Behavioural and Emotional Changes during COVID-19 Lockdown in an Italian Paediatric Population with Neurologic and Psychiatric Disorders

Abstract

On 11 March 2020, a national lockdown was imposed by the Italian government to contain the spread of COVID19 disease. This is an observational longitudinal study conducted at Fondazione Stella Maris (FSM), Italy to investigate lockdown-related emotional and behavioural changes in paediatric neuropsychiatric population. Families having children (1.5–18 years) with neuropsychiatric disorders referred to FSM have been contacted and proposed to fulfil two online questionnaires (General questionnaire and Child Behaviour Check List (CBCL)) to (i) compare (paired two-sample t-tests) the CBCL scores during lockdown with previous ones, and (ii) investigate the influence (multiple linear regression models) of variables such as age, diagnosis grouping (neurological, neurodevelopmental, emotional, and behavioural disorders) and financial hardship. One hundred and forty-one parents fulfilled the questionnaires. Anxiety and somatic problems increased in 1.5–5 years subpopulation, while obsessive-compulsive, post-traumatic and thought problems increased in 6–18 years subpopulation. In the regression models, younger age in the 1.5–5 years subpopulation resulted as “protective” while financial hardship experienced by families during lockdown was related to psychiatric symptoms increasing in the 6–18 years subpopulation. Some considerations, based on first clinical impressions, are provided in text together with comments in relation to previous and emerging literature on the topic.

How Did Italian Adolescents with Disability and Parents Deal with the COVID-19 Emergency?

“…Among adolescents, older adolescents were more anxious, and anxiety was correlated with perceptions of financial problems and with concern about the future. This confirms the findings of another Italian study, where the financial hardship experienced by families during lockdown was associated with the psychological distress of children aged 6 to 18 years old [22].…”

“…This may have allowed adolescents with a motor disability to level the playing field. With due caution, this possible interpretation partly reverses emerging trends described in the literature, which emphasize psychological distress due to quarantine in pediatric populations with disabilities [ 16 , 22 ].…”

Mental and social health of children and adolescents with pre-existing mental or somatic problems during the COVID-19 pandemic lockdown

“…One study in children with autism spectrum disorder (ASD) reported increases in irritability, hyperactivity, inappropriate speech, and speech quality from before to during the pandemic 17 . Another study in a neuropsychiatric child and adolescent sample reported increases in obsessive-compulsive problems, post-traumatic stress, and thought problems 18 . On the other hand, a French study investigated the well-being of 533 children and adolescents with self-reported Attention Deficit/Hyperactivity Disorder (ADHD) during the COVID-19 pandemic 19 .…”

Effects of COVID-19 Lockdown on the Emotional and Behavioral Profiles of Preschool Italian Children with and without Familial Risk for Neurodevelopmental Disorders

“…In addition, school closures and lockdown deprived many children with mental health needs and NDD of access to resources that they usually get through schools [22] and face-to-face therapies [24,25]. Even if most educational and support systems have shifted to online telehealth programs [26,27], these platforms may not be compatible with assistive technology [21] and may be challenging for some young people [22]. Families have been asked to take care of online special education and therapies, which have further increased parents' load and psychological distress, with negative effects on children [20,21].…”