Psychological Symptom Progression in School-Aged Children After COVID-19 Home Confinement: A Longitudinal Study

Abstract

BackgroundThe long-term mental health effects of coronavirus disease 2019 (COVID-19) in children are rarely reported. We aimed to investigate the progression of depressive and anxiety symptoms among a cohort of children in the initial epicenter of COVID-19 in China.MethodsTwo waves of surveys were conducted in the same two primary schools in Wuhan and Huangshi, Hubei province: Wave 1 from 28 February to 5 March, 2020 (children had been confined to home for 30–40 days) and Wave 2 from 27 November to 9 December, 2020 (schools had reopened for nearly 3 months). Depressive and anxiety symptoms were estimated using the Children's Depression Inventory – Short Form (CDI-S) and the Screen for Child Anxiety Related Emotional Disorders (SCARED), respectively. ΔCDI-S and ΔSCARED scores between Wave 2 and Wave 1 were calculated and further categorized into tertiles. Multivariable linear regression and multinomial logistic regression models were then applied.ResultsA total of 1,224 children completed both surveys. The prevalence of mental health outcomes at Wave 2 increased significantly compared to Wave 1, specifically depressive symptoms (age-standardized prevalence rates: 37.5 vs. 21.8%) and anxiety symptoms (age-standardized prevalence rates: 24.0 vs. 19.6%). Higher ΔSCARED scores were observed in females and children in Wuhan, and children with experience of neglect had higher ΔCDI-S (β = 1.12; 95% CI = 0.67–1.58) and ΔSCARED (β = 6.46; 95% CI = 4.73–8.19) scores compared with those without experience of neglect. When the Δ scores were further categorized into tertiles, similar results were found.ConclusionsThe prevalence of depressive and anxiety symptoms after schools resumed was increased compared with that during the home quarantine period, even though the COVID-19 pandemic was under control. Females and children in Wuhan, and also children with experience of neglect were at increased risk of mental health disorders.

Prevalence of mental health symptoms in children and adolescents during the COVID‐19 pandemic: A meta‐analysis

“…After deduplication, we assessed 24,926 abstracts for eligibility (see Figure 1). After the screening process, 191 studies were included in the systematic review 50,51,56–244 with a total...…”

Mental health and quality of life in children and adolescents during the COVID-19 pandemic: a systematic review of longitudinal studies

“…Considering the trajectories of depressive symptoms during the pandemic, the study results are mixed. Most studies ( n = 7) found that depressive symptoms increased (or remained elevated compared to pre-pandemic levels) during the pandemic in the studied populations ( 36–39 , 47 , 51 , 55 ). In a smaller study in Italy on children aged 5–6 years, Cimino et al ( 38 ) surprisingly only found an increase in the group of children with mothers not at risk of psychological problems, while there was no change in depressive symptoms in the at-risk group.…”

“…Nine of the 12 studies that investigated depressive symptoms also measured anxiety symptoms ( 5 , 36 , 39 , 47–49 , 51 , 55 , 56 ). One additional longitudinal study addressed anxiety but not depression in children and adolescents aged 8–18 years in Germany ( 42 ).…”

Mental health status among non-medical college students returning to school during the COVID-19 pandemic in Zhanjiang city: A cross-sectional study

“…A national mental health study conducted in February and April 2020 among Chinese adolescents showed that the prevalence of depression and anxiety increased over time evidently ( Chen et al, 2021 ). The prevalence of depressive and anxiety symptoms among back-to-school children was elevated in comparison to that during the home quarantine period ( Xie et al, 2022 ). The prevalence of insomnia, anxiety and depression among high school students after reopening schools during the COVID-19 was 42.7 to 63.4% ( Puteikis et al, 2022 ).…”