Mental sequelae of the COVID-19 pandemic in children with and without complex medical histories and their parents: well-being prior to the outbreak and at four time-points throughout 2020 and 2021

  1. Melanie Ehrler
  2. Cornelia F. Hagmann
  3. Alexandra Stoeckli
  4. Oliver Kretschmar
  5. Markus A. Landolt
  6. Beatrice Latal
  7. Flavia M. Wehrle

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Abstract

The objective of this study is to understand the long-term mental sequelae for families over the course of the COVID-19 pandemic by longitudinally investigating the well-being of children with and without complex medical histories and their parents. Well-being of 200 children (between 7 and 18 years of age; 73 typically developing, 46 born very preterm, 73 with complex congenital heart disease) and 175 of their parents was assessed prior to and during the first (April–May 2020), second (October–November 2020), third (April–May 2021), and fourth wave (October–November 2021) of the pandemic with standardized questionnaires. Linear mixed models were used to investigate longitudinal changes in child and parent well-being compared to before the pandemic. Social and COVID-19-specific determinants were investigated as predictors of impaired well-being. To illustrate clinical relevance, the proportion of children and parents scoring > 1 SD below normative mean/median was reported. Compared to before the pandemic, child proxy-reported well-being was lower during the first but not the second, third, and fourth waves. Child self-reported well-being was not lower during the pandemic compared to before. Parent well-being dropped during the first wave and remained low throughout the subsequent waves. Proxy-reported child and self-reported parent well-being was lower in families with sparse social support and poor family functioning. Parents of typically developing children reported lower well-being than parents of children born very preterm or with a complex congenital heart disease. In November 2021, 20% of children (both self- and proxy-report) and 24% of parents scored below the normal range compared to 11% (child self-report), 10% (child proxy-report), and 16% (parent self-report), respectively, before the pandemic. The pandemic continues to impact the well-being of parents of school-aged children with and without complex medical histories more than 1 year after its outbreak. Children’s well-being was specifically affected during the first wave of the pandemic and has recovered thereafter. Families with sparse social support and poor family functioning are particularly at risk for compromised well-being and support should be provided to them.

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  1. Version published to 10.1007/s00787-022-02014-6
  2. ScreenIT

    SciScore for 10.1101/2021.12.05.21267236: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The study was approved by the local ethics committee, and all parents gave written informed consent. 2.2.
    Consent: The study was approved by the local ethics committee, and all parents gave written informed consent. 2.2.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: The current longitudinal investigation draws on two cohort studies not originally designed to investigate the mental sequelae of COVID-19 for families. Thus, some limitations require consideration: The questionnaires for the assessments during the pandemic were selected from the study protocol of the cohort studies to allow changes to be investigated. These questionnaires assess well-being rather than mental health symptoms; thus, the conclusions that can be drawn about the prevalence of mental health problems during the pandemic are limited. The study sample includes children with and without complex medical histories and is not representative of the general population of children and parents in Switzerland. However, the longitudinal findings presented here are in line with and complement findings from cross-sectional studies conducted during the initial wave of the pandemic with nationally representative samples that report child and parent well-being compromised in comparison to normative data [11, 25]. The sample size of the current study was relatively small compared to previous cross-sectional studies [e.g., 15, 16, 20]. However, its longitudinal design ensured well-powered analyses owing to within-subject correlations [53]. Participating families come from high and rather homogenous socio-economic backgrounds, as is often seen in prospective cohort studies [54]. This may explain the absence of any effect of SES on well-being, which had been expected from p...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.12.05.21267236v1 on medRxiv