COVID-19 pandemic impact on children and adolescents' mental health: Biological, environmental, and social factors

The Impact of Parental Stress on Italian Adolescents' Internalizing Symptoms during the COVID-19 Pandemic: A Longitudinal Study

The challenges and consequences of COVID-19 imposed massive changes in adolescents' daily routines (e.g., school closures, home confinement, and social distancing rules), which impacted their mental health. This longitudinal study aimed to better understand the changes in adolescents' internalizing symptoms and the underlying mechanisms of parental stress due to COVID-19. We asked 1053 parents of adolescents to complete an online survey during the second and fifth weeks and at the end of home confinement (i.e., four weeks later). Results showed that parents reported their adolescents' anxiety and depression symptoms were more severe at Time 2 than at the first administration. Anxiety symptoms slightly decreased at Time 3, while there was no significant change in depression symptoms. Moreover, parents' expressive suppression mediated the association between parental stress and adolescents' anxiety and depression symptoms, respectively. The findings suggest that as restriction increased, adolescents' anxiety and depression became more severe. Moreover, due to the link between parental stress and adolescents' internalizing disorders helping families to cope with the distress due to the pandemic may have a positive impact on parents, the child, and the family as a whole (i.e., the family climate).

["Now You're Talking!"]

Die Umfrage „Jetzt Sprichst Du!“ veranschaulicht eindrücklich die psychosozialen Belastungen und die Beeinträchtigung von Kindern und Jugendlichen in Österreich während der aktuellen Coronapandemie. Im Rahmen einer Online-Umfrage wurden 5483 Kinder und Jugendliche im Alter von 6 bis 18 Jahren bezüglich ihrer Gefühle, Ängste, Sorgen und Einschätzungen im Zusammenhang mit der Coronapandemie befragt. Es zeigt sich, dass die Kinder und Jugendlichen durch die Situation geängstigt sind und Mädchen hierbei über alle Altersgruppen hinweg stärker belastet sind. In diesem Zusammenhang wird auch deutlich, dass das Risiko einer COVID-19-assoziierten Hospitalisierung ähnlich wie bei Erwachsenen von den Kindern wie Jugendlichen massiv überschätzt wird. Auch macht sich in allen Altersgruppen eine hohe Perspektivenlosigkeit aufgrund der anhaltend herausfordernden Situation bemerkbar. Ferner häufen sich Gefühle von Wut, Ärger, Einsamkeit und Traurigkeit und es zeigt sich eine alarmierende Verschlechterung der Schlafqualität und eine Zunahme der Schlafproblematiken. Die Daten der Umfrage „Jetzt Sprichst Du!“ betonen die Notwendigkeit eines unabdingbaren und raschen Handelns, um sowohl die psychosozialen, entwicklungspsychologischen als auch gesundheitlichen Kollateralschäden in dieser jungen Altersgruppe einzudämmen, soweit dies heute noch möglich ist.

Adolescents' Empowerment for Mental Health Literacy in School: A Pilot Study on ProLiSMental Psychoeducational Intervention

Adolescence is a critical life phase for mental health and anxiety an emerging challenge for adolescents. Psychoeducational interventions to promote mental health literacy (MHL) on anxiety in adolescents are needed. This study aimed to test the primary outcome of a future full-scale trial: improvement of adolescents' anxiety MHL components on recognition, prevention strategies, and self-help strategies. A sample of 38 adolescents, 24 (63.2%) females and 14 (36.8%) males, with an average age of 14.50 years (SD = 0.89) participated in this study. Each class was allocated to the intervention group (IG, n = 21) or the waiting list control group (WLCG, n = 17) with single-blinded randomization. MHL was assessed using the QuALiSMental. The ProLiSMental psychoeducational intervention consists of four or eight weekly sessions of 90 or 45 min for adolescents, using different active pedagogical methods and techniques. There also are initial and final sessions with adolescents, legal guardians, and teachers. There was a significant improvement with a small to relatively strong effect size in many dimensions of anxiety MHL components. This study suggests the progression to the full-scale trial and values the important role of mental health and psychiatric nurses in the adolescents' empowerment for MHL in schools.

Impact of COVID-19 Pandemic on Sleep Quality, Stress Level and Health-Related Quality of Life-A Large Prospective Cohort Study on Adult Danes

The everyday lives of Danish inhabitants have been affected by the COVID-19 pandemic, e.g., by social distancing, which was employed by the government in March 2020 to prevent the spread of SARS-CoV-2. Moreover, the pandemic has entailed economic consequences for many people. This study aims to assess changes in physical and mental health-related quality of life (MCS, PCS), in stress levels, and quality of sleep during the COVID-19 pandemic and to identify factors that impact such changes, using a prospective national cohort study including 26,453 participants from the Danish Blood Donor Study who answered a health questionnaire before the pandemic and during the pandemic. Descriptive statistics, multivariable linear and multinomial logistic regression analyses were applied. A worsening of MCS and quality of sleep was found, and an overall decrease in stress levels was observed. PCS was decreased in men and slightly increased in women. The extent of health changes was mainly affected by changes in job situation, type of job, previous use of anti-depressive medication and the participants’ level of personal stamina. Thus, living under the unusual circumstances that persisted during the COVID-19 pandemic has had a negative impact on the health of the general population. This may, in time, constitute a public health problem.

Children and Adolescent Mental Health in a Time of COVID-19: A Forgotten Priority

Globally, 10–20% of children and adolescents experience mental health conditions, but most of them do not receive the appropriate care when it is needed. The COVID-19 deaths and prevention measures, such as the lockdowns, economic downturns, and school closures, have affected many communities physically, mentally, and economically and significantly impacted the already-neglected children and adolescents’ mental health. As a result, evidence has shown that many children and adolescents are experiencing psychological effects such as depression and anxiety without adequate support. The consequences of not addressing the mental health conditions in children and adolescents extend through adulthood and restrict them from reaching their full potential. The effects of COVID-19 on children and adolescents’ mental health highlight the urgent need for multisectoral home-grown solutions to provide early diagnosis and treatment and educate caregivers on home-based interventions and community outreach initiatives to address children and adolescents’ mental health challenges during this pandemic and beyond.

Beyond a traumatic loss: The experiences of mourning alone after parental death during COVID-19 pandemic

Millions of adolescents around the world lost their loved ones due to the COVID-19 pandemic; at the same time, health protocols in many countries do not allow mourners to practice their familiar rituals around death and dying. This study explored the experience of 15 Iranian adolescents who had lost their parent(s) during the pandemic through a phenomenological approach. Two main themes including distress in a shattered life and crisis in crisis were extracted from the interviews. Findings highlight the importance of immediate and alternative ways of support for adolescents who lost their parents during the pandemic.

Analysis of the psychometric properties of the five-factor self-concept questionnaire (AF-5) in Spanish students during the COVID-19 lockdown

The present research aims to analyse the psychometric properties of the AF5 questionnaire for its adaptation for use with young people during a lockdown period. Research was conducted with a sample of 534 students aged between 13 and 17 years (M = 14.49; SD = 1.805). Exploratory factor analysis was conducted using the FACTOR program and confirmatory factor analysis was conducted using the M-PLUS 7 program. Results indicate that a four-dimensional model is most appropriate for bringing together the emotional and physical dimensions. Further, 11 items were removed due to poor factor loadings. The majority of factors were directly and positively correlated (99%; p < .01). The data obtained supports conclusions that the AF-5 meets validity and reliability requirements for it to be considered a useful instrument for use with young people during the COVID-19 lockdown period.

Hubei's Core Response Policies in the Early Stage of COVID-19

BACKGROUND

This study is aimed at confirming the effectiveness of nonpharmaceutical interventions during the COVID-19 outbreak in Hubei, China.

METHODS

The data are all from the epidemic information released by the National Health Commission of the People's Republic of China and the Health Commission of Hubei Province. We used the multivariable linear regression by the SPSS 19.0 software: the cumulative number of confirmed cases, the cumulative number of cured cases, and the number of daily severe cases were taken as dependent variables, and the six policies, including the Joint Prevention and Control Mechanism of the State Council, lockdown Wuhan city, the first-level response to public health emergencies, the expansion of medical insurance coverage to suspected patients, mobile cabin hospitals, and counterpart assistance in Hubei province, were gradually entered into multiple linear regression models as independent variables.

RESULTS

The factors influencing the cumulative number of diagnosed cases ranged from large to small: mobile cabin hospitals and the expansion of medical insurance coverage to suspected patients. The factors influencing the cumulative number of cured cases ranged from large to small: counterpart support medical teams in Hubei province and mobile cabin hospitals. The factors influencing the number of daily severe cases ranged from large to small: mobile cabin hospitals and the expansion of medical insurance coverage to suspected patients.

CONCLUSION

The mobile cabin hospital is a major reason for the successfully defeating COVID-19 in China. As COVID-19 pandemic spreads globally, the mobile cabin hospital is a successful experience in formulating policies to defeat COVID-19 for other countries in the outbreak phase.

Adapting and validating the coronavirus-19 phobia scale (C19P-S) in Korea

The COVID-19 Phobia Scale (C19P-S) was developed as a screening tool for coronaphobia related to the current COVID-19 pandemic but to date has not been adapted to and validated in Asia. The current study aimed to adapt and validate the C19P-S with a sample of 321 Korean individuals. Analyses showed that the Korean C19P-S (C19P-SK) has excellent reliability (α = .95) and confirmed its structural validity, and convergent and discriminant validity. Therefore, we conclude that the C19P-SK can be used to assess COVID-19 phobia in this population.

Evaluating quality in adolescent mental health services: a systematic review

OBJECTIVES

To evaluate the quality of adolescent mental health service provision globally, according to the WHO Global Standards of adolescent mental health literacy, appropriate package of services and provider competencies.

DESIGN AND DATA SOURCES

Systematic review of 5 databases, and screening of eligible articles, from 1 January 2008 to 31 December 2020.

STUDY ELIGIBILITY CRITERIA

We focused on quantitative and mixed-method studies that evaluated adolescent mental health literacy, appropriate package of services and provider competencies in mental health services, and that targeted depression, anxiety and post-traumatic stress disorder among adolescents (10-19 years). This included adolescents exposed to interventions or strategies within mental health services.

STUDY APPRAISAL AND SYNTHESIS METHODS

Study quality was assessed using the National Institutes for Health Study Quality Assessment Tools. Data were extracted and grouped based on WHO quality Standards.

RESULTS

Of the 20 104 studies identified, 20 articles were included. The majority of studies came from high-income countries, with one from a low-income country. Most of the studies did not conceptualise quality. Results found that an online decision aid was evaluated to increase adolescent mental health literacy. Studies that targeted an appropriate package of services evaluated the quality of engagement between the therapist and adolescent, patient-centred communication, mental health service use, linkages to mental health services, health facility culture and intensive community treatment. Provider competencies focused on studies that evaluated confidence in managing and referring adolescents, collaboration between health facility levels, evidence-based practices and technology use.

CONCLUSIONS AND IMPLICATIONS

There is limited evidence on quality measures in adolescent mental health services (as conforms to the WHO Global Standards), pointing to a global evidence gap for adolescent mental health services. There are several challenges to overcome, including a need to develop consensus on quality and methods to measure quality in mental health settings.

PROSPERO REGISTRATION NUMBER

CRD42020161318.

MicroRNA regulation of prefrontal cortex development and psychiatric risk in adolescence

In this review, we examine the role of microRNAs in the development of the prefrontal cortex (PFC) in adolescence and in individual differences in vulnerability to mental illness. We describe results from clinical and preclinical research indicating that adolescence coincides with drastic changes in local microRNA expression, including microRNAs that control gene networks involved in PFC and cognitive refinement. We highlight that altered levels of microRNAs in the PFC are associated with psychopathologies of adolescent onset, notably depression and schizophrenia. We show that microRNAs can be measured non-invasively in peripheral samples and could serve as longitudinal physiological readouts of brain expression and psychiatric risk in youth.

Influence of the characteristics of the house and place of residence in the daily educational activities of children during the period of COVID-19' confinement

The period of confinement motivated by the COVID-19 pandemic and established by the governments of different countries has influenced the lifestyle of millions of children, not being able to continue carrying out multiple educational activities as they did until confinement. The objective of this research was to determine and analyze whether the living conditions of children during the period of confinement caused by COVID-19 influenced their daily educational activities. A descriptive, comparative and cross-sectional quantitative study with a non-experimental design was carried out, with a single measurement in a single group. Factors associate with living conditions were analyzed, such as the place of residence and the type of house in which Spanish children have been confined, as well as the number and use of technological devices. The parents' perception of the children's state of fatigue, happiness, energy and tiredness was also analyzed. We have worked with a sample of 837 Spanish children. As a data collection instrument, the validated questionnaire on Equipment and Use of Information and Communication Technologies in Households (TIC-H2019) of the National Statistics Institute (INE) was used, following the recommendations of the Statistical Office of the European Union (EUROSTAT). The results confirm some statistically significant influence of the conditions of the house and place of residence on the daily time dedicated to different educational activities such as reading, physical activity, free play or use of technological devices between children residing in small flats and those residing in large flats or houses with garden and those residing in urban and rural settings.

Level up for culture models - How 3D cell culture models benefit SARS-CoV-2 research

Welcome to a new decade and a new issue of the Biomedical Journal - casting a sorrowful look onto a year that will go down in history as a tombstone etched by the COVID-19 pandemic, but also a hopeful glance into the future, now that multiple vaccination programs against the SARS-CoV-2 virus have started. This issue is dedicated to the continuous effort by researchers all around the globe to understand and counter the pathogen, as well as to be better prepared for future threats. Therefore, we learn about the advantages of complex 3D cell culture models for studying host-virus interactions, and the disease course of COVID-19 in children. Moreover, we discover how neutralising monoclonal antibodies and peptide-based vaccines against SARS-CoV-2 are developed, and the therapeutic potentials of lopinavir/ritonavir, mesenchymal stem cells, as well as plant and algae extracts. Finally, we ponder over the lessons to be learnt from SARS-CoV and MERS, and hear about differences between nucleotide-based SARS-CoV-2 detection methods.

Quality of life and occupational performance of children with cancer in the era of the COVID-19 pandemic in terms of rehabilitation

PURPOSE

This study was designed to determine the changes in the quality of life (QOL) and occupational performance of children with cancer and to examine their rehabilitation needs during the pandemic period in Turkey.

METHODS

60 children with cancer and their families participated in the study. The first and second assessments were carried out in April and September 2020, respectively. The pediatric quality of life inventory parent proxy-report was used to evaluate the QOL, and the Canadian occupational performance measurement was used to evaluate children's occupational performance and satisfaction. A qualitative interview was planned to determine the impact of the pandemic on children with cancer alongside their families and therefore determining the rehabilitation needs of the children.

RESULTS

While there is no statistically significant change in the pain-related conditions of the children in the first six months of the pandemic (p > 0.05), procedural and treatment anxieties of the children increased during the treatment. Their QOL including cognitive state, perceived physical appearance and communication skills also showed a statistically significant decrease (p < 0.05). Both the occupational performance and satisfaction scores decreased significantly, covering the pre-pandemic and pandemic era (p < 0.01). In the qualitative interview parents expressed their children's need for physical, psychological and social participation support. Also, they emphasized the need for time management.

CONCLUSIONS

During the COVID-19 pandemic, the QOL and occupational performance level of children with cancer decreased significantly. Holistic rehabilitation approaches complying with pandemic conditions are likely to benefit these children.

How to Improve Physical Activities among Student in the Pandemic COVID-19 era?

Physical activity is one form of healthy behavior, an individual’s efforts to maintain or improve health conditions. There are broad spectrum of benefit such as physical, mental and social if we do regular physical activity. Although there are many benefits, based on RISKESDAS 2018, it is stated that 33.5% of Indonesians lack in physical activity with the most categories at the age of 10-14 and 15-19 years. Physical activity associated with salutogenic concept which described by the Sense of Coherence value. This study aims to find how to improve physical activity of undergraduate students Faculty of Medicine, Public Health and Nursing, University of Gadjah Mada during pandemic. Methods of this study used quantitative approach with cross-sectional design which held online by share google form link to respondents in April-May 2021 during COVID-19 pandemic and involved 360 respondents who were selected by proportion sampling. Instrument used in the study were SOC-13 questionnaire, International Physical Activity Questionnaire short self-administered and Social Environment questionnaire. Statistical test using logistic regression with STATA 14. Result of this study shows that Social Environment and components in Sense Of Coherence affect how a person’s motivation in carrying out activities that beneficial to health such as doing regular physical activity. The results are statistically significant (p-value 0.0000 <0.05). Conclusion of this study, to increase physical activity for undergraduate students during the COVID-19 pandemic, a good social environment and sense of coherence are needed.

Brief Research Report: The Association Between Educational Experiences and Covid-19 Pandemic-Related Variables, and Mental Health Among Children and Adolescents

Introduction: Mental health problems among children and adolescents are frequent. Today, the world is facing a pandemic with a novel coronavirus, which is related to the higher rates of mental problems reported worldwide. The objective of this study was to determine the impact of the Covid-19 related experiences, educational experiences, and family functioning on mental health and wellbeing among children and adolescents in Chile during the Pandemic and lockdown health measures. Methods: This is a cross-sectional analysis of the first wave of an ongoing longitudinal study among girls and boys of Pre-Kindergarten to 12th grade (4-18 years old) in Santiago, Chile. The sample consisted of 979 students from eight different schools. The method of data collection was online surveys administered to parents and adolescents. The dependent variables were mental health problems and wellbeing. Several independent variables were assessed (sociodemographic variables, Covid-19 related experiences, related educational experiences, and family functioning). A descriptive analysis and univariable and multivariable regression models were performed to study the association between variables. Results: Positive educational experiences, primarily academic self-concept, reduced the probability of mental health problems and increased wellbeing. Among covid-19 related variables, practicing meditation or praying reduced emotional problems, while having family or health problems increased emotional problems among adolescents. No clear association between Covid-19 related experiences variables among children was found. Conclusions: Our findings may help educational and public health authorities to plan future school preventive interventions to improve mental health and wellbeing in this population.