study from May 2020 (T1) to October 2024 (T7). On average, the families took part in 56.7% of the survey waves. Descriptive statistics and multivariate regression analyses were used to examine changes in mental health as well as the effects of crisis-related worries and digital media use.

RESULTS

The mental health of children and adolescents was significantly impaired at the beginning of the pandemic, improved again in the following years, but remained at an impaired level in fall 2024 compared to pre-pandemic levels. At the same time, concerns about wars, economic crises, and the climate crisis have increased significantly. Risk factors such as low parental education and parental mental health problems were associated with poorer mental health, while personal, familial, and social resources had a protective effect. A high level of media consumption was documented, which was associated with stressful experiences.

CONCLUSION

Global crises pose significant challenges to the mental health of children and adolescents. Resource-oriented prevention and intervention efforts are urgently needed to support young people in coping with these challenges.

Three Years after the Pandemic: How has the Mental Health of Children and Adolescents Evolved? A Longitudinal Study in Italy, Spain, and Portugal

The COVID-19 pandemic significantly challenged the mental health of children and adolescents, with existing research highlighting the negative effects of restrictive measures to control the virus's spread. However, in the specific context of this pandemic, there is limited understanding of how these difficulties have persisted over time after the situation was fully restored. This study sought to evaluate the pandemic's impact on psychological symptoms in children from Italy, Spain, and Portugal across five-time points (2, 5, and 8 weeks, 6 months, and three and a half years after the pandemic's onset). A total of 1613 parents completed the Psychological Impact of COVID-19 and Confinement on Children and Adolescents Scale, reporting symptoms in their children aged 3-17 years (39.2% female). The findings reveal an initial surge in psychological difficulties-anxiety, mood, sleep, behavioral, eating, and cognitive disturbances-followed by improvements in these domains three and a half years later. By September 2023, Spanish children experienced more significant reductions in symptoms compared to their Italian and Portuguese peers. While the COVID-19 pandemic has been a prolonged crisis, with varying impacts over time and across regions depending on the strictness of restrictions, the trends suggest a gradual improvement in the psychological well-being of children and adolescents.

Management of SARS-CoV-2 Infection-Clinical Practice Guidelines of the Polish Association of Epidemiologists and Infectiologists, for 2025

The first Polish recommendations for the management of COVID-19 were published by the Polish Society of Epidemiologists and Infectiologists (PTEiLChZ) on 31 March 2020, and the last three years ago. The emergence of new SARS-CoV-2 variants, a different course of the disease, as well as new knowledge about therapies and vaccines, requires updating diagnostic, therapeutic, and prophylactic guidelines. Despite the reduction in the threat associated with COVID-19, there is a risk of another epidemic caused by coronaviruses, which was an additional reason for developing a new version of the guidelines. In preparing these recommendations, the Delphi method was used, reaching a consensus after three survey cycles. Compared to the 2022 version, the names of the individual stages of the disease have been changed, adapting them to the realities of clinical practice, and attention was paid to the differences observed in immunosuppressed patients and in children. Some previously recommended drugs have been discontinued, including monoclonal antibodies. In addition, general principles of vaccination were presented, as well as issues related to the post-COVID syndrome.

["Where am I, and where do I want to go?" A Group Therapy Program for Disorientated, Psychosomatically Ill Young People]

"Where am I, and where do I want to go?" A Group Therapy Program for Disorientated, Psychosomatically Ill Young People Abstract: Objective: What influence does the concretization of the postinpatient life and career perspective have on the outcome of the inpatient treatment of psychosomatically ill young people? Method: A randomized case-control study. Results: The participants receive the perspective or orientation group well and see it as an important part of the treatment. Participating patients experience significantly less stress when discharge of (residual) symptoms than patients in the control group. Conclusions: The group program succeeds in drawing the focus of many affected persons away from patient identity toward a healthy future orientation and thus improving the course of therapy. Accordingly, the program should be integrated into standard inpatient therapy. In addition, the question arises as to the possible role of the program in primary prevention.

Supporting youths in global crises: an analysis of risk and resources factors for multiple health complaints in children and adolescents during the COVID-19 pandemic

Introduction

The number of global crises increased in recent years, significantly affecting the health and well-being of children and adolescents worldwide. Awareness of these global crises and their impact on health and well-being has risen since the COVID-19 pandemic. Research indicates that some children and adolescents are more vulnerable to the challenges resulting from these crises than others. This study examines the risk and resources factors for multiple health complaints (MHC) in children and adolescents in Germany during the COVID-19 pandemic.

Methods

We analyzed data from the German population-based longitudinal COPSY (COvid-19 and PSYchological Health) study. A total of 1,673 children and adolescents aged 11 years and older and their parents participated in at least one of the five survey waves between 2020 and 2022. We assessed MHC using the international Health Behavior in School-aged Children Symptom Checklist (HBSC-SCL), which includes four somatic complaints (e.g., headache, abdominal pain) and four psychological complaints (e.g., feeling low, sleeping difficulties). We conducted a mixed model panel regression analysis to examine longitudinal changes in MHC and identified sociodemographic, psychosocial, and pandemic-related risk factors and resources.

Results

Our results revealed increased MHC throughout the COVID-19 pandemic. Girls, single-parent children and adolescents, as well as children and adolescents of mentally ill or highly burdened parents, were at particular risk. A higher subjective perceived burden of the pandemic and COVID-19-related worries were significantly associated with a higher level of MHC. Personal resources, a positive family climate, and more perceived social support were significantly associated with a lower level of MHC.

Discussion

This paper highlights the vulnerability of children and adolescents in a global crisis, such as the COVID-19 pandemic. The results provide a scientific foundation for targeted health promotion and intervention strategies to protect and maintain the health and well-being of young people in future crises.

Exploring the relationship between mental health status and life events in children and adolescents: the role of mediating factors

Background

The mental health status of children and adolescents is significantly influenced by negative life events, yet there is a lack of comprehensive analysis on mediating factors. This study aims to examine the relationship between negative life events and symptoms of anxiety and depression in children and adolescents, as well as to identify potential mediating factors.

Methods

In May 2022, cluster-randomized sampling was used to select 8041 primary, middle, and high school students in Zhaoqing City, Guangdong Province, for the final analysis. The Adolescent Life Events Scale, Self-Rating Anxiety Scale, and Self-Rating Depression Scale were employed to assess negative life events, anxiety symptoms, and depressive symptoms, respectively. Pearson correlation analysis and linear regression analysis were utilized to identify risk factors, and the Bootstrap method was applied for mediation analysis.

Results

The study revealed that 80.52% of children and adolescents experienced negative life events, with 23.38% reporting anxiety symptoms and 42.57% reporting depressive symptoms. Significant positive correlations were observed between negative life events and anxiety symptoms (r = 0.32, p < 0.001), as well as depressive symptoms (r = 0.44, p < 0.001). Mediation analysis further demonstrated that anxiety and depressive symptoms acted as mutual mediators in the relationship between negative life events and each other.

Conclusions

This study underscores the complex interplay between anxiety, depression, and negative life events in children and adolescents. These findings can inform strategies to help mitigate the emotional impact of negative life events, enhance mental health, and provide a scientific basis for developing effective interventions.

COVID-19-related lockdowns and changes in overweight and obesity, movement behaviours, diet quality, and health-related quality of life among regional Australian primary school children: A repeat cross-sectional study

BACKGROUND

During the coronavirus disease 2019 (COVID-19) pandemic, the Australian state of Victoria (in particular, its capital, Melbourne) experienced some of the longest lockdowns in the world.

OBJECTIVE

This repeated cross-sectional study examined changes between March to June 2019 (pre-pandemic) and April to August 2022 (6 to 11 months following pandemic-related lockdowns) in overweight and obesity prevalence, physical activity, sedentary behaviour, sleep, diet quality, and health-related quality of life (HRQoL) among primary school children in north-east Victoria, Australia.

METHODS

Height and weight were measured for Grade 2, 4, and 6 students in 2019 (3889 children) and 2022 (1816 children). Grade 4 and 6 students self-reported on their movement behaviours, diet quality, and HRQoL.

RESULTS

Participation declined among schools (2019:56%, 2022:34%) and students (2019:87%, 2022:75%). Compared to children in 2019, children in 2022 had a higher prevalence of overweight and obesity; were less likely to have met guidelines for moderate-to-vigorous physical activity, recreational screen time, and vegetable consumption; had higher intakes of takeaway food, energy-dense nutrient-poor snacks, and sugar-sweetened beverages; and had lower HRQoL.

CONCLUSION

Children's health-related behaviours and outcomes seemed not to have returned to pre-pandemic levels 6 to 11 months after the final lockdowns lifted for their communities. Continued monitoring and interventions targeting the drivers of childhood obesity are urgently needed.

Mental Health Care Utilization and Prescription Rates Among Children, Adolescents, and Young Adults in France

Importance

Amid escalating mental health challenges among young individuals, intensified by the COVID-19 pandemic, analyzing postpandemic trends is critical.

Objective

To examine mental health care utilization and prescription rates for children, adolescents, and young adults before and after the COVID-19 pandemic.

Design, Setting, and Participants

This population-based time trend study used an interrupted time series analysis to examine mental health care and prescription patterns among the French population 25 years and younger. Aggregated data from the French national health insurance database from January 2016 to June 2023. Data were analyzed from September 2023 to February 2024.

Main Outcomes and Measures

The number of individuals with at least 1 outpatient psychiatric consultation, those admitted for full-time psychiatric hospitalization, those with a suicide attempt, and those receiving psychotropic medication was computed. Data were stratified by age groups and sex. Quasi-Poisson regression modeled deseasonalized data, estimating the relative risk (RR) and 95% CI for differences in slopes before and after the pandemic.

Results

This study included approximately 20 million individuals 25 years and younger (20 829 566 individuals in 2016 and 20 697 169 individuals in 2022). In 2016, the population consisted of 10 208 277 of 20 829 566 female participants (49.0%) and 6 091 959 (29.2%) aged 18 to 25 years. Proportions were similar in 2022. Significant increases in mental health care utilization were observed postpandemic compared with the prepandemic period, especially among females and young people aged 13 years and older. Outpatient psychiatric consultations increased among women (RR, 1.13; 95% CI, 1.07-1.20), individuals aged 13 to 17 years (RR, 1.15; 95% CI, 1.06-1.23), and individuals aged 18 to 25 years (RR, 1.08; 95% CI, 1.03-1.14). Hospitalizations for suicide attempt increased among women (RR, 1.14; 95% CI, 1.02-1.27) and individuals aged 18 to 25 years (RR, 1.07; 95% CI, 1.03-1.12). Regarding psychotropic medications, almost all classes, except hypnotics, increased in prescriptions between 2016 and 2022 for females, with a particularly marked rise in the postpandemic period. For men, only increases in the prescriptions of antidepressants (RR, 1.03; 95% CI, 1.01-1.06), methylphenidate (RR, 1.09; 95% CI, 1.06-1.12), and medications prescribed for alcohol use disorders (RR, 1.08; 95% CI, 1.04-1.13) were observed, and these increases were less pronounced than for women (antidepressant: RR, 1.13, 95% CI, 1.09-1.16; methylphenidate: RR, 1.15; 95% CI, 1.13-1.18; alcohol use dependence: RR, 1.12; 95% CI, 1.08-1.16). Medications reserved for severe mental health situations, such as lithium or clozapine, were prescribed more frequently starting at the age of 6 years.

Conclusions and Relevance

In this study, an interrupted time-series analysis found a marked deterioration in the mental health of young women in France in the after the COVID-19 pandemic, accentuating a trend of deterioration that was already observed in the prepandemic period.

Mental Health of Pediatric Patients with Cystic Fibrosis after 18 Months on Elexacaftor-Tezacaftor-Ivacaftor Therapy

BACKGROUND

Research studies are conflicting regarding new highly effective modulators and the association with mental health symptoms for adults and adolescents with cystic fibrosis (CF). For younger children, small studies and case reports indicate a wide range of effects, ranging from improvement in mood to the development of neuropsychiatric symptoms. However, a large placebo-controlled study indicated no causal connection. This study evaluates the frequency and severity of mental health symptoms in children and adolescents while taking elexacaftor/tezacaftor/ivacaftor (ETI).

METHODS

The study includes 81 pediatric patients with CF followed at Nationwide Children's Hospital (NCH). Patient Reported Outcomes Measurement Information System (PROMIS)-Anxiety and Depression, Patient Health Questionnaire 8 (PHQ-8) and Generalized Anxiety Disorder Questionnaire (GAD-7) were used to screen for depression and anxiety. Age-appropriate questionnaires were completed over the first 18 months after initiating ETI.

RESULTS

At baseline, majority of participants reported mental health symptoms within normal limits (WNL). For participants with elevated baseline measures, depressive and anxiety symptoms significantly decreased throughout the study period. Depending on the metric, patients experiencing depressive and anxiety symptoms dropped to 2-3% (n = 1, on each depressive measure) and 0% (n = 0, on either anxiety measures) respectively by 18 months.

CONCLUSION

Most pediatric patients with CF did not endorse symptoms of depression or anxiety disorders at ETI initiation. Over the first 18 months of ETI usage, the percentage of patients with these symptoms decreased, suggesting that the percentage of patients experiencing severe symptoms of depression and anxiety may decrease with ongoing use of ETI.

Implemental delay as a mediator of the relationship between depression, anxiety, stress and school burnout

INTRODUCTION

Research following the COVID-19 pandemic points to many problems related to adolescents' mental condition, their coping with the organization of daily life and the implementation of school duties, which can lead to school burnout. It includes absenteeism, decreased motivation and academic performance, and a cynical attitude toward peers and teachers. A significant way to protect adolescents' mental health may be by teaching them to complete their daily duties. Still, an obstacle is the observable post-pandemic, increasing tendency to procrastinate, which can exacerbate the effects of school burnout. The study aimed to establish the impact of depression, anxiety and stress on school burnout mediated by procrastination, understood as implemental procrastination.

METHOD

Three questionnaires were used: Depression, Anxiety and Stress Scale, Implemental Delay Scale, and School burnout scale. The study comprised 344 students (57,6% females) from Polish secondary schools (high schools and technical schools), aged 14-20 years (M = 16.69; SD = 1.74). The analysis of relationships between variables studied was performed with the mediation model.

RESULTS

Analyses confirmed the mediating effect of implemental delay on the relationship between depression, stress and school burnout. Unexpectedly, it turned out that the burnout resulting from parental pressure significantly weakened the value of the mediator (implemental delay). In contrast, the value of the predictors (depression and stress) increased. Anxiety was found to be a nonsignificant predictor of school burnout.

CONCLUSION

The data show that stress, depression and procrastination influence school burnout, which depends mainly on the dimension of burnout. Awareness of these relationships can support the creation of specialized prevention programs, allowing students to overcome their problems. At the same time, parents and teachers may help them understand the nature of observed disorders, which has little to do with laziness often attributed to young people.

Temporal trends and social inequities in adolescent and young adult mental health disorders in Catalonia, Spain: a 2008-2022 primary care cohort study

BACKGROUND

The prevalence of mental health disorders in children, teens, and young adults is rising at an alarming rate. This study aims to explore time trends in the incidence of mental disorders among young people in Catalonia, Spain from 2008 to 2022, focusing on the effects of the COVID-19 pandemic and from the perspective of social inequities.

METHODS

A cohort study using primary care records from the SIDIAP database was conducted. It included 2,088,641 individuals aged 10 to 24 years. We examined the incidence of depressive, anxiety, eating, and attention deficit/hyperactivity disorders, stratified by sex, age, deprivation, and nationality.

RESULTS

All disorders reflected an increasing trend throughout the study period: depressive disorders (IRR: 2.44, 95% CI: 2.31-2.59), anxiety disorders (IRR: 2.33, 95% CI: 2.27-2.39), ADHD (IRR: 2.33, 95%CI: 2.17-2.50), and eating disorders (IRR: 3.29, 95% CI: 3.01-3.59). A significant increase in incidence was observed after the outbreak of the COVID-19 pandemic. In 2022, anxiety disorders were most frequent, with an incidence rate (IR) of 2,537 per 100,000 persons-year (95% CI: 2,503-2,571). Depressive disorders followed with an IR of 471 (95% CI: 458-486), ADHD with an IR of 306 (95% CI: 295-317) and eating disorders with an IR of 249 (95% CI: 239-259). Significant associations were reported with sex, age, deprivation, and nationality.

CONCLUSION

The incidence of all studied disorders has steadily increased, reaching unprecedented levels during the pandemic. Understanding these trends is essential for an appropriate healthcare response, while addressing the non-medical determinants, requires action across all sectors of society.

A Longitudinal Study of Loneliness Before the End of the COVID-19 Pandemic: Trajectories, Predictors, and Impact on Chinese Adolescent Mental Health

Background

COVID-19 threatened global health, however little is known about the long-term courses of loneliness and their effect on mental health in adolescents. This study aimed to explore the trajectories of loneliness among adolescents in Taizhou, Zhejiang Province, China, during the last phase of the pandemic. We also aimed to identify risk factors in each loneliness course and the impact of loneliness on emotional problems, peer problems, hyperactivity and conduct problems.

Methods

The study employed multistage cluster sampling to collect four waves of data from 2347 Chinese adolescents (average baseline age of 14.7 years) covering a period of 20 months (October 2021 - May 2023). The UCLA 3-Item Loneliness Scale and the Strengths and Difficulties Questionnaire were utilized to assess loneliness and mental health problems, respectively. Growth mixture modelling was employed to identify latent classes of loneliness trajectories. Associated risk factors were investigated using multinomial logistic regression model. Mixed-effects logistic regression models were constructed to examine the long-term impact of loneliness classes on mental health outcomes.

Results

The overall percentage of loneliness increased from 22.9% at baseline to 32.2% at the fourth wave in our sample. Three classes of loneliness were identified: Decreasing Low Loneliness (58.71%), Increasing Medium Loneliness (36.52%), and Increasing High Loneliness (4.77%). Risk factors for poorer loneliness trajectories included lack of physical exercise habits, poorer mental health literacy, medium or low perceived social support, having study difficulties, being female, higher grades, and lower economic status. Loneliness classes were associated with the severity and variability of emotional problems, peer problems, hyperactivity and conduct problems (ORs for the highest loneliness class: 10.24, 4.21, 3.87, 2.68, respectively). Individuals in the higher loneliness classes experienced a significant increase in these mental health problems over time (p < 0.05 for interactions between loneliness classes and time).

Conclusion

During the last phase of the pandemic, a large proportion of adolescents in our study endured medium to high levels of loneliness with no signs of improvement. Both unfavorable loneliness trajectories adversely affected internalizing and externalizing problems and displayed an upward trend in these difficulties. Results highlight the importance of tackling loneliness and improving mental health in adolescents.

The impact of neighborhood deprivation on mental health and quality of life in children and adolescents during the COVID-19 pandemic: Findings from the COPSY Hamburg study

INTRODUCTION

Socioeconomic inequalities have been associated with poorer mental health outcomes in children and adolescents during the COVID-19 pandemic. Despite numerous studies on individual risk factors, the impact of societal environment, such as neighborhood characteristics, on changes in mental health has rarely been investigated. This study investigates the effect of neighborhood deprivation on mental health problems and health-related quality of life (HRQoL) in children and adolescents during the COVID-19 pandemic in Hamburg, Germany.

METHODS

Data were derived from the prospective German COPSY Hamburg study. Children and adolescents aged between 11-20 years and their parents participated in the study, which took place in summer 2020 (T1) and summer 2022 (T2). Neighborhood deprivation was assessed by a neighborhood status index. Mental health problems and HRQoL were assessed using internationally validated and established instruments. The prevalence of mental health problems and impaired HRQoL was reported. Analysis of covariance was conducted to examine the effect of neighborhood deprivation of the districts in Hamburg on the (changes in) mental health problems and HRQoL while controlling for social individual-level indicators.

RESULTS

The total sample included in the statistical analysis consisted of N = 2,645 families. Children and adolescents living in more deprived areas had higher levels of general mental health problems and depressive symptoms during the COVID-19 pandemic. However, differences in neighborhood deprivation did not relate to the HRQoL and the averaged changes in children and adolescents' mental health problems and HRQoL from summer 2020 to summer 2022.

DISCUSSION

Neighborhood deprivation is associated with impaired mental health in youth during the COVID-19 pandemic. Children and adolescents' mental health and overall well-being should be addressed by health promotion measures to create a health-promoting living environment, including diverse neighborhoods. Future research should focus on uniform assessment methods and addressing additional neighborhood factors.

Development will (try to) find its way: a qualitative study of Chilean adolescent mental health during and after lockdown

BACKGROUND

The COVID-19 pandemic has had a well-evidenced impact on adolescents, who are especially sensitive to pandemic disruptions given the critical role of socialization in their development. In Chile too, evidence shows increases in mental health complaints among adolescents over the lockdown period. Our study aimed at exploring the experiences of Chilean adolescents regarding their mental health during the lockdown and school closure (March 2020-December 2021), and during the return to on-site education (2022) as informed by adolescents and school staff, with a focus on family, school, and social sources of risk and support for adolescents' wellbeing during these periods.

METHODS

Using a qualitative approach, we conducted semi-structured interviews with 19 adolescents and 16 staff members from schools in an urban area of Chile.

RESULTS

Through thematic analysis, we generated five themes: [1] Adolescents in a mental health crisis, comprising a range of distressing experiences and mental health problems. This crisis was fueled by alterations in the functioning of adolescents' systems: [2] Broken support systems (peers and school); [3] The school agenda must go on, reflecting schools' strict compliance with the educational curriculum; and [4] Blurred boundaries between home and school life and within the family. Finally [5], Development will (try to) find its way describes how most participants experienced a bouncing back to wellbeing in the course of the school year upon return, and how some developmental milestones took place despite the abnormal conditions, providing evidence for resilience amid pandemic adversity.

CONCLUSIONS

The findings give insight into how the exchanges between the adolescent and the social systems they are embedded in were interfered. The results help us understand the challenges for mental health during and after the pandemic, and highlight adolescents' capacity to thrive as normality was restored. The results also underscore the importance of upholding stability across adolescents' systems and routines, in order to mitigate impacts on wellbeing amid abnormal circumstances. The findings are relevant for development-informed initiatives in policy design in the aftermath of the pandemic and in future crisis management responses.

The effect of school lockdown on well-being and self-esteem of adolescents during the COVID-19 pandemic in Hungary

Introduction

The COVID-19 pandemic affected adolescents' mental health diversely.

Methods

Our objective was to examine the one-year change in well-being (WHO-5 well-being index) and self-esteem (Rosenberg self-esteem scale) among secondary school students affected by school lockdown (lockdown group) compared to control students unaffected by the pandemic (pre-pandemic group), utilizing data from a longitudinal survey study conducted in Hungary. We used linear mixed models stratified by sex and adjusted for family structure and family communication.

Results

Two hundred twenty seven pre-pandemic (128 girls, 99 boys) and 240 lockdown (118 girls, 122 boys) students were included. Both boys' and girls' well-being declined in the pre-pandemic group but remained stable in the lockdown group. Post-hoc analyses on WHO-5 items revealed that the pre-pandemic and lockdown groups differed significantly on Item 4 (waking up feeling fresh and relaxed). Boys' self-esteem did not change over the observation period in neither groups. As for girls, self-esteem of girls during lockdown increased over the observation period, while it did not change in the pre-pandemic group. Better family communication was consistently associated with higher well-being and self-esteem scores for both sexes.

Discussion

Our results suggested that students may have benefitted from altered academic circumstances due to lockdown (e.g., more sleep) and students struggling with waking up early benefitted the most from lockdown (as shown in our post hoc analysis). Additionally, our results also indicate that families should be involved in mental health promotion interventions, especially in time of adversities. This study underscores the multifaceted effects of pandemic-related factors on adolescent mental health and highlights the need to also investigate the unexpected benefits of pandemic-related restrictions to incorporate this knowledge in health promotion programs targeting the well-being of students.

Clarifying the Links between Perceived Stress and Depressiveness: a Longitudinal Study of COVID-19's Effects on Adolescents in Germany

Young people are navigating an increasingly uncertain and unstable social and economic environment, further complicated by COVID-19. Individual resources and vulnerabilities, such as mental health and sensitivity to stress, play a significant role in how well youth adapt to the career paths and living conditions altered by the pandemic, a dynamic that is not yet well understood. This study examined the role of COVID-19 on the intertwined relation between perceived stress and depressiveness (negative and positive affect) in adolescents, focusing on gender differences. Longitudinal data from 673 German adolescents (Mage = 16.8 years, SDage = 0.91; female = 59%) were collected in three waves, before (T1) and during the pandemic (T2, T3). Using Latent Change Score models, the bidirectional relation between perceived stress and depressiveness was analyzed, considering gender as a moderator. The results showed that adolescents who found their situation stressful were at risk of developing depressiveness at the outbreak of the pandemic and throughout its progression. As the pandemic progressed, an increase in positive affect was linked to heightened perceived stress. Gender-specific differences were particularly evident in the levels of perceived stress and depressiveness, with women being more vulnerable. This study highlights how vulnerabilities in stress perception affect adolescents' mental health, with gender-specific differences underscoring the need for tailored mental health measures.

The effect of received social support on preferred coping strategies and perceived quality of life in adolescents during the covid-19 pandemic

The article raises the issue of the quality of life (QoL) of adolescents during the COVID-19 pandemic, its relationships with coping and mediating role of the received social support (RSS). The nationwide survey was conducted from September 13, 2021 to October 1, 2021. The total of 4970 individuals aged 10-18 years old were researched in Poland. The KIDSCREEN-27, the Brief COPE by Charles S. Carver in the Polish adaptation and the Berlin Social-Support Scales were employed in the research. SPSS and PROCESS macro were used for descriptive, correlational, and mediation analyses. The results indicate the relationship between the perceived QoL (QoL) with active coping, seeking social support coping and helplessness coping. The essential mediating role of the RSS was confirmed for the relationship between coping with stress and QoL in the group of the individuals researched. The findings imply that both in daily and difficult situations, social systems of support should be activated to provide environment for optimal development of adolescents, diminish consequences of potential risk factors, and enhance the significance of protective factors.

How Distressed Are Adolescent Students? A Mix-Method Study on High School Students in Northern Italy, Two Years after the Beginning of the COVID-19 Pandemic

Adolescence is a central phase for the development of a person's identity, involving complex multidimensional changes and increasing vulnerability to distress. This study aimed to investigate the psychological well-being of adolescent students in Brescia (Northern Italy), two years after the beginning of the COVID-19 pandemic. An online survey investigated the extent and the reasons reported by high school students (13-21 years) for their emotional distress (ED), also considering other factors such as physical activity, nutrition, sleep and smartphone overuse. The main reasons for ED were classified through a qualitative analysis of the free-text answers. A total of 1686 students agreed to participate, and 50% showed a presence of ED. According to a multiple logistic analysis, adolescents were more at risk of ED if they were female (AdjOR 2.3), older (AdjOR 1.6), slept less than 8 h (AdjOR 1.5), perceived increased anxiety (AdjOR 3.4), and adopted certain eating behaviors, e.g., comfort food consumption (AdjOR 2.0). According to free-text answers, the main reasons for ED were "school pressure", "relationships with family and peers", "negative emotional states" and "the pandemic". The results show a high level of ED among adolescents, and the reported reasons may help to better address their psychological needs after the pandemic.

Trajectories of mental health in children and adolescents during the COVID-19 pandemic: findings from the longitudinal COPSY study

BACKGROUND

Mental health and health-related quality of life (HRQoL) in children and adolescents deteriorated during the COVID-19 pandemic. The aim of this population-based longitudinal study was to explore whether distinct mental health trajectories in youths can be identified over the course of the pandemic.

METHODS

Mental health problems (MHP), psychosomatic symptoms and HRQoL were assessed at five time points between May 2020 and October 2022 in 744 children and adolescents aged 7 to 20 years using established instruments. We used generalized mixture modeling to identify distinct mental health trajectories and fixed-effects regressions to analyse covariates of the identified profiles of change.

RESULTS

We found five distinct linear latent trajectory classes each for externalising MHP and psychosomatic symptoms and four trajectory classes for internalising MHP. For HRQoL, a single-class solution that indicates a common development process proved to be optimal. The largest groups remained almost stable at a low internalising and externalising symptom level (64 to 74%) and consistently showed moderate psychosomatic symptoms (79%), while 2 to 18% showed improvements across the pandemic. About 10% of the youths had consistently high internalising problems, while externalising problems deteriorated in 18% of youths. Class membership was significantly associated with initial HRQoL, parental and child burden, personal resources, family climate and social support.

CONCLUSIONS

The mental health of most children and adolescents remained resilient throughout the pandemic. However, a sizeable number of youths had consistently poor or deteriorating mental health. Those children and adolescents need special attention in schools and mental health care.

The Psychosocial Impact of the COVID-19 Pandemic on Italian Families: The Perception of Quality of Life and Screening of Psychological Symptoms

Throughout the COVID-19 period, families were forced to stay indoors, adapting to online schooling, remote work, and virtual social engagements, inevitably altering the dynamics within households. There was a notable increase in mental health challenges in terms of anxiety and depression in children and adolescents. This study intended to explore the psychosocial effects of the COVID-19 pandemic on Italian families by adopting self- and proxy-report questionnaires on anxiety, anger, and health-related quality of life. The results showed that approximately 20% obtained a clinical anxiety score and only 10% obtained a clinical anger score. There was a difference in the perception of the quality of life reported by the child and that perceived by the parent. A stepwise regression model showed that total anxiety scores were predicted by sex, quality of life scores from the parents' self-report version, and the total anger score. Another stepwise regression model identified physiological and social anxiety as the best predictors that impact quality of life. Parental well-being actively influences the well-being of children, so it is fundamental to implement preventive programs and promote child well-being by providing parents the most adequate support possible.

Subjective health and psychosomatic complaints of children and adolescents in Germany: Results of the HBSC study 2009/10 - 2022

Background

Subjective health and well-being are important health indicators in childhood and adolescence. This article shows current results and trends over time between 2009/10 and 2022.

Methods

The Health Behaviour in School-aged Children (HBSC) study examined subjective health, life satisfaction and psychosomatic complaints of N = 21,788 students aged 11 to 15 years in the school years 2009/10, 2013/14, 2017/18 and in the calendar year 2022. Multivariate regression analyses show the associations between sociodemographic characteristics and well-being in 2022, as well as trends since 2009/10.

Results

The majority of children and adolescents indicate a good subjective health and high life satisfaction. About half of the girls and one third of the boys report multiple psychosomatic health complaints, with a clear increase over time. Older adolescents, girls and gender diverse adolescents are at an increased risk of poor well-being. Subjective health and life satisfaction varied between 2009/10 and 2022, with a significant deterioration between 2017/18 and 2022.

Conclusions

The high proportion of children and adolescents with psychosomatic complaints, as well as the observed gender and age differences, underline the need for target group-specific prevention, health promotion and continuous health monitoring.