Quality of life and mental health in children and adolescents during the first year of the COVID-19 pandemic: results of a two-wave nationwide population-based study.
Anxiety
COVID-19
Children and adolescents
Depression
Mental health
Quality of life
Journal
European child & adolescent psychiatry
ISSN: 1435-165X
Titre abrégé: Eur Child Adolesc Psychiatry
Pays: Germany
ID NLM: 9212296
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
10
05
2021
accepted:
29
09
2021
medline:
21
4
2023
pubmed:
13
10
2021
entrez:
12
10
2021
Statut:
ppublish
Résumé
The COVID-19 pandemic has disrupted the lives of children and adolescents worldwide. The German COPSY study is among the first population-based longitudinal studies to examine the mental health impact of the pandemic. The objective of the study was to assess changes in health-related quality of life (HRQoL) and mental health in children and adolescents and to identify the associated risk and resource factors during the pandemic. A nationwide longitudinal survey was conducted with two waves during the pandemic (May/June 2020 and December 2020/January 2021). In total, n = 1923 children and adolescents aged 7 to 17 years and their parents participated (retention rate from wave 1 to wave 2: 85%). The self-report and parent-proxy surveys assessed HRQoL (KIDSCREEN-10), mental health problems (SDQ with the subscales emotional problems, conduct problems, hyperactivity, and peer problems), anxiety (SCARED), depressive symptoms (CES-DC, PHQ-2) and psychosomatic complaints (HBSC-SCL). Mixed model panel regression analyses were conducted to examine longitudinal changes in mental health and to identify risk and resource factors. The HRQoL of children and adolescents decreased during the pandemic, and emotional problems, peer-related mental health problems, anxiety, depressive and psychosomatic symptoms increased over time, however the change in global mental health problems from wave 1 to wave 2 was not significant, and some changes were negligible. Socially disadvantaged children and children of mentally burdened parents were at particular risk of impaired mental health, while female gender and older age were associated with fewer mental health problems. A positive family climate and social support supported the mental health of children and adolescents during the pandemic. Health promotion, prevention and intervention strategies could support children and adolescents in coping with the pandemic and protect and maintain their mental health.
Sections du résumé
BACKGROUND
BACKGROUND
The COVID-19 pandemic has disrupted the lives of children and adolescents worldwide. The German COPSY study is among the first population-based longitudinal studies to examine the mental health impact of the pandemic. The objective of the study was to assess changes in health-related quality of life (HRQoL) and mental health in children and adolescents and to identify the associated risk and resource factors during the pandemic.
METHODS
METHODS
A nationwide longitudinal survey was conducted with two waves during the pandemic (May/June 2020 and December 2020/January 2021). In total, n = 1923 children and adolescents aged 7 to 17 years and their parents participated (retention rate from wave 1 to wave 2: 85%). The self-report and parent-proxy surveys assessed HRQoL (KIDSCREEN-10), mental health problems (SDQ with the subscales emotional problems, conduct problems, hyperactivity, and peer problems), anxiety (SCARED), depressive symptoms (CES-DC, PHQ-2) and psychosomatic complaints (HBSC-SCL). Mixed model panel regression analyses were conducted to examine longitudinal changes in mental health and to identify risk and resource factors.
RESULTS
RESULTS
The HRQoL of children and adolescents decreased during the pandemic, and emotional problems, peer-related mental health problems, anxiety, depressive and psychosomatic symptoms increased over time, however the change in global mental health problems from wave 1 to wave 2 was not significant, and some changes were negligible. Socially disadvantaged children and children of mentally burdened parents were at particular risk of impaired mental health, while female gender and older age were associated with fewer mental health problems. A positive family climate and social support supported the mental health of children and adolescents during the pandemic.
DISCUSSION
CONCLUSIONS
Health promotion, prevention and intervention strategies could support children and adolescents in coping with the pandemic and protect and maintain their mental health.
Identifiants
pubmed: 34636964
doi: 10.1007/s00787-021-01889-1
pii: 10.1007/s00787-021-01889-1
pmc: PMC8506100
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
575-588Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021. The Author(s).
Références
Fore HH (2020) A wake-up call: COVID-19 and its impact on children’s health and wellbeing. Lancet Glob Health 8(7):e861–e862. https://doi.org/10.1016/S2214-109X(20)30238-2
doi: 10.1016/S2214-109X(20)30238-2
pubmed: 32405458
pmcid: 7217644
Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S (2021) Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a meta-analysis. JAMA Pediatr. https://doi.org/10.1001/jamapediatrics.2021.2482
doi: 10.1001/jamapediatrics.2021.2482
pubmed: 34369987
pmcid: 8353576
Ma L, Mazidi M, Li K, Li Y, Chen S, Kirwan R, Zhou H, Yan N, Rahman A, Wang W, Wang Y (2021) Prevalence of mental health problems among children and adolescents during the COVID-19 pandemic: a systematic review and meta-analysis. J Affect Disord 293:78–89. https://doi.org/10.1016/j.jad.2021.06.021
doi: 10.1016/j.jad.2021.06.021
pubmed: 34174475
pmcid: 9711885
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. Eur Child Adolesc Psychiatry. https://doi.org/10.1007/s00787-021-01726-5
doi: 10.1007/s00787-021-01726-5
pubmed: 34636964
pmcid: 8506100
Lee J (2020) Mental health effects of school closures during COVID-19. Lancet Child Adolesc Health 4(6):421–421. https://doi.org/10.1016/S2352-4642(20)30109-7
doi: 10.1016/S2352-4642(20)30109-7
pubmed: 32302537
pmcid: 7156240
Thomas EY, Anurudran A, Robb K, Burke TF (2020) Spotlight on child abuse and neglect response in the time of COVID-19. Lancet Public Health 5(7):e371
doi: 10.1016/S2468-2667(20)30143-2
pubmed: 32619538
pmcid: 7326432
Amerio A, Brambilla A, Morganti A, Aguglia A, Bianchi D, Santi F, Costantini L, Odone A, Costanza A, Signorelli C, Serafini G, Amore M, Capolongo S (2020) COVID-19 lockdown: housing built environment’s effects on mental health. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph17165973
doi: 10.3390/ijerph17165973
pubmed: 32937855
pmcid: 7559491
Holmes EA, O’Connor RC, Perry VH, Tracey I, Wessely S, Arseneault L, Ballard C, Christensen H, Cohen Silver R, Everall I, Ford T, John A, Kabir T, King K, Madan I, Michie S, Przybylski AK, Shafran R, Sweeney A, Worthman CM, Yardley L, Cowan K, Cope C, Hotopf M, Bullmore E (2020) Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry 7(6):547–560. https://doi.org/10.1016/S2215-0366(20)30168-1
doi: 10.1016/S2215-0366(20)30168-1
pubmed: 32304649
pmcid: 7159850
Bignardi G, Dalmaijer ES, Anwyl-Irvine AL, Smith TA, Siugzdaite R, Uh S, Astle DE (2020) Longitudinal increases in childhood depression symptoms during the COVID-19 lockdown. Arch Dis Child 106(8):791–797. https://doi.org/10.1136/archdischild-2020-320372
doi: 10.1136/archdischild-2020-320372
pubmed: 33298552
Waite P, Pearcey S, Shum A, Raw JAL, Patalay P, Creswell C (2021) How did the mental health symptoms of children and adolescents change over early lockdown during the COVID-19 pandemic in the UK? JCPP Adv 1:e12009. https://doi.org/10.1111/jcv2.12009
doi: 10.1111/jcv2.12009
pubmed: 34485988
pmcid: 8206715
Hawes MT, Szenczy AK, Olino TM, Nelson BD, Klein DN (2021) Trajectories of depression, anxiety and pandemic experiences; a longitudinal study of youth in New York during the Spring-Summer of 2020. Psychiatry Res 298:113778. https://doi.org/10.1016/j.psychres.2021.113778
doi: 10.1016/j.psychres.2021.113778
pubmed: 33550176
pmcid: 9754702
Otto C, Reiss F, Voss C, Wüstner A, Meyrose A-K, Hölling H, Ravens-Sieberer U (2020) Mental health and well-being from childhood to adulthood: design, methods and results of the 11-year follow-up of the BELLA study. Eur Child Adolesc Psychiatry. https://doi.org/10.1007/s00787-020-01630-4
doi: 10.1007/s00787-020-01630-4
pubmed: 32918625
pmcid: 8505294
Moor I, Winter K, Bilz L, Bucksch J, Finne E, John N, Kolip P, Paulsen L, Ravens-Sieberer U, Schlattmann M, Sudeck G, Brindley C, Kaman A, Richter M (2020) The 2017/18 Health Behaviour in School-aged Children (HBSC) study: Methodology of the World Health Organization’s child and adolescent health study. J Health Monit 5(3):88–102. https://doi.org/10.25646/6904
doi: 10.25646/6904
pubmed: 35146275
pmcid: 8734187
Brauns H, Scherer S, Steinmann S (2003) The CASMIN educational classification in international comparative research. In: Hoffmeyer-Zlotnik J, Wolf C (eds) Advances in cross-national comparison: a European working book for demographic and socio-economic variables. Springer, Boston, pp 221–244. https://doi.org/10.1007/978-1-4419-9186-7_11
doi: 10.1007/978-1-4419-9186-7_11
Krause KR, Chung S, Adewuya AO, Albano AM, Babins-Wagner R, Birkinshaw L, Brann P, Creswell C, Delaney K, Falissard B, Forrest CB, Hudson JL, Ishikawa S-i, Khatwani M, Kieling C, Krause J, Malik K, Martínez V, Mughal F, Ollendick TH, Ong SH, Patton GC, Ravens-Sieberer U, Szatmari P, Thomas E, Walters L, Young B, Zhao Y, Wolpert M (2021) International consensus on a standard set of outcome measures for child and youth anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder. Lancet Psychiatry 8(1):76–86. https://doi.org/10.1016/S2215-0366(20)30356-4
doi: 10.1016/S2215-0366(20)30356-4
pubmed: 33341172
Ravens-Sieberer U, The European KIDSCREEN Group (2006) The KIDSCREEN Questionnaires quality of life questionnaires for children and adolescents: handbook. Pabst Science Publisher, Lengerich
Ravens-Sieberer U, Auquier P, Erhart M, Gosch A, Rajmil L, Bruil J, Power M, Duer W, Cloetta B, Czemy L, Mazur J, Czimbalmos A, Tountas Y, Hagquist C, Kilroe J (2007) The KIDSCREEN-27 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Q Life Res 16(8):1347–1356. https://doi.org/10.1007/s11136-007-9240-2
doi: 10.1007/s11136-007-9240-2
Ravens-Sieberer U, Erhart M, Rajmil L, Herdman M, Auquier P, Bruil J, Power M, Duer W, Abel T, Czemy L, Mazur J, Czimbalmos A, Tountas Y, Hagquist C, Kilroe J (2010) Reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents’ well-being and health-related quality of life. Q Life Res 19(10):1487–1500. https://doi.org/10.1007/s11136-010-9706-5
doi: 10.1007/s11136-010-9706-5
Ravens-Sieberer U, Gosch A, Rajmil L, Erhart M, Bruil J, Power M, Duer W, Auquier P, Cloetta B, Czemy L, Mazur J, Czimbalmos A, Tountas Y, Hagquist C, Kilroe J (2008) The KIDSCREEN-52 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Value Health 11(4):645–658. https://doi.org/10.1111/j.1524-4733.2007.00291.x
doi: 10.1111/j.1524-4733.2007.00291.x
pubmed: 18179669
Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38(5):581–586. https://doi.org/10.1111/j.1469-7610.1997.tb01545.x
doi: 10.1111/j.1469-7610.1997.tb01545.x
pubmed: 9255702
Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40(11):1337–1345. https://doi.org/10.1097/00004583-200111000-00015
doi: 10.1097/00004583-200111000-00015
pubmed: 11699809
Woerner W, Becker A, Rothenberger A (2004) Normative data and scale properties of the German parent SDQ. Eur Child Adolesc Psychiatry 13:3–10. https://doi.org/10.1007/s00787-004-2002-6
doi: 10.1007/s00787-004-2002-6
Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S, Baugher M (1999) Psychometric properties of the screen for child anxiety related emotional disorders (SCARED): a replication study. J Am Acad Child Adolesc Psychiatry 38(10):1230–1236. https://doi.org/10.1097/00004583-199910000-00011
doi: 10.1097/00004583-199910000-00011
pubmed: 10517055
Barkmann C, Erhart M, Schulte-Markwort M, The BELLA Study Group (2008) The German version of the centre for epidemiological studies depression scale for children: psychometric evaluation in a population-based survey of 7 to 17 years old children and adolescents - results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl 1):116–124. https://doi.org/10.1007/s00787-008-1013-0
doi: 10.1007/s00787-008-1013-0
pubmed: 19132311
Kroenke K, Spitzer RL, Williams JB (2003) The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care 41(11):1284–1292. https://doi.org/10.1097/01.Mlr.0000093487.78664.3c
doi: 10.1097/01.Mlr.0000093487.78664.3c
pubmed: 14583691
Löwe B, Kroenke K, Gräfe K (2005) Detecting and monitoring depression with a two-item questionnaire (PHQ-2). J Psychosom Res 58(2):163–171. https://doi.org/10.1016/j.jpsychores.2004.09.006
doi: 10.1016/j.jpsychores.2004.09.006
pubmed: 15820844
Haugland S, Wold B (2001) Subjective health complaints in adolescence—reliability and validity of survey methods. J Adolesc 24(5):611–624. https://doi.org/10.1006/jado.2000.0393
doi: 10.1006/jado.2000.0393
pubmed: 11676508
Ravens-Sieberer U, Erhart M, Torsheim T, Hetland J, Freeman J, Danielson M, Thomas C (2008) An international scoring system for self-reported health complaints in adolescents. Eur J Public Health 18(3):294–299. https://doi.org/10.1093/eurpub/ckn001
doi: 10.1093/eurpub/ckn001
pubmed: 18252752
Schneewind K, Beckmann M, Hecht-Jackl A (1985) Familienklima-Skalen. Bericht 8.1 und 8.2. Ludwig Maximilians Universität, Institut für Psychologie-Persönlichkeitspsychologie und Psychodiagnostik, München
Otto C, Haller AC, Klasen F, Hölling H, Bullinger M, Ravens-Sieberer U (2017) Risk and protective factors of health-related quality of life in children and adolescents: results of the longitudinal BELLA study. PLoS ONE 12(12):e0190363. https://doi.org/10.1371/journal.pone.0190363
doi: 10.1371/journal.pone.0190363
pubmed: 29284054
pmcid: 5746247
Donald CA, Ware JE (1984) The measurement of social support. Res Community Ment Health 4:325–370
Moser A, Stuck AE, Silliman RA, Ganz PA, Clough-Gorr KM (2012) The eight-item modified Medical Outcomes Study Social Support Survey: psychometric evaluation showed excellent performance. J Clin Epidemiol 65(10):1107–1116. https://doi.org/10.1016/j.jclinepi.2012.04.007
doi: 10.1016/j.jclinepi.2012.04.007
pubmed: 22818947
pmcid: 4119888
Sherbourne CD, Stewart AL (1991) The MOS social support survey. Soc Sci Med 32(6):705–714. https://doi.org/10.1016/0277-9536(91)90150-b
doi: 10.1016/0277-9536(91)90150-b
pubmed: 2035047
Wooldridge J (2002) Econometric analysis of cross section and panel data, 2nd edn. The MIT Press, London
Ravens-Sieberer U, Kaman A, Otto C, Adedeji A, Devine J, Erhart M, Napp A-K, Becker M, Blanck-Stellmacher U, Löffler C, Schlack R, Hurrelmann K (2020) Mental health and quality of life in children and adolescents during the COVID-19 pandemic—results of the COPSY study. Dtsch Arztebl Int 117:828–829. https://doi.org/10.3238/arztebl.2020.0828
doi: 10.3238/arztebl.2020.0828
pubmed: 33568260
pmcid: 8005842
Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Erlbaum Associates, Hillsdale
Thorisdottir IE, Asgeirsdottir BB, Kristjansson AL, Valdimarsdottir HB, Jonsdottir Tolgyes EM, Sigfusson J, Allegrante JP, Sigfusdottir ID, Halldorsdottir T (2021) Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: a longitudinal, population-based study. Lancet Psychiatry. https://doi.org/10.1016/s2215-0366(21)00156-5
doi: 10.1016/s2215-0366(21)00156-5
pubmed: 34090582
Chaplin TM, Aldao A (2013) Gender differences in emotion expression in children: a meta-analytic review. Psychol Bull 139(4):735–765. https://doi.org/10.1037/a0030737
doi: 10.1037/a0030737
pubmed: 23231534
Betsch C, Wieler LH, Habersaat K (2020) Monitoring behavioural insights related to COVID-19. Lancet 395(10232):1255–1256. https://doi.org/10.1016/s0140-6736(20)30729-7
doi: 10.1016/s0140-6736(20)30729-7
pubmed: 32247323
pmcid: 7163179
Reiss F (2013) Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med 90:24–31. https://doi.org/10.1016/j.socscimed.2013.04.026
doi: 10.1016/j.socscimed.2013.04.026
pubmed: 23746605
Hoebel J, Michalski N, Wachtler B, Diercke M, Neuhauser H, Wieler LH, Hˆvener C (2021) Socioeconomic differences in the risk of infection during the second SARS-CoV-2 wave in Germany. Dtsch Arztebl Int 118(15):269–270. https://doi.org/10.3238/arztebl.m2021.0188
doi: 10.3238/arztebl.m2021.0188
pubmed: 34114548
pmcid: 8287075
McLaughlin KA, Gadermann AM, Hwang I, Sampson NA, Al-Hamzawi A, Andrade LH, Angermeyer MC, Benjet C, Bromet EJ, Bruffaerts R, Caldas-de-Almeida JM, de Girolamo G, de Graaf R, Florescu S, Gureje O, Haro JM, Hinkov HR, Horiguchi I, Hu C, Karam AN, Kovess-Masfety V, Lee S, Murphy SD, Nizamie SH, Posada-Villa J, Williams DR, Kessler RC (2012) Parent psychopathology and offspring mental disorders: results from the WHO World Mental Health Surveys. Br J Psychiatry 200(4):290–299. https://doi.org/10.1192/bjp.bp.111.101253
doi: 10.1192/bjp.bp.111.101253
pubmed: 22403085
pmcid: 3317036
Kaman A, Otto C, Klasen F, Westenhöfer J, Reiss F, Hölling H, Ravens-Sieberer U (2021) Risk and resource factors for depressive symptoms during adolescence and emerging adulthood - A 5-year follow-up using population-based data of the BELLA study. J Affect Disord 280(Pt A):258–266. https://doi.org/10.1016/j.jad.2020.11.036
doi: 10.1016/j.jad.2020.11.036
pubmed: 33220562