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Open Access 01-10-2021 | COVID-19

The impact of lockdown during the COVID-19 pandemic on mental and social health of children and adolescents

Authors: Michiel A. J. Luijten, Maud M. van Muilekom, Lorynn Teela, Tinca J. C. Polderman, Caroline B. Terwee, Josjan Zijlmans, Leonie Klaufus, Arne Popma, Kim J. Oostrom, Hedy A. van Oers, Lotte Haverman

Published in: Quality of Life Research | Issue 10/2021

Abstract

Purpose

During the COVID-19 pandemic in the Netherlands, governmental regulations resulted in a lockdown for adults as well as children/adolescents. Schools were closed and contact with other people was limited. In this cross-sectional, population-based study, we aimed to investigate the mental/social health of children/adolescents during COVID-19 lockdown.

Methods

Two representative samples of Dutch children/adolescents (8–18 years) before COVID-19 (2018, N = 2401) and during lockdown (April 2020, N = 844) were compared on the Patient-Reported Outcomes Measurement Information System (PROMIS) domains: global health, peer relationships, anxiety, depressive symptoms, anger, sleep-related impairment by linear mixed models and calculating relative risks (RR (95% CI)) for the proportion of severe scores. Variables associated with worse mental/social health during COVID-19 were explored through multivariable regression models. The impact of COVID-19 regulations on the daily life of children was qualitatively analyzed.

Results

Participants reported worse PROMIS T-scores on all domains during COVID-19 lockdown compared to before (absolute mean difference range 2.1–7.1 (95% CI 1.3–7.9). During lockdown, more children reported severe Anxiety (RR = 1.95 (1.55–2.46) and Sleep-Related Impairment (RR = 1.89 (1.29–2.78) and fewer children reported poor Global Health (RR = 0.36 (0.20–0.65)). Associated factors with worse mental/social health were single-parent family, ≥ three children in the family, negative change in work situation of parents due to COVID-19 regulations, and a relative/friend infected with COVID-19. A large majority (> 90%) reported a negative impact of the COVID-19 regulations on daily life.

Conclusion

This study showed that governmental regulations regarding lockdown pose a serious mental/social health threat on children/adolescents that should be brought to the forefront of political decision-making and mental healthcare policy, intervention, and prevention.

Shen, K.-L., Yang, Y.-H., Jiang, R.-M., Wang, T.-Y., Zhao, D.-C., Jiang, Y., et al. (2020). Updated diagnosis, treatment and prevention of COVID-19 in children: Experts’ consensus statement (condensed version of the second edition). World Journal of Pediatrics, 16(3), 232–239. https://doi.org/10.1007/s12519-020-00362-4CrossRefPubMedPubMedCentral

Fong, V. C., & Iarocci, G. (2020). Child and family outcomes following pandemics: A systematic review and recommendations on COVID-19 policies. Journal of Pediatric Psychology. https://doi.org/10.1093/jpepsy/jsaa092CrossRef

Kwong, A. S. F., Pearson, R. M., Adams, M. J., Northstone, K., Tilling, K., Smith, D., et al. (2020). Mental health during the COVID-19 pandemic in two longitudinal UK population cohorts. medRxiv. https://doi.org/10.1101/2020.06.16.20133116.CrossRef

Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., et al. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health, 17(5), 1729. https://doi.org/10.3390/ijerph17051729CrossRefPubMedCentral

Gualano, M. R., Lo Moro, G., Voglino, G., Bert, F., & Siliquini, R. (2020). Effects of COVID-19 lockdown on mental health and sleep disturbances in Italy. International Journal of Environmental Research and Public Health, 17(13), 4779. https://doi.org/10.3390/ijerph17134779CrossRefPubMedCentral

Vindegaard, N., & Benros, M. E. (2020). COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain, Behavior, and Immunity. https://doi.org/10.1016/j.bbi.2020.05.048CrossRefPubMedPubMedCentral

O’Connor, R. C., Wetherall, K., Cleare, S., McClelland, H., Melson, A. J., Niedzwiedz, C. L., et al. (2020). Mental health and wellbeing during the COVID-19 pandemic: Longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study. British Journal of Psychiatry. https://doi.org/10.1192/bjp.2020.212CrossRef

Pierce, M., Hope, H., Ford, T., Hatch, S., Hotopf, M., John, A., et al. (2020). Mental health before and during the COVID-19 pandemic: A longitudinal probability sample survey of the UK population. The Lancet Psychiatry, 7(10), 883–892. https://doi.org/10.1016/S2215-0366(20)30308-4CrossRefPubMedPubMedCentral

Pieh, C., Budimir, S., & Probst, T. (2020). The effect of age, gender, income, work, and physical activity on mental health during coronavirus disease (COVID-19) lockdown in Austria. Journal of Psychosomatic Research, 136, 110186. https://doi.org/10.1016/j.jpsychores.2020.110186CrossRefPubMedPubMedCentral

10.

Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., et al. (2020). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity. https://doi.org/10.1016/j.bbi.2020.04.028CrossRefPubMedPubMedCentral

11.

Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., Shafran, R., Brigden, A., et al. (2020). Rapid systematic review: The impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. Journal of the American Academy of Child and Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2020.05.009CrossRefPubMedPubMedCentral

12.

Fegert, J. M., Vitiello, B., Plener, P. L., & Clemens, V. (2020). Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: A narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child and Adolescent Psychiatry and Mental Health, 14, 1–11. https://doi.org/10.1186/s13034-020-00329-3CrossRef

13.

Galea, S., Merchant, R. M., & Lurie, N. (2020). The mental health consequences of COVID-19 and physical distancing: The need for prevention and early intervention. JAMA Internal Medicine, 180(6), 817–818. https://doi.org/10.1001/jamainternmed.2020.1562CrossRefPubMed

14.

Green, P. (2020). Risks to children and young people during covid-19 pandemic. BMJ, 369, m1669. https://doi.org/10.1136/bmj.m1669CrossRefPubMed

15.

Valenzuela, J., Crosby, L. E., & Harrison, R. R. (2020). Commentary: Reflections on the COVID-19 pandemic and health disparities in pediatric psychology. Journal of Pediatric Psychology, 45(8), 839–841. https://doi.org/10.1093/jpepsy/jsaa063CrossRefPubMed

16.

Golberstein, E., Wen, H., & Miller, B. F. (2020). Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2020.1456CrossRefPubMed

17.

Xie, X., Xue, Q., Zhou, Y., Zhu, K., Liu, Q., Zhang, J., et al. (2020). Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2020.1619CrossRefPubMedPubMedCentral

18.

Zhou, S.-J., Zhang, L.-G., Wang, L.-L., Guo, Z.-C., Wang, J.-Q., Chen, J.-C., et al. (2020). Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19. European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-020-01541-4CrossRef

19.

Duan, L., Shao, X., Wang, Y., Huang, Y., Miao, J., Yang, X., et al. (2020). An investigation of mental health status of children and adolescents in china during the outbreak of COVID-19. Journal of Affective Disorders, 275, 112–118. https://doi.org/10.1016/j.jad.2020.06.029CrossRefPubMedPubMedCentral

20.

Ravens-Sieberer, U., Kaman, A., Erhart, M., Devine, J., Schlack, R., & Otto, C. (2021). Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-021-01726-5CrossRef

21.

Bignardi, G., Dalmaijer, E. S., Anwyl-Irvine, A. L., Smith, T. A., Siugzdaite, R., Uh, S., et al. (2020). Longitudinal increases in childhood depression symptoms during the COVID-19 lockdown. Archives of Disease in Childhood. https://doi.org/10.1136/archdischild-2020-320372CrossRefPubMed

22.

Magson, N. R., Freeman, J. Y. A., Rapee, R. M., Richardson, C. E., Oar, E. L., & Fardouly, J. (2021). Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic. Journal of Youth and Adolescence, 50(1), 44–57. https://doi.org/10.1007/s10964-020-01332-9CrossRefPubMed

23.

Hawes, M. T., Szenczy, A. K., Klein, D. N., Hajcak, G., & Nelson, B. D. (2021). Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic. Psychological Medicine. https://doi.org/10.1017/s0033291720005358CrossRefPubMedPubMedCentral

24.

Luijten, M. A., van Litsenburg, R. R., Terwee, C. B., Grootenhuis, M. A., & Haverman, L. (2021). Psychometric properties of the Patient-Reported Outcomes Measurement Information System (PROMIS®) pediatric item bank peer relationships in the Dutch general population. Quality of Life Research. https://doi.org/10.1002/acr.24094CrossRefPubMedPubMedCentral

25.

Haverman, L., van Oers, H. A., Limperg, P. F., Hijmans, C. T., Schepers, S. A., Sint Nicolaas, S. M., et al. (2014). Implementation of electronic patient reported outcomes in pediatric daily clinical practice: The KLIK experience. Clinical Practice in Pediatric Psychology, 2(1), 50–67. https://doi.org/10.1037/cpp0000043CrossRef

26.

Cella, D., Gershon, R., Lai, J. S., & Choi, S. (2007). The future of outcomes measurement: Item banking, tailored short-forms, and computerized adaptive assessment. QualLife Research, 16(Suppl 1), 133–141. https://doi.org/10.1007/s11136-007-9204-6CrossRef

27.

Irwin, D. E., Stucky, B. D., Langer, M. M., Thissen, D., DeWitt, E. M., Lai, J. S., et al. (2012). PROMIS Pediatric Anger Scale: An item response theory analysis. Quality of Life Research, 21(4), 697–706. https://doi.org/10.1007/s11136-011-9969-5CrossRefPubMed

28.

DeWalt, D. A., Thissen, D., Stucky, B. D., Langer, M. M., Morgan, D. E., Irwin, D. E., et al. (2013). PROMIS Pediatric Peer Relationships Scale: Development of a peer relationships item bank as part of social health measurement. Health Psychology, 32(10), 1093–1103. https://doi.org/10.1037/a0032670CrossRefPubMed

29.

Forrest, C. B., Bevans, K. B., Pratiwadi, R., Moon, J., Teneralli, R. E., Minton, J. M., et al. (2014). Development of the PROMIS (R) pediatric global health (PGH-7) measure. QualLife Research, 23(4), 1221–1231. https://doi.org/10.1007/s11136-013-0581-8CrossRef

30.

Forrest, C. B., Meltzer, L. J., Marcus, C. L., de la Motte, A., Kratchman, A., Buysse, D. J., et al. (2018). Development and validation of the PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment item banks. Sleep. https://doi.org/10.1093/sleep/zsy054CrossRefPubMed

31.

Irwin, D., Stucky, B., Langer, M., Thissen, D., DeWitt, E., Lai, J. S., et al. (2010). An item response analysis of the pediatric PROMIS anxiety and depressive symptoms scales. Quality of Life Research, 19(4), 595–607. https://doi.org/10.1007/s11136-010-9619-3CrossRefPubMedPubMedCentral

32.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oaCrossRef

33.

Jia, H., & Lubetkin, E. I. (2009). Time trends and seasonal patterns of health-related quality of life among US adults. Public Health Reports, 124(5), 692–701. https://doi.org/10.1177/003335490912400511CrossRefPubMedPubMedCentral

Title: The impact of lockdown during the COVID-19 pandemic on mental and social health of children and adolescents
Authors: Michiel A. J. Luijten
Maud M. van Muilekom
Lorynn Teela
Tinca J. C. Polderman
Caroline B. Terwee
Josjan Zijlmans
Leonie Klaufus
Arne Popma
Kim J. Oostrom
Hedy A. van Oers
Lotte Haverman
Publication date: 01-10-2021
Publisher: Springer International Publishing
Keywords: COVID-19
Anxiety
Published in: Quality of Life Research / Issue 10/2021
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-021-02861-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The impact of lockdown during the COVID-19 pandemic on mental and social health of children and adolescents

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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