Novel Coronavirus Pandemic Impacts Children and Adolescents’ Psychological Well-Being in Heavily Hit Chinese Provinces

  1. Jing Ma
  2. Jun Ding
  3. Jiawen Hu
  4. Kai Wang
  5. Shuaijun Xiao
  6. Ting Luo
  7. Shuxiang Yu
  8. Chuntao Liu
  9. Yunxuan Xu
  10. Yingxian Liu
  11. Changhong Wang
  12. Suqin Guo
  13. Xiaohua Yang
  14. Haidong Song
  15. Yaoguo Geng
  16. Yu Jin
  17. Huayun Chen
  18. Chunyu Liu

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Abstract

In light of the novel coronavirus’s (COVID-19’s) threat to public health worldwide, we sought to elucidate COVID-19’s impacts on the mental health of children and adolescents in China. Through online self-report questionnaires, we aimed to discover the psychological effects of the pandemic and its associated risk factors for developing mental health symptoms in young people.

We disseminated a mental health survey through online social media, WeChat, and QQ in the five Chinese provinces with the most confirmed cases of COVID-19 during the late stage of the country-wide lockdown. We used a self-made questionnaire that queried children and adolescents aged 6 to 18 on demographic information, psychological status, and other lifestyle and COVID-related variables.

A total of 17,740 children and adolescents with valid survey data participated in the study. 10,022 (56.5%), 11,611 (65.5%), 10,697 (60.3%), 6,868 (38.7%), and 6,225 (35.1%) participants presented, respectively, more depressive, anxious, compulsive, inattentive, and sleep-related problems compared to before the outbreak of COVID-19. High school students reported a greater change in depression and anxiety than did middle school and primary school students. Despite the fact that very few children (0.1%) or their family members (0.1%) contracted the virus in this study, the psychological impact of the pandemic was clearly profound. Fathers’ anxiety appeared to have the strongest influence on a children’s psychological symptoms, explaining about 33% of variation in the child’s overall symptoms. Other factors only explained less than 2% of the variance in symptoms once parents’ anxiety was accounted for.

The spread of COVID-19 significantly influenced the psychological state of children and adolescents. It is clear that children and adolescents, particularly older adolescents, need mental health support during the pandemic. The risk factors we uncovered suggest that reducing fathers’ anxiety is particularly critical to addressing young people’s mental health disorders in this time.

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  1. ScreenIT

    SciScore for 10.1101/2021.08.27.21262700: (What is this?)

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

    Table 1: Rigor

    EthicsConsent: The IRB waived the need for the parents’ consent, since it is online anonymous survey.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses: Data were analyzed using SPSS version 25.0.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    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:
    One limitation of the current study is the fact that all participants filled in the questionnaire online without supervision, though rigorous quality control was implemented. Additionally, the sample size collected in Hubei, the hardest-hit area, is the smallest in this study. The respondents in this area may not represent subjects in the area well in comparison to participants in the other provinces. In conclusion, the COVID-19 outbreak has influenced Chinese children’s and adolescents’ psychological states significantly. More than half of the participants experienced more anxious and depressive symptoms than before, and about one-third of the participants had more sleepless and inattentive symptoms. With respect to their baseline states of mood and anxiety, adolescents were more anxious than younger children, and high school students were more depressive and anxious than middle school and primary school students. Father’s perceived anxiety about the virus had a substantially stronger influence on a child’s psychological symptoms than mother’s anxiety did. Other factors, including age, history of mental disorders, mandatory quarantine status, whether the participant’s mothers worked as a medical staff member, exercise intensity, and whether the child’s parents had been infected with COVID-19, were also found to have significant effects on the child’s psychological symptoms. Stil, when added together, they explained less than 2% of variances in the child’s symptoms once paren...

    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.
    • No funding statement was detected.
    • No protocol registration statement was detected.

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

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.08.27.21262700 on medRxiv