Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Child and Adolescent Psychiatry and Mental Health
Published in: Child and Adolescent Psychiatry and Mental Health 1/2020

Open Access 01-12-2020 | Child Maltreatment | Review

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

Authors: Jörg M. Fegert, Benedetto Vitiello, Paul L. Plener, Vera Clemens

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2020

Login to get access

Abstract

Background

The coronavirus disease 2019 (COVID-19) is profoundly affecting life around the globe. Isolation, contact restrictions and economic shutdown impose a complete change to the psychosocial environment in affected countries. These measures have the potential to threaten the mental health of children and adolescents significantly. Even though the current crisis can bring with it opportunities for personal growth and family cohesion, disadvantages may outweigh these benefits. Anxiety, lack of peer contact and reduced opportunities for stress regulation are main concerns. Another main threat is an increased risk for parental mental illness, domestic violence and child maltreatment. Especially for children and adolescents with special needs or disadvantages, such as disabilities, trauma experiences, already existing mental health problems, migrant background and low socioeconomic status, this may be a particularly challenging time. To maintain regular and emergency child and adolescent psychiatric treatment during the pandemic is a major challenge but is necessary for limiting long-term consequences for the mental health of children and adolescents. Urgent research questions comprise understanding the mental health effects of social distancing and economic pressure, identifying risk and resilience factors, and preventing long-term consequences, including—but not restricted to—child maltreatment. The efficacy of telepsychiatry is another highly relevant issue is to evaluate the efficacy of telehealth and perfect its applications to child and adolescent psychiatry.

Conclusion

There are numerous mental health threats associated with the current pandemic and subsequent restrictions. Child and adolescent psychiatrists must ensure continuity of care during all phases of the pandemic. COVID-19-associated mental health risks will disproportionately hit children and adolescents who are already disadvantaged and marginalized. Research is needed to assess the implications of policies enacted to contain the pandemic on mental health of children and adolescents, and to estimate the risk/benefit ratio of measures such as home schooling, in order to be better prepared for future developments.
Literature
1.
2.
Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729.PubMedCentralCrossRef
3.
4.
5.
Fegert JM, Berthold O, Clemens V, Kölch M. COVID-19-Pandemie: Kinderschutz ist systemrelevant. Dtsch Arztebl Int. 2020;117(14):A-703.
6.
7.
Gifford-Smith ME, Brownell CA. Childhood peer relationships: social acceptance, friendships, and peer networks. J Sch Psychol. 2003;41(4):235–84.CrossRef
8.
Oberle E, Schonert-Reichl KA, Thomson KC. Understanding the link between social and emotional well-being and peer relations in early adolescence: gender-specific predictors of peer acceptance. J Youth Adolesc. 2010;39(11):1330–42.PubMedCrossRef
9.
10.
Viner RM, Russell SJ, Croker H, Packer J, Ward J, Stansfield C, et al. School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review. Lancet Child Adolesc Health. 2020.
11.
Stikkelbroek Y, Bodden DH, Reitz E, Vollebergh WA, van Baar AL. Mental health of adolescents before and after the death of a parent or sibling. Eur Child Adolesc Psychiatry. 2016;25(1):49–59.PubMedCrossRef
12.
Frasquilho D, Matos MG, Salonna F, Guerreiro D, Storti CC, Gaspar T, et al. Mental health outcomes in times of economic recession: a systematic literature review. BMC Public Health. 2016;16:115.PubMedPubMedCentralCrossRef
13.
Haw C, Hawton K, Gunnell D, Platt S. Economic recession and suicidal behaviour: possible mechanisms and ameliorating factors. Int J Soc Psychiatry. 2015;61(1):73–81.PubMedCrossRef
14.
Kiernan FM. Income loss and the mental health of young mothers: evidence from the recession in Ireland. J Ment Health Policy Econ. 2019;22(4):131–49.PubMed
15.
Holling H, Schlack R, Petermann F, Ravens-Sieberer U, Mauz E. Psychopathological problems and psychosocial impairment in children and adolescents aged 3–17 years in the German population: prevalence and time trends at two measurement points (2003–2006 and 2009–2012): results of the KiGGS study: first follow-up (KiGGS Wave 1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014;57(7):807–19.PubMedCrossRef
16.
Riley AW, Valdez CR, Barrueco S, Mills C, Beardslee W, Sandler I, et al. Development of a family-based program to reduce risk and promote resilience among families affected by maternal depression: theoretical basis and program description. Clin Child Fam Psychol Rev. 2008;11(1):12–29.PubMedCrossRef
17.
Bosanac P, Buist A, Burrows G. Motherhood and schizophrenic illnesses: a review of the literature. Aust N Z J Psychiatry. 2003;37(1):24–30.PubMedCrossRef
18.
Klein M. Kinder aus alkoholbelasteten Familien - Ein Überblick zu Forschungsergebnissen und Handlungsperspektiven. Suchttherapie. 2001;2(03):118–24.CrossRef
19.
Rasic D, Hajek T, Alda M, Uher R. Risk of mental illness in offspring of parents with schizophrenia, bipolar disorder, and major depressive disorder: a meta-analysis of family high-risk studies. Schizophr Bull. 2014;40(1):28–38.PubMedCrossRef
20.
Schneider D, Harknett K, McLanahan S. Intimate partner violence in the great recession. Demography. 2016;53(2):471–505.PubMedCrossRef
21.
Elder GHJ. Children of the great depression: social changes in life experience. Boulder, CO. USA; 1974.
22.
Elder GHJ, Conger RD. Children of the land: adversity and success in rural America. Chicago, IL, USA; 2000.
23.
Peterman A, Potts A, O’Donnell M, Thompson K, Shah N, Oertelt-Prigione S, et al. Pandemics and violence against women and children. center for global development working paper. 2020. (in press).
24.
25.
26.
Holt S, Buckley H, Whelan S. The impact of exposure to domestic violence on children and young people: a review of the literature. Child Abuse Negl. 2008;32(8):797–810.PubMedCrossRef
27.
MacMillan HL, Wathen CN, Varcoe CM. Intimate partner violence in the family: considerations for children’s safety. Child Abuse Negl. 2013;37(12):1186–91.PubMedCrossRef
28.
Hillis SD, Mercy JA, Saul JR. The enduring impact of violence against children. Psychol Health Med. 2017;22(4):393–405.PubMedCrossRef
29.
Huang MI, O’Riordan MA, Fitzenrider E, McDavid L, Cohen AR, Robinson S. Increased incidence of nonaccidental head trauma in infants associated with the economic recession. Pediatrics. 2011;8(2):171.PubMed
30.
Schneider W, Waldfogel J, Brooks-Gunn J. The Great Recession and risk for child abuse and neglect. Child Youth Serv Rev. 2017;72:71–81.PubMedCrossRef
31.
Paleologou MP, Anagnostopoulos DC, Lazaratou H, Economou M, Peppou LE, Malliori M. Adolescents’ mental health during the financial crisis in Greece: the first epidemiological data. Psychiatriki. 2018;29(3):271–4.PubMedCrossRef
32.
Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912–20.PubMedPubMedCentralCrossRef
33.
Horesh D, Brown AD. Traumatic stress in the age of COVID-19: a call to close critical gaps and adapt to new realities. Psychol Trauma. 2020;12(4):331–5.PubMedCrossRef
34.
Sprang G, Silman M. Posttraumatic stress disorder in parents and youth after health-related disasters. Disaster Med Public Health Prep. 2013;7(1):105–10.PubMedCrossRef
35.
36.
37.
Okusaga O, Yolken RH, Langenberg P, Lapidus M, Arling TA, Dickerson FB, et al. Association of seropositivity for influenza and Coronaviruses with history of mood disorders and suicide attempts. J Affect Disord. 2011;130(1–2):220–5.PubMedCrossRef
38.
Severance EG, Dickerson FB, Viscidi RP, Bossis I, Stallings CR, Origoni AE, et al. Coronavirus immunoreactivity in individuals with a recent onset of psychotic symptoms. Schizophr Bull. 2011;37(1):101–7.PubMedCrossRef
39.
Herrman H, Stewart DE, Diaz-Granados N, Berger EL, Jackson B, Yuen T. What is resilience? Can J Psychiatry. 2011;56(5):258–65.PubMedCrossRef
40.
Zoellner T, Maercker A. Posttraumatic growth in clinical psychology—a critical review and introduction of a two component model. Clinical Psychology Review. 2006;26(5):626–53.PubMedCrossRef
41.
Schaefer JA, Moos RH. Life crises and personal growth. Personal coping: theory, research, and application. Westport: Praeger Publishers/Greenwood Publishing Group; 1992. p. 149–70.
42.
Park CL, Cohen LH, Murch RL. Assessment and prediction of stress-related growth. J Pers. 1996;64(1):71–105.PubMedCrossRef
43.
Lee D, Brooks-Gunn J, McLanahan SS, Notterman D, Garfinkel I. The Great Recession, genetic sensitivity, and maternal harsh parenting. Proc Natl Acad Sci USA. 2013;110(34):13780–4.PubMedCrossRefPubMedCentral
44.
Wu P, Liu X, Fang Y, Fan B, Fuller CJ, Guan Z, et al. Alcohol abuse/dependence symptoms among hospital employees exposed to a SARS outbreak. Alcohol Alcohol. 2008;43(6):706–12.PubMedPubMedCentralCrossRef
45.
Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect. 2008;136(7):997–1007.PubMedCrossRef
46.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245–58.PubMedCrossRef
47.
Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T. The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS Med. 2012;9(11):e1001349.PubMedPubMedCentralCrossRef
48.
Neamah HH, Sudfeld C, McCoy DC, Fink G, Fawzi WW, Masanja H, et al. Intimate partner violence, depression, and child growth and development. Pediatrics. 2018;142(1):e20173457.PubMedCrossRef
49.
50.
Bowen E. The impact of intimate partner violence on preschool children’s peer problems: an analysis of risk and protective factors. Child Abuse Negl. 2015;50:141–50.PubMedPubMedCentralCrossRef
51.
Brown DW, Anda RF, Tiemeier H, Felitti VJ, Edwards VJ, Croft JB, et al. Adverse childhood experiences and the risk of premature mortality. Am J Prev Med. 2009;37(5):389–96.PubMedCrossRef
52.
Seppala P, Vornanen R, Toikko T. Are children with a number of disabilities and long-term illnesses at increased risk of mental violence, disciplinary violence, and serious violence? J Interpers Violence. 2020:886260519898440.
53.
Hein TC, Monk CS. Research Review: neural response to threat in children, adolescents, and adults after child maltreatment—a quantitative meta-analysis. J Child Psychol Psychiatry. 2017;58(3):222–30.PubMedCrossRef
54.
Duffy KA, McLaughlin KA, Green PA. Early life adversity and health-risk behaviors: proposed psychological and neural mechanisms. Ann N Y Acad Sci. 2018;1428(1):151–69.PubMedPubMedCentralCrossRef
55.
Wiener J, Biondic D, Grimbos T, Herbert M. Parenting stress of parents of adolescents with attention-deficit hyperactivity disorder. J Abnorm Child Psychol. 2016;44(3):561–74.PubMedCrossRef
56.
Compas BE, Jaser SS, Bettis AH, Watson KH, Gruhn MA, Dunbar JP, et al. Coping, emotion regulation, and psychopathology in childhood and adolescence: a meta-analysis and narrative review. Psychol Bull. 2017;143(9):939–91.PubMedCrossRefPubMedCentral
57.
Gruhn MA, Compas BE. Effects of maltreatment on coping and emotion regulation in childhood and adolescence: a meta-analytic review. Child Abuse Negl. 2020;103:104446.PubMedCrossRef
58.
Caporino NE, Exley S, Latzman RD. Youth Anxiety About Political News. Child Psychiatry & Human Development. 2020.
59.
Hartman CA, Rommelse N, van der Klugt CL, Wanders RBK, Timmerman ME. Stress exposure and the course of ADHD from childhood to young adulthood: comorbid severe emotion dysregulation or mood and anxiety problems. J Clin Med. 2019;8(11):1824.PubMedCentralCrossRef
60.
Hawton K, Bergen H, Geulayov G, Waters K, Ness J, Cooper J, et al. Impact of the recent recession on self-harm: longitudinal ecological and patient-level investigation from the Multicentre Study of Self-harm in England. J Affect Disord. 2016;191:132–8.PubMedCrossRef
61.
Plener PL, Schumacher TS, Munz LM, Groschwitz RC. The longitudinal course of non-suicidal self-injury and deliberate self-harm: a systematic review of the literature. Borderline Pers Disord Emot Dysregul. 2015;2:2.CrossRef
62.
von Werthern M, Grigorakis G, Vizard E. The mental health and wellbeing of Unaccompanied Refugee Minors (URMs). Child Abuse Negl. 2019;98:104146.CrossRef
63.
Rousseau C, Oulhote Y, Ruiz-Casares M, Cleveland J, Greenaway C. Encouraging understanding or increasing prejudices: a cross-sectional survey of institutional influence on health personnel attitudes about refugee claimants’ access to health care. PLoS ONE. 2017;12(2):e0170910.PubMedPubMedCentralCrossRef
64.
Blackmore R, Gray KM, Boyle JA, Fazel M, Ranasinha S, Fitzgerald G, et al. Systematic review and meta-analysis: the prevalence of mental illness in child and adolescent refugees and asylum seekers. J Am Acad Child Adolesc Psychiatry. 2019.
65.
66.
67.
Vigerland S, Lenhard F, Bonnert M, Lalouni M, Hedman E, Ahlen J, et al. Internet-delivered cognitive behavior therapy for children and adolescents: a systematic review and meta-analysis. Clin Psychol Rev. 2016;50:1–10.PubMedCrossRef
68.
Rice SM, Goodall J, Hetrick SE, Parker AG, Gilbertson T, Amminger GP, et al. Online and social networking interventions for the treatment of depression in young people: a systematic review. J Med Internet Res. 2014;16(9):e206.PubMedPubMedCentralCrossRef
69.
Reyes-Portillo JA, Mufson L, Greenhill LL, Gould MS, Fisher PW, Tarlow N, et al. Web-based interventions for youth internalizing problems: a systematic review. J Am Acad Child Adolesc Psychiatry. 2014;53(12):1254–70.PubMedCrossRef
70.
Domhardt M, Steubl L, Baumeister H. Internet- and mobile-based interventions for mental and somatic conditions in children and adolescents. Z Kinder Jugendpsychiatr Psychother. 2020;48(1):33–46.PubMedCrossRef
71.
Metadata
Title
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
Authors
Jörg M. Fegert
Benedetto Vitiello
Paul L. Plener
Vera Clemens
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2020
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-020-00329-3

Other articles of this Issue 1/2020

Child and Adolescent Psychiatry and Mental Health 1/2020 Go to the issue

Research article

Adolescents with full or subthreshold anorexia nervosa in a naturalistic sample: treatment interventions and patient satisfaction

Research article

Children and young people’s experiences of completing mental health and wellbeing measures for research: learning from two school-based pilot projects

Research article

Violence against children and adolescents by nursing staff: prevalence rates and implications for practice

Review

Family violence against children in the wake of COVID-19 pandemic: a review of current perspectives and risk factors

Research article

The importance of social factors in the association between physical activity and depression in children

Research article

Integrating clinical and research training in child psychiatry: fifteen-year outcomes of a federally supported program