The Impact of the COVID-19 Pandemic and Societal Infection Control Measures on Children and Adolescents' Mental Health: A Scoping Review

Abstract

Background: The COVID-19 pandemic is primarily a crisis that affects people's physical health. However, it is well-known from previous epidemics and pandemics that there are other indirect negative impacts on mental health, among others. The purpose of this scoping review was to explore and summarise primary empirical research evidence on how the COVID-19 pandemic and societal infection control measures have impacted children and adolescents' mental health.Methods: A literature search was conducted in five scientific databases: PubMed, APA PsycINFO, Web of Science, CINHAL, and Social Science Premium Collection. The search string was designed using the Population (0–18 years), Exposure (COVID-19), Outcomes (mental health) framework. Mental health was defined broadly, covering mental well-being to mental disorders and psychiatric conditions.Results: Fifty-nine studies were included in the scoping review. Of these, 44 were cross-sectional and 15 were longitudinal studies. Most studies reported negative impact of the COVID-19 pandemic on child and adolescent mental health outcomes, yet the evidence was mixed. This was also the case for studies investigating societal control measures. Strong resilience, positive emotion regulation, physical activity, parental self-efficacy, family functioning and emotional regulation, and social support were reported as protective factors. On the contrary, emotional reactivity and experiential avoidance, exposure to excessive information, COVID-19 school concerns, presence of COVID-19 cases in the community, parental mental health problems, and high internet, social media and video game use were all identified as potentially harmful factors.Conclusions: Due to the methodological heterogeneity of the studies and geographical variation, it is challenging to draw definitive conclusions about the real impact of the COVID-19 pandemic on the mental health of children and adolescents. However, the existing body of research gives some insight to how parents, clinicians and policy makers can take action to mitigate the effects of COVID-19 and control measures. Interventions to promote physical activity and reduce screen time among children and adolescents are recommended, as well as parenting support programs.

Global burden of mental health problems among children and adolescents during COVID-19 pandemic: A systematic umbrella review

“…Physical activity and regular exercise were associated with improved mental health across multiple reviews [41,44,47,48,50,51]. Staying home for increased duration and lack of daily routine affected mental health in many children and adolescents, as reported by Panchal et al…”

“…A total of 24 citations met our preliminary criteria and were retained for full-text review. After full-text evaluation, 17 systematic reviews [29,34,[48][49][50][51][52][53][54][40][41][42][43][44][45][46][47], including 6 meta-analytic reviews [34,42,43,46,49,51] met all criteria of this umbrella review and were selected for further analysis (see Table 2).…”

“…The methodological quality of the reviews was assessed using the JBI critical appraisal checklist (See Supplementary Material). Most of the reviews (n = 13) included in this umbrella review were of high quality [29,34,51,53,54,[40][41][42][43][44][48][49][50], whereas the remaining (n = 4) reviews had medium quality [45][46][47]52]. None of the reviews were identified to have low methodological quality as per the JBI checklist.…”

“…Thirteen reviews reported a varying burden of anxiety among children and adolescents during this pandemic [29,34,51,53,54,40,43,44,[46][47][48][49][50]. The prevalence of anxiety ranged from 1.85% to 74% across primary studies included in the reviews.…”

The relationship between behavioral problems and screen time in children during COVID-19 school closures in Japan

“…Although gaming alone and gaming in groups were not associated with depressive symptoms in adolescents ( 31 ), it might be better for children to watch TV with other people rather than watch it alone ( 32 ). As children were prohibited from contacting non-family members amidst the COVID-19 school closure, it might be possible that screen time exerted more profound effects then in comparison to during the annual school closure ( 33 ). Research suggests that educational efficacy in remote learning systems is higher with interactive communication than one way communication ( 34 ).…”