Mental and Social Health of Children and Adolescents With Pre-existing Mental or Somatic Problems During the COVID-19 Pandemic Lockdown

  1. Josjan Zijlmans
  2. Lorynn Teela
  3. Hanneke van Ewijk
  4. Helen Klip
  5. Malindi van der Mheen
  6. Hyun Ruisch
  7. Michiel A. J. Luijten
  8. Maud M. van Muilekom
  9. Kim J. Oostrom
  10. Jan Buitelaar
  11. Pieter J. Hoekstra
  12. Ramón Lindauer
  13. Arne Popma
  14. Wouter Staal
  15. Robert Vermeiren
  16. Hedy A. van Oers
  17. Lotte Haverman
  18. Tinca J. C. Polderman

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Abstract

Background: The COVID-19 lockdown increases psychological problems in children and adolescents from the general population. Here we investigate the mental and social health during the COVID-19 lockdown in children and adolescents with pre-existing mental or somatic problems.

Methods: We included participants (8–18 years) from a psychiatric ( N = 249) and pediatric ( N = 90) sample, and compared them to a general population sample ( N = 844). Measures were assessed during the first lockdown (April-May 2020) in the Netherlands. Main outcome measures were Patient-Reported Outcomes Measurement Information System (PROMIS®) domains: Global Health, Peer Relationships, Anxiety, Depressive Symptoms, Anger, and Sleep-Related Impairment, as reported by children and youth. Additionally, socio-demographic variables, COVID-19-related questions, changes in atmosphere at home from a parent and child perspective, and children's experiences of lockdown regulations were reported by parents.

Results: On all measures except Global Health, the pediatric sample reported least problems. The psychiatric sample reported significantly more problems than the general population sample on all measures except for Anxiety and Peer Relationships. Having a COVID-19 affected friend/relative and a COVID-19 related change in parental work situation negatively moderated outcome, but not in the samples with pre-existing problems. All parents reported significant decreases in atmosphere at home, as did children from the general population.

Conclusion: We observed significant differences in mental and social health between three child and adolescent samples during the COVID-19 pandemic lockdown and identified COVID-19-related factors influencing mental and social health.

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  1. Version published to 10.3389/fpsyt.2021.692853
  2. ScreenIT

    SciScore for 10.1101/2020.12.15.20248237: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: All children and parents provided informed consent and the study was approved by the Medical Ethics Committee of the Amsterdam UMC.
    IRB: All children and parents provided informed consent and the study was approved by the Medical Ethics Committee of the Amsterdam UMC.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data analysis: We used the Statistical Package for Social Sciences (SPSS) version 26.0 for statistical analyses.
    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:
    Limitations of our study include low response rates and a potential selection bias of our samples, which limit extrapolation of our results. In particular, the pediatric sample was relatively small. Additionally, due to the cross-sectional design of this study, we cannot assess what factors have impacted on the change in mental and social health of children and adolescents due to the COVID-19 pandemic lockdown. Finally, there may be individual differences in how children respond to the lockdown. The literature so far hints at a potential diverse range of effects that the COVID-19 pandemic has on children and adolescents with pre-existing vulnerabilities, ranging from an increase in mental health problems to reduction of stress, loss of social pressure, and improved well-being 20. For future research, we recommend studying this variability more in depth. This study contributes to ‘a call for action for mental health science’ by Holmes et al. 37 who argue that this type of research should be one of the main priorities in research during the COVID-19 pandemic. Our findings present descriptive data that compare mental and social health between vulnerable groups of children and adolescents and a general population. Future studies need to examine additional factors related to the COVID-19 pandemic lockdown and should apply longitudinal designs which will enable tracking the course of mental and social health when the COVID-19 lockdown regulations continue or return in the future.

    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.

    About SciScore

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  3. Version published to 10.1101/2020.12.15.20248237v1 on medRxiv