Internalizing problems before and during the COVID-19 pandemic in independent samples of Dutch children and adolescents with and without pre-existing mental health problems

Abstract

The aim of the study was to assess internalizing problems before and during the pandemic with data from Dutch consortium Child and adolescent mental health and wellbeing in times of the COVID-19 pandemic, consisting of two Dutch general population samples (GS) and two clinical samples (CS) referred to youth/psychiatric care. Measures of internalizing problems were obtained from ongoing data collections pre-pandemic (NGS = 35,357; NCS = 4487) and twice during the pandemic, in Apr–May 2020 (NGS = 3938; clinical: NCS = 1008) and in Nov–Dec 2020 (NGS = 1489; NCS = 1536), in children and adolescents (8–18 years) with parent (Brief Problem Monitor) and/or child reports (Patient-Reported Outcomes Measurement Information System®). Results show that, in the general population, internalizing problems were higher during the first peak of the pandemic compared to pre-pandemic based on both child and parent reports. Yet, over the course of the pandemic, on both child and parent reports, similar or lower levels of internalizing problems were observed. Children in the clinical population reported more internalizing symptoms over the course of the pandemic while parents did not report differences in internalizing symptoms from pre-pandemic to the first peak of the pandemic nor over the course of the pandemic. Overall, the findings indicate that children and adolescents of both the general and clinical population were affected negatively by the pandemic in terms of their internalizing problems. Attention is therefore warranted to investigate long-term effects and to monitor if internalizing problems return to pre-pandemic levels or if they remain elevated post-pandemic.

The effects of COVID-19 on child mental and social health: biannual assessments up to April 2022 in a clinical and two general population samples

“…In previous work we discussed that internalizing problems may be less readily noticed by parents or may be perceived as less problematic (Fischer et al, 2022). However, the current data suggest that parents do notice internalizing problems of their children, although in a later stage of the pandemic than children themselves.…”

“…The parent-reported outcomes regarding internalizing problems are similar, although the effects seem delayed; parents reported increased internalizing problems from April 2021 onwards, but not before. In previous work we discussed that internalizing problems may be less readily noticed by parents or may be perceived as less problematic (Fischer et al, 2022). However, the current data suggest that parents do notice internalizing problems of their children, although in a later stage of the pandemic than children themselves.…”

“…It comprises (parents of) children aged 8-18 from two general population samples and one clinical sample. We previously reported on the first two pandemic measurements of this study (Fischer et al, 2022). The two population samples are 1) The Netherlands Twin Register (NTR; Ligthart et al, 2019), a twin cohort that has collected data over the past 35 years in the general Dutch population; 2) The KLIK group, which aimed to collect samples representative of the Dutch population using an online panel agency.…”

“…Prospective studies on child mental health during the pandemic that include pre-pandemic measurements are scarce but do seem to confirm that predominantly affective problems such as depressive, anxious, and stress symptoms worsened in the first months after the onset of the COVID-19 pandemic. This seems to be the case for children from the general population (Barendse et al, 2022; Bignardi et al, 2021; de France et al, 2022; Fischer et al, 2022; Luijten, van Muilekom, et al, 2021; van der Velden et al, 2022) as well as for children with pre-existing mental health problems (Breaux et al, 2021; Fischer et al, 2022). On the contrary, some other studies challenge the mental burden of the COVID-19 pandemic in children and report small or no significant differences in mental health problems (Bouter et al, 2022; Burdzovic Andreas & Brunborg, 2021).…”

Perceived stress, coping strategies, and mental health status among adolescents during the COVID-19 pandemic in Switzerland: a longitudinal study

“…To date, researchers have largely focused on the immediate consequences of the first lockdown on mental health outcomes and/or the few following months. Studies addressing the pandemic's long-term effects on mental health among adolescents at later stages of the pandemic are scarce [21][22][23]. Additionally, to our knowledge, no studies investigated the impact of associated factors (e.g., COVID-related stressors, and coping strategies that might help to reduce or prevent the development of mental health symptoms) at later stages in Switzerland.…”