Prevalence of elevated anxiety symptoms among children in quarantine with COVID-19 infection in the State of Qatar: A cross-sectional study

Abstract

Background: Children are particularly vulnerable to the psychological effects of the COVID-19 pandemic. The disruption in daily life has impacted children significantly. Moreover, the increased worrying associated with the probability of getting infected or becoming seriously unwell due to infection can potentially precipitate anxiety disorders among children. Objective: This study aimed to determine rates of elevated anxiety symptoms in children with COVID-19 infection. It also explored whether there were any differences in terms of age, gender, and residency status. Method: A cross-sectional, questionnaire-based study with 88 participants (children aged 7-13 years, 54.5% males, 45.5% females) from two institutional quarantine centers. The Spence Children’s Anxiety Scale and its validated Arabic version (self-reported questionnaires) were used to measure anxiety symptoms. Results: 36.3% children reported elevated anxiety symptoms. A lower rate of 32.8% was reported in younger children (7-11 years) compared to 45.8% in older children (12 and 13 years). 70.4% and 57.9% children reported physical injury fears and separation anxiety respectively. A higher prevalence of overall anxiety was reported in children from expatriate families (40.6%) compared to native children (25%). The difference in the mean scores between the expatriate and native group of children was found statistically significant for obsessive-compulsive symptoms. Conclusions: The prevalence of elevated anxiety symptoms among children in quarantine with COVID-19 infection can be much higher than that reported in the general population. Older children can have elevated anxiety symptoms more commonly than their younger counterparts can. Expatriate children are likely to be more vulnerable to the psychological impact of the pandemic compared to children from local families. Our results suggest the crucial need of focusing on the psychological impact of COVID-19 pandemic on children. The prioritization and effective management of the mental health needs of children should be a vital component of the overall, global response to the pandemic.

Neuropsychiatric Manifestations of COVID-19 in Hospitalized Pediatrics: A Multicenter Cross-sectional Study

“…In the present study, psychiatric manifestations were reported in 58 patients (15.5%), and the most common psychiatric disorders were SAD, MDD, GAD, insomnia, and ODD. In a crosssectional study on two institutional quarantine centers in Qatar, Khan et al reported anxiety symptoms in 36.03% of children with COVID-19 infection, of whom about 70% and 58% had physical injury fears and SAD, respectively (28). Although our findings are related to admitted COVID-19 patients, SAD was the most common in both studies.…”

COVID-19 and mental health disorders in children and adolescents (Review)

“…Research has concluded that children require the closeness of other people to feel safe, especially during stressful events, and children who are separated from their parents experience increased anxiety, which negatively affects their quality of life ( Kılınçel et al 2021 ). A cross-sectional study in Qatar found that in 149 COVID-19-infected children, the rate of separation anxiety (57.9%) was significantly higher than the normal prevalence ( Khan et al 2021 ; Shear et al 2006 ). In contrast, staying with parents during a health crisis gives children confidence and reduces their anxiety ( Knutsson et al 2008 ), as the presence of the parents may assist the children with adapting to their environment ( Khan et al 2021 ).…”

“…A cross-sectional study in Qatar found that in 149 COVID-19-infected children, the rate of separation anxiety (57.9%) was significantly higher than the normal prevalence ( Khan et al 2021 ; Shear et al 2006 ). In contrast, staying with parents during a health crisis gives children confidence and reduces their anxiety ( Knutsson et al 2008 ), as the presence of the parents may assist the children with adapting to their environment ( Khan et al 2021 ). During the current outbreak, children separated from their parents infected with COVID-19 experienced greater levels of anxiety and negative thoughts, possibly related to the fear of parental departure ( Kılınçel et al 2021 ).…”

“…Some studies have suggested that higher rates of anxiety are present in older children (aged 12 to 13 years), as children of this age can better conceptualize the COVID-19 situation, and they appear to be more worried and fearful about the disease ( Khan et al 2021 ; Smirni, Lavanco, and Smirni 2020 ). In contrast, other studies have not observed that children's age affects the severity of psychological problems ( Liu, Liu, and Liu 2020 ; Jiao et al 2020 ).…”

Home quarantines and cumulative risk exposure among young children: Isolation and maladaptation.

“…When combined with low socioeconomic status, social isolation is considered a greater risk for a child’s development than poverty and social isolation taken separately (Fortin & Bigras, 1997). Studies on the mental health consequences for children isolated due to COVID-19 revealed symptoms of acute stress, depression, generalized anxiety, and adjustment disorder (Khan et al, 2021; Liu et al, 2020; Patrick et al, 2020; Racine et al, 2021; Ravens-Sieberer et al, 2023). Parents had reported a worsening trend in their children’s mental health since the beginning of the outbreak, as children exhibited a range of disordered behavioral and emotional expressions such as clinging, irritability, focus reduction, sleeping difficulties, and appetite changes during isolations or lockdowns (Aljunaidy & Adi, 2021; Giannotti et al, 2022; Jiao et al, 2020; Orgilés et al, 2020).…”