The infected and the affected: A longitudinal study of the impact of the COVID-19 pandemic on schoolchildren in Florida

Abstract

ObjectivesTo identify risk factors associated with symptoms of anxiety, depression, and obsessive-compulsive disorder (OCD) among children during the 1st year of the COVID-19 pandemic.MethodsA longitudinal study with three cross-sectional timepoints [April 2020 (n = 273), October 2020 (n = 180), and April 2021 (n = 116)] was conducted at a K-12 public school in Florida. Infection and sero-positivity for SARS-CoV-2 was determined by molecular and serologic approaches. Adjusted odds ratios using mixed effect logistic regression models for symptom-derived indicators of anxiety, depression, and OCD in children in April 2021 are presented; past infection and seropositivity were included in the models.ResultsThe prevalence of anxiety, depression, or OCD moved from 47.1, to 57.2, to 42.2% across the three timepoints during the study. By endline of the study, in April 2021, non-white children were at higher risk for depression and OCD. Risk for anxiety, depression, and OCD was associated with students who lost a family member due to COVID-19 and who were identified as at-risk in previous timepoints. Rates of SARS-CoV-2 infection and seropositivity were low and not statistically associated with assessed outcomes.ConclusionsIn situations like the COVID-19 pandemic, targeted mental health interventions and screenings are needed in children and adolescents, especially among minority children.

The Parallel Pandemic: A Systematic Review on the Effects of the COVID-19 Pandemic on OCD among Children and Adolescents

“…Despite being the least cited factors in this theme, with only one mention each, the roles of race, education, and personal beliefs and attitudes cannot be understated. Racial background significantly increased the risk of OCD among non-White participants compared to their white counterparts [49]. The prevalence of White students, Black students, Hispanic students, and Multiracial/Other participants were 22.8%, 50.0%, 42.9%, and 100%, respectively.…”

“…Diagnosis of relatives and family members with COVID-19 was also a highly cited (4) factor shaping OCD outcomes among children and adolescents. All the studies unequivocally reported a significant association between participants' adverse OCD outcomes and diagnoses of relatives and family members [4,34,36,49]. OCD was associated with participants who lost a family member due to COVID-19 [50].…”

“…Study [31] also limited their study to young people aged 13 to 19. In studies [30,47] researchers also worked with pediatric samples up to 18 years old; Similarly, studies [48,49] also researched pandemicinduced OCD trends among K-12 students at a developmental research school, which made it highly likely that 18-year-olds were included in the study.…”

“…As shown in Table S1, the relationships between the COVID-19 pandemic and OCD among children and adolescents were mixed. That notwithstanding, an overwhelming majority of the included studies (n = 17; 77%) reported that the COVID-19 pandemic had an adverse impact on OCD among children and adolescents [4,5,7,[32][33][34]36,[38][39][40][41][42]45,46,[48][49][50]. A few studies (n = 3, 17%) found mixed relationships [31,37,47], and two (n = 2, 9%) found no influence of the pandemic on OCD among children and adolescents [30,51].…”

“…Overall, children and adolescents who were diagnosed with other conditions, including prior COVID-19 infection [42], pre-COVID psychiatric diagnosis of OCD [32,38,39], presentation of aggressive and sexual symptoms [34], and pre-COVID psychiatric diagnosis of comorbid mental health and autism spectrum disorder/developmental delay [5,37,42,50] experienced higher rates of obsessions and worsening of OCD symptoms during the pandemic. In study [49], a three-point longitudinal study, participants that were previously identified as at risk for OCD in any of the earlier two time points were associated with risk of OCD in the third time point during the pandemic. Study [41], however, found that COVID-19 had a negative impact on OCD symptoms with or without comorbidities.…”