COVID-19 related posttraumatic stress disorder in children and adolescents in Saudi Arabia

Abstract

Introduction The COVID-19 pandemic resulted in quarantine/lockdown measures in most countries. Quarantine may create intense psychological problems including post-traumatic stress disorder (PTSD) especially for the vulnerable critically developing children/adolescents. Few studies evaluated PTSD associated with infectious disasters but no Saudi study investigated PTSD associated with COVID-19 in children/adolescents. This study was undertaken to screen for PTSD in children/adolescent in Saudi Arabia to identify its prevalence/risk factors during COVID-19 pandemic and its quarantine. Methods A cross-sectional survey was conducted after 2 months form start of quarantine for COVID-19 pandemic utilizing the original English version and an Arabic translated version for the University of California at Los Angeles Brief COVID-19 Screen for Child/Adolescent PTSD that can be parent-reported or self-completed by older children/adolescents. Participants (Saudi citizens/non-Saudi residents) were approached online via social media. Results Five hundred and thirty seven participants were enrolled. The participants were 262 boys and 275 girls with a mean age of 12.25±3.77 years. Symptoms of no, minimal, mild and potential PTSD were identified in 15.5%, 44.1%, 27.4% and 13.0% of children/adolescents, respectively. The age, gender, school grade, and residence were not predictive of PTSD symptoms. Univariate analysis of risk factors for PTSD revealed that work of a close relative around people who might be infected was significantly different between groups of PTSD symptoms, but this difference disappeared during multivariate analysis. Children/adolescents of Saudi citizens had significantly lower median total PTSD score than children/adolescents of expatriate families (p = 0.002). Conclusion PTSD associated with the COVID-19 and its resultant quarantine shouldn’t be overlooked in different populations as it is expected in a considerable proportion of children/adolescents with variable prevalence, risk factors and severity. Parents/healthcare providers must be aware of PTSD associated with COVID-19 or similar disasters, so, they can provide children/adolescent with effective coping mechanisms.

Impact of COVID-19 on Saudi Children: Special Focus on Behavioral, Social, and Emotional Aspects, 2020-2021

“…Similarly, a Saudi-Arabia-based study reported that one-third of the children in its sample experienced mild levels of post-traumatic stress due to COVID-19-related quarantine/lockdown measures [28]. In congruence with these findings, the present study found that children not diagnosed with COVID-19 and/or not required to quarantine appeared calmer, more thoughtful, and more emotionally stable.…”

Children’s Psychological Reactions to the COVID-19 Pandemic

“…In the 2021 investigation by Liu and colleagues [6], 18.4% of children who had been hospitalized for COVID-19 experienced clinically significant PTSD, but this study assessed a small convenience sample that may not be representative of all children with COVID-19. A study conducted 2 months after widespread lockdown in Saudi Arabia assessed PTSD in a random national sample of children (7 to 18 years of age) in which COVID-19 illness of the child or close relative and COVID-19 death of a close relative or friend were reported by 3.7% and 3.9%, respectively [10]. Potential PTSD was identified in 13.0% of the sample [10].…”

“…A study conducted 2 months after widespread lockdown in Saudi Arabia assessed PTSD in a random national sample of children (7 to 18 years of age) in which COVID-19 illness of the child or close relative and COVID-19 death of a close relative or friend were reported by 3.7% and 3.9%, respectively [10]. Potential PTSD was identified in 13.0% of the sample [10]. In a longitudinal population-based investigation in the United Kingdom (U.K.), Wright and colleagues [11 •] revealed increased PTSD symptoms 3 months after distancing measures were initiated relative to an earlier assessment from December to March 2020.…”

Posttraumatic Stress Disorder in Children in the Context of the COVID-19 Pandemic

“…A review of exposure characteristics, PTSD rates, and the assessment of diagnostic criteria in six COVID-19 studies that assessed PTSD in general child populations 3 , 4 , 5 , 6 , 7 , 8 evidenced the concerns raised in the adult literature. 1 Only two papers provided much detail on participants’ COVID-19 experiences or exposure, 5 , 6 and none clearly limited the diagnosis of PTSD to participants who met the exposure criterion. In a sample with a sizeable number of children who knew someone who tested positive for, or died of, COVID-19, 45% scored above the study’s threshold for PTSD.…”