Emotional and Behavioral Impact of the COVID-19 Epidemic in Adolescents

Prevalence rate of perceived gender discrimination and its associations with suicide behaviors in Chinese adolescents: the mediating roles of depressive symptoms and anxiety symptoms

This cross-sectional study aimed to investigate the prevalence rate of perceived gender discrimination and its associations with suicidal ideation and suicide attempts, as well as the mediating roles of depressive symptoms and anxiety symptoms in Chinese adolescents. From October 2021 to March 2022, we adopted a multi-stage stratified cluster random sampling method to recruit students from grades 7-12 in China. A total of 79,211 adolescents aged 10-19 years from eight provinces completed the survey with valid data for the current study. Data were weighted to adjust for unequal probabilities of selection and differential response as well as to post-stratify the sample to match the population distribution. The weighted prevalence rate of perceived gender discrimination was 3.5% in Chinese adolescents, with girls having a higher prevalence rate than boys (5.5% vs.1.7%; P-value < 0.001). In the full-adjusted model, perceived gender discrimination was associated with a higher likelihood of suicidal ideation (OR, 2.16; 95% CI, 1.93-2.42) and suicide attempts (OR, 1.62; 95% CI, 1.39-1.88). Mediation analyses showed that depressive symptoms and anxiety symptoms significantly mediated 39.5% and 5.7% of the association between perceived gender discrimination and suicidal ideation, respectively, and depressive symptoms and anxiety symptoms significantly mediated 54.3% and 7.0% of the association between perceived gender discrimination and suicide attempts, respectively. These findings suggest the need for targeted interventions to reduce gender discrimination against adolescents, especially girls, which might help prevent their suicidal behaviors and mental health problems.

Psychiatric hospitalizations among adolescents during the pandemic in Italy: a retrospective study

OBJECTIVES

The COVID-19 pandemic has negatively impacted child and adolescent mental health. The study outcome was the evaluation of the pandemic impact on adolescents' hospitalizations in an acute psychiatric ward.

METHODS

With an observational and retrospective design, we collected selected variables among adolescents hospitalized in an acute psychiatric ward from 01/07/2017 to 30/06/2022. Data were statistically processed.

RESULTS

Our sample consisted of 118 minors with an average age of 15.7 ± 1.2 SD, mostly represented by females (61 %) and Italians (60.2 %), who made 204 hospitalizations in the study period. The admissions by years drastically decreased in 2020 concomitantly with the lockdown and increased in the first half of 2022. The admission rate was higher in winter and spring, except in 2020 when all admissions decreased (p=0.000). Females more frequently were hospitalized for suicidal behavior and acute anxiety (p=0.000) and were discharged with acute stress reactions, eating disorders, and mood disorder diagnoses (p=0.000). Differently, males more frequently were hospitalized for aggressive behavior (p=0.000) and discharged with ADHD diagnosis (p=0.000). At multiple linear regression, the duration of hospitalization (dependent variable) was negatively associated with "the pandemic period" (p=0.017) and "absent aggressive behavior" (p=0.003), and positively with "autism" diagnosis (p=0.000).

CONCLUSIONS

We highlighted the more stressful impact of COVID-19 pandemic on female adolescents, who required more frequently psychiatric hospitalizations due to suicidal behavior, anxiety and mood disorders.

Interventions to build resilience and to ameliorate negative psychosocial effects of the COVID-19 pandemic on children and adolescents: a systematic review and meta-analysis

The psychosocial health of children and adolescents has been particularly affected by the COVID-19 pandemic. Containment measures have restricted social development, education and recreational activities, may have increased family conflicts and, in many cases, led to feelings of loneliness, sleep disturbances, symptoms of anxiety and depression. We conducted a systematic review to identify interventions that seek to ameliorate these detrimental effects of the COVID-19 pandemic and to build resilience in children and adolescents. Literature searches were conducted in the databases MEDLINE, EMBASE, PsycINFO, CENTRAL, WHO COVID-19 Global literature on coronavirus disease and Cochrane COVID-19 Study Register (up to 30 June 2022). The searches retrieved 9557 records of which we included 13 randomized-controlled trials (RCTs) for evidence synthesis. Included studies predominantly implemented online group sessions for school-aged children with either a psychological component, a physical activity component, or a combination of both. A meta-analysis of seven studies on anxiety and five on depressive symptoms provided evidence for a positive effect of interventions by reducing anxiety (Standardized Mean Difference (SMD) (95% CI): - 0.33 (- 0.59; - 0.06)) and depressive symptoms (SMD (95% CI): - 0.26 (- 0.36; - 0.16)) compared to the control interventions. Studies also showed improvements in positive mental health outcomes, such as resilience (n = 2) and mental and psychological wellbeing (n = 2). Exploratory subgroup analyses suggested a greater effectiveness of interventions that (i) are of higher frequency and duration, (ii) enable personal interaction (face-to-face or virtually), and (iii) include a physical activity component. Almost all studies were judged to be at high risk of bias and showed considerable heterogeneity. Further research may focus on the contribution of different intervention components or distinct subgroups and settings, and should examine children and adolescents over longer follow-up periods.

Development will (try to) find its way: a qualitative study of Chilean adolescent mental health during and after lockdown

BACKGROUND

The COVID-19 pandemic has had a well-evidenced impact on adolescents, who are especially sensitive to pandemic disruptions given the critical role of socialization in their development. In Chile too, evidence shows increases in mental health complaints among adolescents over the lockdown period. Our study aimed at exploring the experiences of Chilean adolescents regarding their mental health during the lockdown and school closure (March 2020-December 2021), and during the return to on-site education (2022) as informed by adolescents and school staff, with a focus on family, school, and social sources of risk and support for adolescents' wellbeing during these periods.

METHODS

Using a qualitative approach, we conducted semi-structured interviews with 19 adolescents and 16 staff members from schools in an urban area of Chile.

RESULTS

Through thematic analysis, we generated five themes: [1] Adolescents in a mental health crisis, comprising a range of distressing experiences and mental health problems. This crisis was fueled by alterations in the functioning of adolescents' systems: [2] Broken support systems (peers and school); [3] The school agenda must go on, reflecting schools' strict compliance with the educational curriculum; and [4] Blurred boundaries between home and school life and within the family. Finally [5], Development will (try to) find its way describes how most participants experienced a bouncing back to wellbeing in the course of the school year upon return, and how some developmental milestones took place despite the abnormal conditions, providing evidence for resilience amid pandemic adversity.

CONCLUSIONS

The findings give insight into how the exchanges between the adolescent and the social systems they are embedded in were interfered. The results help us understand the challenges for mental health during and after the pandemic, and highlight adolescents' capacity to thrive as normality was restored. The results also underscore the importance of upholding stability across adolescents' systems and routines, in order to mitigate impacts on wellbeing amid abnormal circumstances. The findings are relevant for development-informed initiatives in policy design in the aftermath of the pandemic and in future crisis management responses.

Trends in Adolescent Health: Successes and Challenges From 2010 to the Present

PURPOSE

This review considers trends in some of the major adolescent health outcomes and contextual influences since 2010, and explores the relevance of recent cultural, societal, and public health developments on adolescent well-being.

METHODS

Based on a review of major reports published since 2010, we identified key topics of impact on adolescent health and development across several domains (education, economic opportunity, sexual and reproductive health, nutrition, and mental health) and ecological levels (from individual- to macro-level influences). Within these areas, we synthesized findings to describe recent trends, noting variation across countries/regions, gender/sex, and other social stratifications when possible.

RESULTS

Since 2010, progress in several areas of sexual and reproductive health has been most striking, with notable global declines in female genital mutilation/cutting, child marriage, HIV transmission, and adolescent childbearing. Participation and retention in school has increased, although the COVID-19 pandemic interrupted positive progress for many adolescents and contributed to social isolation and economic insecurity. The mental health and nutrition domains have clear challenges. Increased internalizing mental health issues have been observed cross-culturally, especially among girls. The prevalence of anemia has remained stagnant, while overweight and obesity rates are rising. Within domains, we highlight uneven progress across and within countries.

DISCUSSION

Based on recent successes and emerging challenges in adolescent well-being, we find that more and better research is needed that consistently takes an intersectional perspective, and critically, action must be taken to consolidate the gains in sexual and reproductive health and extend them to other areas of adolescent health.

Immunogenicity and Safety of SARS-CoV-2 Protein Subunit Recombinant Vaccine (IndoVac®) as a Heterologous Booster Dose against COVID-19 in Indonesian Adolescents

Adolescents are vulnerable to Coronavirus disease 2019 (COVID-19) infections; thus, their antibodies should be maintained above the protective value. This study aimed to evaluate the immune response and safety to the SARS-CoV-2 protein subunit recombinant vaccine (IndoVac®) as a heterologous booster dose against COVID-19 in Indonesian adolescents. This open-label prospective intervention study enrolled 150 clinically healthy adolescents aged 12-17 years who had received complete primary doses of the CoronaVac® vaccine from Garuda Primary Care Centres in Bandung City. The result of immunogenicity was presented with a 95% confidence interval (CI) and analyzed with t-tests from 14 days and 3, 6, and 12 months. The neutralizing antibody geometric mean titers (GMTs) (IU/mL) at baseline and 14 days after booster dose were 303.26 and 2661.2, respectively. The geometric mean fold rises (GMFR) at 3, 6, and 12 months after booster dose were 6.67 (5.217-8.536), 3.87 (3.068-4.886), and 2.87 (2.232-3.685), respectively. Both the neutralizing antibody and IgG antibody were markedly higher in the adolescents than in the adults at every timepoint. The incidence rate of adverse effects (AEs) until 28 days after booster dose was 82.7%, with a higher number of local events reported. Most reported solicited AEs were local pain followed by myalgia with mild intensity. Unsolicited AEs varied with each of the incidence rates < 10%, mostly with mild intensity. Adverse events of special interest (AESI) were not observed. At the 12-month follow-up after the booster dose, four serious adverse events (SAEs) not related to investigational products and research procedures were noted. This study showed that IndoVac® has a favorable immunogenicity and safety profile as a booster in adolescents and that the antibody titer decreases over time.

The effect of proximity to grocery stores and the pandemic on parents' and youths' perceptions of eating habits in predominately African American rural communities

Background

Rural communities have a disproportionately high level of childhood obesity along with high rates of food insecurity.

Objectives

To assess the eating habits of youth in predominantly African American rural communities and assess the association between proximity to a grocery store and eating habits as well as how the COVID-19 pandemic may have impacted eating habits.

Methods

203 youth and parents completed a 16-item survey. Analyses were performed to assess the effect of having a neighborhood grocery store as well as to compare responses between youth and parents.

Results

Having a neighborhood grocery store was associated with increased consumption of vegetables (F(1,122) = 41.56) and fruits (F(1,121) = 65.05), decreased consumption of chips (F(1,125) = 79.51) and a smaller percentage of overweight youth (χ2(1,125) = 5.03). Parents underestimated the effect of the COVID-19 pandemic on youth eating habits (χ2 (1,198) = 17.88).

Conclusion

Proximity to a grocery store significantly associated with eating habits and weight in the rural communities examined. Given the steady decrease in the number rural grocery stores over the past decade it is important to consider how to improve access to healthy foods in these communities.

Impact of the COVID-19 Pandemic on Youth Substance Use and Substance-Related Risk Factors and Outcomes: Implications for Prevention, Treatment, and Policy

Youth substance use and substance use disorders (SUD) are major public health issues associated with significant societal cost. The coronavirus SARS-CoV-2 (COVID-19) pandemic and pandemic-related lockdowns, school closures, and social distancing dramatically impacted the daily lives of young people worldwide, resulting in major disruptions to normal developmental trajectories and complex (and at times opposing effects) on different SUD risk and protective factors, which contributed to inconsistent outcomes. During the COVID-19 pandemic, substance use prevalence rates decreased in the general population of US youth, but increased for certain vulnerable subgroups. Additionally, overdose deaths related to fentanyl rose significantly among US youth.

Clinical Signs and Symptoms of Anxiety Due to Adverse Childhood Experiences: A Cross-Sectional Trial in Adolescents

BACKGROUND

Adverse Childhood Experiences (ACEs) are linked to the development of anxiety in adolescence. According to recent studies, the COVID-19 pandemic represents a novel ACE that is associated with anxiety among adolescents. This study investigates the relationship between ACEs, COVID-19, and anxiety in adolescents.

METHODS

A cross-sectional study was conducted using a community sample of 248 boys and girls ages 12 to 15 years (mean = 13.50 years) from five high schools in Eastern Attica. A total of four questionnaires were used: (1) Demographic Questionnaire, (2) State-Trait Anxiety Inventory for Children-STAIC, (3) Adverse Childhood Experiences Scale, and (4) COVID-19 Impact Scale.

RESULTS

The results demonstrated a moderate association between the total number of ACEs and anxiety (trait and state) in adolescence (trait anxiety: ρ = 0.37, p < 0.001; state anxiety: ρ = 0.29, p < 0.001). Girls scored significantly higher than boys on both trait anxiety (U = 4353, p < 0.001; mean difference = 5.5) and state anxiety (U = 5822.5, p = 0.014; mean difference = 2). The number of ACEs was found to be significantly related to the impact of COVID-19 (β = 0.025, p < 0.001).

CONCLUSIONS

This study highlights the significant link between ACEs and increased anxiety in adolescents, which is further exacerbated by the COVID-19 pandemic. The findings indicate that girls are more affected than boys. These results emphasize the need for targeted mental health interventions to enhance coping mechanisms, reduce stress, and address anxiety in adolescents, particularly during global crises like the pandemic. Developing such programs is essential for supporting the mental well-being of youth facing multiple stressors.

Post-COVID-19 internet addiction, depression, and pornography addiction among adolescents: Findings from a nationwide study in Bangladesh

Background and Aims

Regulations response to COVID-19 has increased internet addiction (IA), depression, and pornography addiction (PA) among adolescents worldwide. The objective of this nationwide study was to assess the current prevalence rate of IA, depression, and PA after the post-COVID-19 period among school-going adolescents in Bangladesh.

Methods

A total of 8832 male and female adolescents participated in this research. The cross-sectional study was conducted online using a simple random sampling method. Including the sociodemographic variables, Young's IA Test (IAT-20) Scale, Patient Health Questionnaire (PHQ-9), and Pornography Craving Questionnaire (PCQ-12) were used to measure IA, depression, and PA. By SPSS version 25.0, the prevalence and correlation between IA, depression, and PA were analyzed using the Chi-square test, binary logistic regression, and a bivariate co-relation matrix.

Results

Sixty-three percent, 76.6%, and 62.9% of the students were suffering from IA, depression, and PA respectively. Depressive and anxious symptoms were significantly associated with IA. Female students were more depressed than males. Males were more addicted to pornography than females. Students who utilized social media but didn't exercise had greater depression and PA. IA, depression, and PA were correlated.

Conclusion

The research emphasizes the need for comprehensive mental health treatments, digital literacy programs, and family and teacher participation to reduce IA, depression, and PA among adolescents post-COVID-19. Promotion of physical exercise and supporting policies to build safer online settings for adolescents are also encouraged.

COVID-19 Posttraumatic Stress Disorder and Mental Health among Spanish Adolescents: SESSAMO Project

Background: Child and adolescent mental health problems have increased after the COVID-19 pandemic. The objective of this study was to establish the association of the presence and intensity of posttraumatic stress due to COVID-19 with the presence of (1) self-harm and suicide risk, (2) depressive and anxious symptoms, (3) eating disorders and (4) problematic Internet and video game use. Methods: A cross-sectional analysis was performed on a sample of second-fourth grade secondary school students (14 to 16 years old) from Navarra and the Canary Islands recruited at the SESSAMO project. Validated questionnaires were used to assess the intensity of posttraumatic stress due to COVID-19, risk of suicide and presence of self-harm, symptoms of mental disorder and problematic use of the Internet and video games. Results: Out of 1423 participants analyzed, those with the highest level of posttraumatic stress showed a significant increase in the risk of suicide (OR = 5.18; 95% CI = 2.96-9.05) and in the presence of eating disorder symptoms (OR = 3.93; 95% CI = 2.21-7.00), and higher anxiety and depression scores (b coefficient for anxiety = 11.1; CI = 9.7-12.5; for depression = 13.0; CI = 11.5-14.5) as compared to those with the lowest level. Participants with a high level of posttraumatic stress were almost 10 times more likely to present problematic video game use (OR = 9.49; 95% CI = 3.13-28.82). Conclusions: Years after the pandemic, posttraumatic stress derived from it continues to impact the mental health of adolescents. Further long-term research is needed, as well as close follow-up and intervention in this population.

Impact of the COVID-19 Pandemic on Swedish Adolescents' Mental Health, Psychosocial Functioning, Risk Behaviours, and Victimisation: Gender Differences and Implications

The COVID-19 pandemic has shown varying effects on adolescents' mental health, psychosocial functioning, risk behaviours, and victimisation. This study aims to examine the changes reported by a sample of Swedish adolescents (N = 1607) at the end of the first year of the pandemic in relation to these factors. Data were collected with an electronic survey between September 2020 and February 2021, targeting upper-secondary high school students (aged 15-19 years). The results indicate a relatively low overall impact of the pandemic on Swedish upper-secondary school students, with notable gender differences. Compared to adolescent women, a higher percentage of adolescent men reported experiencing elevated levels of anxiety, depression, sleep disturbances, anger, and increased illicit drug use as consequences of the pandemic. In contrast, women demonstrated an increase in several salutogenic behaviours. Victimisation rates generally decreased during this period. These findings underscore the importance of heightened awareness among professionals within schools, social services, and healthcare settings regarding the distinct challenges encountered by a larger portion of adolescent men during the COVID-19 pandemic in Sweden.

Post-Pandemic Evolution of Suicide Risk in Children and Adolescents Attending a General Hospital Accident and Emergency Department

BACKGROUND

Lockdowns and other health protective measures, such as social distancing, imposed during the COVID-19 pandemic nurtured unprecedented levels of stress and social isolation around the world. This scenario triggered an increase in suicide thoughts and self-harm behaviours among children and young people. However, the longer-term impact of the pandemic on children's and adolescents' mental health, especially with regard to self-harm, is still to be fully discovered.

METHODS

We carried out a retrospective study where we collected data related to suicide ideation and self-harm behaviours in all patients aged under 18 that required on-call psychiatric services at the General Hospital Accident and Emergency (A&E) department in Salamanca, Spain, during 2019 (pre-pandemic) and in both 2021 and 2022 to capture possible variation at different time points during the post-pandemic period.

RESULTS

A total of 316 patients aged under 18 were seen by on-call psychiatric services at the A&E department during the three time periods: 78 in 2019, 98 in 2021 and 140 in 2022. The mean age was 15.12 (SD 2.25) and females represented more than twice the number of males each year. More than half of all patients assessed during 2022 disclosed suicide thoughts, whilst in 2019, it was near 25%. This increase in suicide ideation rates was more marked among females (X2 = 15.127; p = 0.001), those aged over 15 (X2 = 16.437; p < 0.001) and/or those with a previous history of mental health problems (X2 = 17.823; p < 0.001). We identified an increase in the proportion of males with suicide ideas, especially between 2021 and 2022 (X2 = 8.396; p = 0.015).

CONCLUSIONS

Our study suggests that children's and adolescents' demand for urgent mental healthcare and their clinical presentations in A&E departments with suicide thoughts and/or self-injuries do not seem to be declining after the pandemic but increasing over time. More research is warranted to understand possible factors involved in this sustained upward trend.

Effects of Gender and Social Network Use on High School Students’ Emotional Well-Being during COVID-19

Various studies conducted during the COVID-19 pandemic have confirmed changes in online behaviour, with young people increasingly using social networks. This trend appears to correlate with a heightened risk of various psychological and emotional problems. The main aim of this study is to explore the patterns of social network use among high school students amidst the pandemic, particularly focusing on the presence of specific emotional problems and potential gender differences. In addition, this study aims to contribute to the existing body of knowledge on the influence of lockdown measures on adolescents. A probabilistic sample of N = 825 students from 20 high schools in Zagreb participated in this study. Alongside basic sociodemographic variables, this study assessed social network habits and emotional problems using the Depression Anxiety Stress Scales 21 (DASS-21). The findings indicate intensive social media engagement during the pandemic. The results of the MANOVA analysis (gender x daily time on social media) show significant effects of both the time spent on social networks and gender on mental health, while no interaction effect was observed. Female students and those who spend more time on social media have higher levels of depression, anxiety, and stress symptoms. These findings underscore the need for addressing emotional problems and habits in the virtual environment of high school students and implementing appropriate preventive and treatment interventions.

Conduct problems, hyperactivity, and screen time among community youth: can mindfulness help? an exploratory study

Background

The influence of mindfulness-based intervention (MBI) programs on behavioural problems among community youth is largely understudied. While technology continues to evolve and the prevalence of screen-based activities is rising, limited studies have accounted for screen time when examining the efficacy of an MBI. Accordingly, this study investigated the impact of MBI on conduct problems and hyperactivity among community youth, accounting for sociodemographic characteristics and four types of screen time.

Method

Linear regression models were used to investigate 1) the association between four types of screen time and behavioural problems (i.e., conduct problems and hyperactivity) and 2) the efficacy of online mindfulness programs in reducing behavioural problems among community youth. The data were collected at baseline, intervention completion and 1-month follow-up (Spring 2021 to Spring 2022) in Ontario, Canada (n=117, mean age=16.82, male=22%, non-White=21%).

Results

The average score for conduct problems was within the normal range, while the average score for hyperactivity was considered borderline at baseline. Accounting for other types of screen time, time spent playing video games was significantly associated with increased conduct problems (β= 1.75, p=.03), albeit rendering non-significant after correcting for multiple comparisons. The online mindfulness program was significantly associated with reduced hyperactivity, controlling for baseline mental health, age, sex and screen time.

Conclusion

The current findings suggest a 12-week online mindfulness program may play a positive role in reducing hyperactivity even when accounting for screen time. Our findings advocate the evidence base on the efficacy of MBI in managing hyperactivity.

Emotions and music through an innovative project during compulsory secondary education

This article presents the results and main conclusions of a quasi-experimental study after the implementation of an innovative project extended as a multi-year programme, called 'MusMotion', applied in compulsory secondary education, which is based on the relationship between music and emotions, as well as its effects on the academic performance of adolescents. The research analysed and tested an educational innovation project that improves students' academic performance, as well as the classroom climate between teachers and students (N = 444). A key strand of this research concerns the use of music to support students' emotional development and awareness. As we will explain, the results of this research have shown positive outcomes that have direct implications for pedagogy and classroom practice. The results confirm that there is a relationship between emotions and students' academic performance, and the innovative educational programme MusMotion can help to improve students' academic performance and the classroom climate by improving their state of mind. Educational systems, through the management of emotions via music, could help many children who today may have difficulty with their emotions.

School students' burdens and resources after 2 years of COVID-19 in Austria: a qualitative study using content analysis

Introduction

The mental health of young people has been severely affected by the COVID-19 pandemic and the measures associated with it. Mental health symptoms increased across various domains during the pandemic and subjective wellbeing decreased.

Methods

This study examined the burdens and resources of Austrian school students (M = 16.63 years old) in the third year of the pandemic and compared them descriptively with the burdens and resources identified in a comparative study in 2021. A cross-sectional online survey with open-ended questions from April to May 2022 provided data that was analyzed using qualitative content analysis. A sub-sample of N = 214 was selected from the larger sample. This sub-sample is representative for the Austrian population aged 15-19 in terms of gender and migrant background.

Results

Analysis of the open-ended questions showed that concerns about the pandemic and the burdens of the measures were no longer on young people's minds at the time of the survey in 2022. On the other hand, stress at school was increasing and the opening of schools and the resumption of face-to-face teaching were challenging for respondents. While resuming social contacts and leisure activities was mentioned as a resource by many respondents, some also expressed a desire for more time off and a retreat into coping strategies such as sleeping more or avoiding problems.

Discussion

Our findings suggest that there is a need for low-threshold support from teachers and parents to help students catch up on missed lessons and to empathize with the mas they make the transition back to "old normal".

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

Background

The COVID-19 pandemic has significantly impacted the mental health of children and families, i.e., due to measures like social distancing and remote schooling. While previous research has shown negative effects on mental health and health-related quality of life (HRQoL), most studies have focused on pre-post comparisons in the early pandemic stages. This systematic review aims to examine longitudinal studies to understand the long-term impacts of the pandemic on children and adolescents.

Methods

This systematic review adhered to the PRISMA guidelines and was preregistered in the international prospective register of systematic reviews (Record ID: CRD42022336930). We systematically searched PubMed/MEDLINE, Web of Science, PsycINFO, PSYNDEX, and the WHO-COVID-19 database and included studies published up to August 30, 2022. Based on pre-defined eligibility criteria, longitudinal and prospective studies that assessed the mental health or quality of life of children or adolescents (0-19 years) in the general population over a longer time span (at two or more measurement points) during the COVID-19 pandemic were included in the review. The methodological quality of the included studies was assessed using an adapted version of the Effective Public Health Practice Project (EPHPP) checklist. Narrative data synthesis was used to summarize the findings.

Results

A total of 5,099 results were obtained from literature searches, with 4,935 excluded during title/abstract screening. After reviewing 163 full-text articles, 24 publications were included in the review. Sample sizes ranged between n = 86 and n = 34,038. The length of the investigated time periods and the number of assessment points, as well as outcomes, varied. The majority of studies were of moderate methodological quality. Mental health outcomes were more frequently studied compared to measures of HRQoL. The findings from these studies mostly suggest that children and adolescents experienced heightened mental health problems, specifically internalizing symptoms like anxiety and depression. Further, there was a decline in their overall HRQoL over the course of the COVID-19 pandemic that did not necessarily subside when lockdowns ended.

Conclusion

It is crucial to continue monitoring the mental health and well-being of children and adolescents following the pandemic to identify groups at risks and plan interventions. This should ideally be conducted by large systematic studies, using validated instruments, and encompassing representative samples to obtain reliable and comprehensive insights with the aim of improving youth mental health care.

Effect of salidroside on neuroprotection and psychiatric sequelae during the COVID-19 pandemic: A review

The coronavirus disease 2019 (COVID-19) pandemic has affected the mental health of individuals worldwide, and the risk of psychiatric sequelae and consequent mental disorders has increased among the general population, health care workers and patients with COVID-19. Achieving effective and widespread prevention of pandemic-related psychiatric sequelae to protect the mental health of the global population is a serious challenge. Salidroside, as a natural agent, has substantial pharmacological activity and health effects, exerts obvious neuroprotective effects, and may be effective in preventing and treating psychiatric sequelae and mental disorders resulting from stress stemming from the COVID-19 pandemic. Herein, we systematically summarise, analyse and discuss the therapeutic effects of salidroside in the prevention and treatment of psychiatric sequelae as well as its roles in preventing the progression of mental disorders, and fully clarify the potential of salidroside as a widely applicable agent for preventing mental disorders caused by stress; the mechanisms underlying the potential protective effects of salidroside are involved in the regulation of the oxidative stress, neuroinflammation, neural regeneration and cell apoptosis in the brain, the network homeostasis of neurotransmission, HPA axis and cholinergic system, and the improvement of synaptic plasticity. Notably, this review innovatively proposes that salidroside is a potential agent for treating stress-induced health issues during the COVID-19 pandemic and provides scientific evidence and a theoretical basis for the use of natural products to combat the current mental health crisis.

Twenty years of emotional-behavioral problems of community adolescents living in Italy measured through the Achenbach system of empirically based assessment (ASEBA): a systematic review and meta-analysis

Background

This is a systematic review and meta-analysis of emotional and behavioral problems among Italian community adolescents in the last 20 years, as assessed through the ASEBA questionnaires CBCL 6-18, YSR 11-18 and TRF 6-18. Research questions address: (1) pooled means of problems' scores in questionnaires scales; (2-3) variations in scores according to sociodemographic and time-related factors, and studies' quality; (4) trends in research with ASEBA instruments along with other outcomes, e.g., psychopathological symptoms.

Methods

A systematic literature review of Scopus, EBSCO, PubMed, Web of Science, and ProQuest databases using the PRISMA 2020 guidelines was conducted on November, 2021, and of grey literature on December, 2021. The quality of studies was assessed through the Newcastle-Ottawa Scale.

Results

Forty-four studies were eligible for the systematic review, of which 34 were included for meta-analysis. Results showed that: (1) emotional-behavioral problems were higher when assessed by the CBCL and lower when assessed by the YSR compared to normative data; (2) there were no gender and age differences, except for higher scores of Anxious/Depression symptoms, in girls. (3) internalizing and attention problems increased over the last two decades. (4) major trends of Italian research investigate adolescents' emotional behavioral problems concerning attachment, comorbid symptoms, especially internet addictions, and eating disorders.

Discussion

Despite some limitations (e.g., low-medium quality of most studies, no data on the TRF, under-representation of some geographical areas, some search-related choices), these data provides Italian practitioners and international researchers of some parameter to evaluate Italian adolescents emotional-behavioral problems. Registered on PROSPERO N. CRD42022299999.

Vertebral Fractures in Pediatric Suicidal Jumpers: A Retrospective Study with Epidemiological and Clinical Analysis before and after the COVID-19 Pandemic

BACKGROUND

From the beginning of the COVID-19 pandemic, reports in the literature confirm a significant increase in suicide attempts in children and adolescents. At the Bambino Gesù Pediatric Hospital Emergency Department (Rome, Italy), there was a dramatic increase in suicidal jumpers. Many of these presented vertebral fractures.

METHODS

This retrospective study includes all suicidal jumpers with vertebral fractures treated from April 2017 to March 2023. We collected and compared data from three years before to three years after the pandemic, analyzing vertebral fractures.

RESULTS

From April 2019 to March 2020, 141 cases of suicide attempt arrived at the emergency department. Five of these were suicidal jumpers without vertebral fractures. From April 2020 to March 2023, 362 cases of suicide were hospitalized and 19 were suicidal jumpers; 12 reported vertebral fractures (mean age 14 years). Seven patients were treated by percutaneous pedicle fixation. Three patients needed an open spinal surgery by posterior approach. One case with cervical fractures was treated by Halo-Vest.

CONCLUSIONS

This is the first report that shows a sharp increase in vertebral body fractures due to suicide jumping attempts in children and adolescents. This could be a new epidemiological phenomenon persisting or even increasing over time in the pediatric population as a consequence of the COVID-19 pandemic.

Crisis as Opportunity, Risk, or Turmoil: Qualitative Study of Youth Narratives About the COVID-19 Pandemic

PURPOSE

The present study employed a narrative approach in order to explore how young people constructed meanings regarding their sense of self in the context of COVID-19 experiences. Adolescents have been identified as a particularly vulnerable group, as the developmental challenges they face are superimposed and amplified by the accidental crisis caused by the pandemic.

METHODS

An in-depth narrative analysis was conducted on written accounts of 13 females aged 17-23 years from Serbia. We selected these narratives from a larger sample of 70 responses (M = 20.1; SD = 2.9; 85.7% female) collected via an online form. We used reflexive thematic analysis as a tool for the selection process of the narratives subjected to in-depth narrative analysis.

RESULTS

Young people told stories that differ significantly in coherence, affective tone, personal agency, and depth of self-exploration. Narrative analysis of the selected accounts identified three distinct types of stories: (1) crisis as an opportunity for personal growth, (2) crisis as a risk for the sense of self, and (3) crisis as inner turmoil.

DISCUSSION

Narrative analysis enabled us to recognize three distinct processes of youth meaning-making related to the sense of self in times of crisis, all reflecting a significant impact on their core developmental task. Personal narratives served different functions; for some, the pandemic was framed as a challenge one could grow from, while others were left devastated or overwhelmed. Narrative coherence reflected youths' capacities for integrating experiences not necessarily connected to their psychological well-being.

Trajectories of social withdrawal and social anxiety and their relationship with self-esteem before, during, and after the school lockdowns

The closure of schools during the COVID-19 pandemic affected adolescents' social withdrawal and social anxiety. Yet, self-esteem may have acted as a protective factor during this period. This study aimed to compare the trajectories of social withdrawal and social anxiety before (Year 1), during (Year 2 and 3), and after (Year 4) the closure of schools imposed by the COVID-19-related lockdowns, and to investigate the association of self-esteem with these trajectories. Participants were 844 (50.6% boys) Portuguese adolescents (mean age 12.70 years, SD = 1.14). The Social and Emotional Competencies Evaluation Questionnaire (QACSE) was used to assess social withdrawal and social anxiety, while The Global Self-Esteem scale of the Self-Description Questionnaire II was used to measure self-esteem. Growth curve analysis showed that social withdrawal and social anxiety had more negative trajectories during the year in which the school closures occurred. In addition, adolescents reported higher social withdrawal after the lockdowns than before the pandemic. Higher self-esteem was associated with a more positive trajectory in social withdrawal. Therefore, the results showed the negative of impact of the closure of schools on adolescents' social anxiety and social withdrawal, and that self-esteem was a protective factor during these challenging and adverse events.

Effect of the pandemic on prehospital management of patients with mental and behavioral disorders: a retrospective cohort study

The novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection and the accompanying coronavirus disease (Covid-19) have shifted the priority of human and technical resources toward their handling, thus affecting the usual standards of care for populations diagnosed with other clinical entities. The phenomenon becomes even more apparent in patients with presenting symptoms of mental and behavioral disorders, a category already vulnerable and underrepresented in regard to its prehospital approach and management. For the purposes of the current retrospective cohort study, we used records of the Polish National Emergency Medical Service Command Support System for the time period between April 1, 2019 and April 30, 2021, the official register of medical interventions delivered in Poland by Emergency Medical Services (EMS). We aimed to examine the potential impact of the COVID-19 pandemic across the Masovian Voivodeship on individuals seeking medical care for mental and behavioral disorders pertaining in the "F" category of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). We examined the individuals' baseline characteristics, prehospital vital parameters and EMS processing times in a population of 59,651 adult patients (04/2019-03/2020, 28,089 patients, 04/2020-03/2021, 31,562 patients) handled by EMS teams. Compared to pre-COVID-19, EMS personnel handled fewer patients, but more patients required mental and behavioral care. Throughout the duration of the pandemic, all prehospital time periods were significantly delayed due to the increased time needed to prepare crew, vehicles, and technical equipment to ensure COVID-19 prevention and overcrowding in Emergency Departments (EDs).

Behavioral and Sleep Disorders in Children and Adolescents following COVID-19 Disease: A Case-Control Study

INTRODUCTION

Recent studies show that neuropsychiatric disorders are the most frequent sequelae of COVID-19 in children.

PURPOSE

Our work aimed to evaluate the impact of SARS-CoV-2 infection on behavior and sleep in children and adolescents.

MATERIALS AND METHODS

We enrolled 107 patients aged 1.5-18 years who contracted COVID-19 between one year and one month prior to data collection, referred to the University of Campania Luigi Vanvitelli in Italy. We asked their parents to complete two standardized questionnaires for the assessment of behavior (Child Behavior CheckList (CBCL)) and sleep (Sleep Disturbance Scale for Children (SLDS)). We analysed and compared the results with a control group (pre-COVID-19 pandemic).

RESULTS

In the COVID-19 group, the major results were found for sleep breathing disorders, sleep-wake transition disorders and disorders of initiating and maintaining sleep for the SDSC questionnaire, and internalizing scale, total scale and anxiety/depression for the CBCL questionnaire. The comparison of the CBCL results of the cases with the controls revealed statistically significant differences for the following items: internalizing scale, externalizing scale, somatic complaints, total score, thought problems [(p < 0.01)], anxious/depressed problems and withdrawn [(p < 0.001)].

CONCLUSIONS

COVID-19 has impacted children's and adolescents' mental health. Adolescents were the most affected patient group for internalizing problems, including anxiety and depression.

A national multiple baseline cohort study of mental health conditions in early adolescence and subsequent educational outcomes in New Zealand

Young people experiencing mental health conditions are vulnerable to poorer educational outcomes for many reasons, including: social exclusion, stigma, and limited in-school support. Using a near-complete New Zealand population administrative database, this prospective cohort study aimed to quantify differences in educational attainment (at ages 15-16 years) and school suspensions (over ages 13-16 years), between those with and without a prior mental health condition. The data included five student cohorts, each starting secondary school from 2013 to 2017 respectively (N = 272,901). Both internalising and externalising mental health conditions were examined. Overall, 6.8% had a mental health condition. Using adjusted modified Poisson regression analyses, those with prior mental health conditions exhibited lower rates of attainment (IRR 0.87, 95% CI 0.86-0.88) and higher rates of school suspensions (IRR 1.63, 95% CI 1.57-1.70) by age 15-16 years. Associations were stronger among those exhibiting behavioural conditions, compared to emotional conditions, in line with previous literature. These findings highlight the importance of support for young people experiencing mental health conditions at this crucial juncture in their educational pathway. While mental health conditions increase the likelihood of poorer educational outcomes, deleterious outcomes were not a necessary sequalae. In this study, most participants with mental health conditions had successful educational outcomes.

The impact of the COVID-19 pandemic on psychiatric emergency consultations in adolescents

BACKGROUND

There is growing evidence that the COVID-19 pandemic, and its associated social distancing measures, affect adolescents' mental health. We wanted to examine whether and how the number and characteristics of adolescents' psychiatric emergency presentations have changed throughout the pandemic.

METHODS

We extracted data from the records of 977 psychiatric emergency consultations of adolescents aged 12- 19 who had been referred to the mobile psychiatric emergency services in Rotterdam, the Netherlands between January 1st 2018 and January1st 2022. Demographic, contextual, and clinical characteristics were recorded. Time-series-analyses were performed using quasi-Poisson Generalized Linear Model to examine the effect of the first and second COVID-19 lockdown on the number of psychiatric emergency consultations, and to explore differences between boys and girls and internalizing versus externalizing problems.

RESULTS

The number of psychiatric emergency consultations regarding adolescents increased over time: from about 13 per month in 2018 to about 29 per month in 2021. During the COVID-19 pandemic, the increase was tempered. In the second wave a pronounced increase of psychiatric emergencies among adolescents with internalizing problems but not with externalizing problems was found.

CONCLUSION

Despite the reported increase of mental health problems in adolescents during the COVID-19 pandemic, we did find a smaller increase in psychiatric emergency consultations in this group then would be expected considering the overall trend. Besides changes in help-seeking and access to care, a possible explanation may be that a calmer, more orderly existence, or more parental supervision led to less psychiatric emergency situations in this age group. In the second wave the number of emergency consultations increased especially among girls with internalizing problems. While there has been a particular fall in emergency referrals of adolescents with externalizing problems since the start of the pandemic it is still too early to know whether this is a structural phenomenon. It would be important to elucidate whether the changes in emergency referrals reflect a true change in prevalence of urgent internalizing and externalizing problems in adolescents during the pandemic or a problem related to access to care.

Adolescence in lockdown: The protective role of mentalizing and epistemic trust

OBJECTIVE

Mentalizing is the ability to interpret one's own and others' behavior as driven by intentional mental states. Epistemic trust (openness to interpersonally transmitted information) has been associated with mentalizing. Balanced mentalizing abilities allow people to cope with external and internal stressors. Studies show that social isolation imposed by the COVID-19 pandemic was highly stressful for most people, especially for adolescents. Here we examine whether mentalizing and epistemic trust were protective factors in relation to emotional distress during the lockdown.

METHOD

A total of 131 nonclinical adolescents, aged between 12 and 18 years, were evaluated during the lockdown using the Reflective Functioning Questionnaire for Youth, Inventory of Parent and Peer Attachment, Perceived Stress Scale, and Difficulties in Emotion Regulation Scale.

RESULTS

Results from network analysis showed that epistemic trust and mentalizing were negatively associated with perceived stress and emotion dysregulation. Epistemic trust in fathers was associated with level of perceived stress, and epistemic trust in mothers with emotion dysregulation.

CONCLUSION

These findings suggest that epistemic trust and the capacity to mentalize were low in adolescents during lockdown, and this was associated with high levels of stress. However, robust levels of epistemic trust and mentalizing may have acted as protective factors that buffered individuals from the risk of emotional dysregulation during the lockdown.

Generalized anxiety among Finnish youth from 2013 to 2021-Trend and the impact of COVID-19

BACKGROUND

Alarming levels of emotional symptoms among youth were reported during the COVID-19 pandemic. Studies assessing these figures against the pre-pandemic developments are rare. We examined the trend of generalized anxiety (GA) in adolescents in the 2010s and the effect of the COVID-19 pandemic against this trend.

METHODS

Data from the Finnish School Health Promotion study with 750,000 participants aged 13-20 between 2013 and 2021 was analyzed using GAD-7 to measure self-reported GA (cut-off ≥10). Inquiries were made about remote learning arrangements. Effects of time and COVID-19 were analyzed with logistic regression.

RESULTS

Among females, an increasing trend in GA between 2013 and 2019 was found (OR per year 1.05), and the prevalence increased from 15.5 % to 19.7 %. Among males, the trend was decreasing (OR = 0.98), with prevalence from 6.0 % to 5.5 %. Increase in GA from 2019 to 2021 was stronger in females (19.7 % to 30.2 %) than males (5.5 % to 7.8 %), while the effect of COVID-19 on GA was equally strong (OR = 1.59 vs. OR = 1.60) against the pre-pandemic trends. Remote learning was associated with elevated levels of GA, especially among those with unmet needs for learning support.

LIMITATIONS

The design of repeated cross-sectional surveys doesn't allow analyses of within individual changes.

CONCLUSIONS

Given the pre-pandemic trends of GA, the COVID-19 effect on it appeared equal in both sexes. The increasing pre-pandemic trend among adolescent females and the strong effect of COVID-19 on GA among both sexes warrants constant monitoring of mental health of the youth in the aftermath of the COVID-19 pandemic.

Impact of COVID-19 Confinement on Mental Health in Youth and Vulnerable Populations: An Extensive Narrative Review

The objective of this narrative review is to analyze the impact of COVID-19 on the mental health of particularly vulnerable groups. This information will allow a better understanding of the determining factors that influence the appearance and/or maintenance of mood disorders. To achieve the main objective of this study, a critical review was carried out in which primary sources such as scientific articles, secondary sources such as databases, and other appropriate reference indexes were considered. The results indicated that there was an increase in the diagnosis of mood disorders and the use of medication associated with these disorders, mainly during the period of reclusion that was declared worldwide in March 2020. In addition, risk factors such as loneliness, a lack of resilience, and a lack of adequate coping strategies negatively impacted these groups. The future consequences of this may be reflected over many years thereafter, and it is important that all data obtained from this point forward be considered by mental health professionals and the general population. This review can be a starting point for looking directly at the most vulnerable populations and considering both the resources available to them and the possible aftermath of a traumatic period in everyone’s lives.

COVID-19 Pandemic Has Changed the Psychiatric Profile of Adolescents Attempting Suicide: A Cross-Sectional Comparison

The COVID-19 pandemic is having a major impact on the mental health of adolescents, leading to suicidal behaviors. However, it remains to be clarified whether the COVID-19 pandemic has changed the psychiatric profile of adolescent suicide attempters.

METHODS

a retrospective observational analytical study was conducted to assess age, gender and clinical characteristics of adolescents attempting suicide during the year before and the year after the global lockdown.

RESULTS

ninety adolescents (12-17 y.o.) were recruited consecutively from February 2019 to March 2021 at the emergency ward for having attempted suicide. Fifty-two (57.8%) attended before the lockdown (pre-pandemic group) and thirty-eight (42.2%) the year after (pandemic group). There were significant differences in diagnostic categories between the periods (p = 0.003). Adjustment and conduct disorders were more frequent in the pre-pandemic group, while anxiety and depressive disorders were more prevalent during the pandemic. Although the severity of suicide attempts did not show significant differences between the two study periods (0.7), the generalized linear model showed that the suicide attempt severity was significantly associated with current diagnosis (p = 0.01).

CONCLUSIONS

the psychiatric profile of adolescents attempting suicide was different before and during the COVID-19 pandemic. During the pandemic, the proportion of adolescents with a prior psychiatric history was lower, and most of them were diagnosed with depressive and anxiety disorders. These diagnoses were also associated with a greater severity in the intentionality of suicide attempt, regardless of the study period.

Long-Term Effects of COVID-19 Pandemic on Migraine in Adolescents. A Retrospective Analysis of the Population Attending the Headache Center in Different Phases of the Pandemic

BACKGROUND

Literature data report that the first COVID-19 pandemic had an impact on the progression of migraine both in adults and children. The present study aimed to verify how the migraine course and psychological aspects varied in adolescent patients in relation to some of the different phases of the COVID-19 pandemic and compared with the months before COVID-19. In addition, the relationship between the characteristics of headache episodes and psychological and school-related aspects were analyzed.

METHODS

The study included 418 adolescents. Based on the timing of the evaluation, they were categorized into patients observed before the COVID-19 pandemic (pre COVID) or during the first (COVID 1) or second (COVID 2) wave of the pandemic. Subjects were also categorized into three further groups: those who had high or low frequency of migraine attacks during the month, those who had mild or severe pain during the attack, and those who were taking prophylactic drugs. The Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scales were utilized to assess depression and anxiety.

RESULTS

We observed a significant increase in the frequency of attacks and the use of prophylactic drugs during the COVID 2 period compared to the COVID 1 and pre-COVID periods (p < 0.05). Patients showed higher levels of anxiety and depression during each of the two COVID periods compared with the pre-COVID months (p < 0.05), especially during the COVID 2 period (p < 0.05).

CONCLUSION

Our results show long-term negative impacts of the COVID-19 pandemic on clinical parameters and psychological symptoms in adolescents with migraine.

Digital and physical factors influencing an individual's preventive behavior during the COVID-19 pandemic in Taiwan: A perspective based on the S-O-R model

COVID-19 has caused considerable stress to individuals and communities. Daily press briefings on public health during the COVID-19 pandemic have increased individuals' feelings of social pressure. Abrupt changes to a person's immediate environment, such as the changes caused by COVID-19, can substantially affect their mental health and cognitive adjustment. On the basis of the stimulus-organism-response (S-O-R) framework, we examined the effects of digital and physical stimuli related to COVID-19 in Taiwan on individuals' psychological states and preventive behavior, including social distancing and personal hygiene. The data obtained from 498 valid survey questionnaires indicated that digital and physical factors including informativeness, social pressure, and severity exerted direct effects on cognitive assimilation and anxiety, which in turn affected individuals' preventive behavior. Moreover, cognitive assimilation and anxiety had significant mediating effects on the relationships of informativeness, social pressure, and severity with individuals' preventive behavior. The results of this study indicate how digital and physical stimulus factors affect cognitive assimilation and anxiety, which influence preventive behavior during a pandemic.

The Impact of the COVID-19 Pandemic on Pediatric Mental Health Emergency

OBJECTIVE

The aim of this study was to compare pre/post-coronavirus disease 2019 pandemic changes in mental health-related visits to the pediatric emergency department.

MATERIALS AND METHODS

We conducted a retrospective analysis of all mental health-related pediatric emergency department visits to a tertiary general hospital between June and September 2019, 2020, and 2021. We described pre/post-coronavirus disease 2019 changes in the use of pediatric emergency departments, such as timing of visits, sex discrepancies, diagnostic distribution, discharge planning, and others.

RESULTS

Compared with the corresponding months before the pandemic (n = 187), mental health-related pediatric emergency department visits decreased by 20.8% in June-September 2020 (n = 148) and increased by 12.2% in 2021 (n = 210). The distributions of age, sex, timing of visits, reasons for presentations, hospitalization, and outpatient clinic appointment rates were not statistically significant between the years. Self-harm in females and aggression/violence in males were the most common reasons for presentation to pediatric emergency departments in each year. In the post-pandemic period, ambulance use and patients referred by other hospitals for psychiatric consultation increased, while the completion time of consultations decreased (P < .05). The frequency of attention-deficit hyperactivity disorder and depression decreased, but obsessive-compulsive disorder and anxiety disorders were more common in the post-pandemic period than in the corresponding months before the pandemic (P < .05).

CONCLUSION

Our results suggest that the coronavirus disease 2019 pandemic resulted in a significant change in mental health-related visits to the pediatric emergency department. Those in the groups with reduced visits may be at risk for delayed access to treatment for their mental and behavioral difficulties.

Aggressive behavior, boredom, and protective factors among college students during closed-off management of the COVID-19 pandemic in China

Background

Chinese colleges have implemented strict closed-off management in response to the outbreak of a new variant of the new coronavirus, Omicron. But such management measures may lead to more aggressive behavior. The study aimed to determine the associations between boredom and aggressive behavior with aggression and to examine the impact of boredom on aggression through the moderating role of cognitive flexibility.

Methods

The Multidimensional State Boredom Scale, the Reactive-Proactive Aggression Questionnaire, and the Cognitive Flexibility Inventory were applied to a sample of 719 college students who were in a closed-off management environment.

Results

For individuals with high cognitive flexibility, the relationship between state boredom and proactive aggression was not significant. The relationship between state boredom and proactive aggression was significantly positively correlated for individuals with low cognitive flexibility, especially low substitutability. Cognitive flexibility has no significant moderating effect on the relationship between state boredom and reactive aggression.

Conclusion

The findings highlighted the importance of boredom as a potential risk factor for aggression, while cognitive flexibility appears as a potential protective factor.

How COVID-19 Phases Have Impacted Psychiatric Risk: A Retrospective Study in an Emergency Care Unit for Adolescents

Dramatic events during the COVID-19 pandemic have acutely impacted the psychosocial environment worldwide, with negative implications for mental health, particularly for more vulnerable children and adolescents with severe psychiatric illnesses. Some data suggest that the pandemic waves may have produced different psychopathological consequences, further worsening in the second phase of the pandemic, compared to those in the first lockdown, soon after March 2020. To test the hypothesis of a further worsening of psychiatric consequences of COVID-19 in the second lockdown compared to the first lockdown, we focused our analysis on a consecutive sample of youth referred to a psychiatric emergency unit for acute mental disorders in the time period between March 2019-March 2021. The sample, consisting of 241 subjects (123 males and 118 females, ranging in age from 11 to 17 years), was divided into three groups: Pre-Lockdown Group (PLG, 115 patients); First Lockdown Group (FLG, 65 patients); and Second Lockdown Group (SLG, 61 patients). Patients in the SLG presented more frequently with non-suicidal self-injuries (NSSIs), suicidal ideation, and suicidal behavior, while no significant differences in self-harm were found between PLG and FLG. Eating disorders were more frequent in both the FLG and SLG, compared to the PLG, while sleep problems were higher only in the SLG. Furthermore, patients in the SLG presented with more frequent psychological maltreatments and neglect, as well as with psychiatric disorders in the parents. Adverse traumatic experiences and internalizing disorders were significantly associated with an increased risk of suicidality. Intellectual disability was less represented from the PLG to SLG, and similarly, the rate of ADHD was lower in the SLG. No differences were found for the other psychiatric diagnoses. This information may be helpful for a better understanding and management of adolescents with severe emotional and behavioral disorders after the exposure to long-lasting collective traumas.

How has the COVID-19 pandemic affected young people?-Mapping knowledge structure and research framework by scientometric analysis

Since the outbreak of COVID-19, there has been a large body of literature focusing on the relationship between the COVID-19 pandemic and young people. The purpose of this study is to explore the current research status and the specific mechanism of COVID-19's effects on young people based on related literature. This paper mainly used VOS viewer and CiteSpace software to conduct a scientometric analysis of 5,077 publications retrieved from the Web of Science database. The results show that the main contributors to the field were mainly from North America and Europe, and the trend of research focus was from shallow to deep. The five main research areas in the field were summarized by keyword clustering analysis as follows: lifestyle changes due to lockdown; changes in stress and emotions; psychological illness and trauma; risk perception and practice toward the epidemic; interventions and social support. Finally, they were linked by four pathways to form a framework that integrates the relationships between the five domains and between elements within each of them, revealing the mechanism of COVID-19's effect on young people. In addition, less studied but promising elements are also presented in the framework, such as research on special groups (disadvantaged socioeconomic groups and sexual minority youth) and extreme suicidal tendencies that deserve our further attention.

Extended reality for mental health: Current trends and future challenges

Virtual and augmented reality have been used to diagnose and treat several mental health disorders for decades. Technological advances in these fields have facilitated the availability of commercial solutions for end customers and practitioners. However, there are still some barriers and limitations that prevent these technologies from being widely used by professionals on a daily basis. In addition, the COVID-19 pandemic has exposed a variety of new scenarios in which these technologies could play an essential role, like providing remote treatment. Disorders that traditionally had received less attention are also getting in the spotlight, such as depression or obsessive-compulsive disorder. Improvements in equipment and hardware, like Mixed Reality Head Mounted Displays, could help open new opportunities in the mental health field. Extended reality (XR) is an umbrella term meant to comprise Virtual reality (VR), mixed reality (MR), and augmented reality (AR). While XR applications are eminently visual, other senses are being explored in literature around multisensory interactions, such as auditory, olfactory, or haptic feedback. Applying such stimuli within XR experiences around mental disorders is still under-explored and could greatly enrich the therapeutic experience. This manuscript reviews recent research regarding the use of XR for mental health scenarios, highlighting trends, and potential applications as well as areas for improvement. It also discusses future challenges and research areas in upcoming topics such as the use of wearables, multisensory, and multimodal interaction. The main goal of this paper is to unpack how these technologies could be applied to XR scenarios for mental health to exploit their full potential and follow the path of other health technologies by promoting personalized medicine.

Short- and Long-Term Impacts of the COVID-19 Pandemic on Suicide-Related Mental Health in Korean Adolescents

This study investigated the short-term (in 2020) and long-term (in 2021) impacts of the COVID-19 pandemic on suicide-related characteristics in Korean adolescents in comparison with the pre-pandemic period (in 2019) and examined the factors associated with those impacts. Secondary data of the cross-sectional 15th-17th (2019-2021) Korea Youth Risk Behavior Web-based Survey targeting adolescents in school were utilized. The proportions of adolescents with depression, suicidal ideation, suicide planning, and suicide attempts were 26.5%, 12.2%, 3.7%, and 2.4%, respectively. Following an adjustment, depression, suicidal ideation, and suicide attempts significantly improved in the short term and depression and suicide attempts improved significantly in the long term (i.e., 2021), albeit to a lesser degree. The associated variables in the short-term analysis (i.e., 2020) reflected the socioeconomic vulnerabilities (e.g., lower household socioeconomic status [SES], unhealthy status, and unhealthy behaviors), as well as the socioeconomically favorable indicators (e.g., high household SES and high academic achievement). In the long-term, suicidal ideation was no longer associated with a lack of engagement in hand washing, and suicide attempts were no longer associated with the amount of internet time used for studying. For a successful suicide prevention, it is necessary to develop in-school interventions that address the relevant factors identified in this study and the community-based interventions that target out-of-school adolescents.

Hospitalizations for Anorexia Nervosa during the COVID-19 Pandemic in France: A Nationwide Population-Based Study

The COVID-19 pandemic has had a detrimental impact on mental health, including on food-related behaviors. However, little is known about the effect of the pandemic on anorexia nervosa (AN). We sought to assess an association between the COVID-19 pandemic and a potential increase in hospitalizations for AN in France. We compared the number of hospitalizations with a diagnosis of AN during the 21-month period following the onset of the pandemic with the 21-month period before the pandemic using Poisson regression models. We identified a significant increase in hospitalizations for girls aged 10 to 19 years (+45.9%, RR = 1.46[1.43−1.49]; p < 0.0001), and for young women aged 20 to 29 (+7.0%; RR = 1.07[1.04−1.11]; p < 0.0001). Regarding markers of severity, there was an increase in hospitalizations for AN associated with a self-harm diagnosis between the two periods. Multivariate analysis revealed that the risk of being admitted for self-harm with AN increased significantly during the pandemic period among patients aged 20−29 years (aOR = 1.39[1.06−1.81]; p < 0.05 vs. aOR = 1.15[0.87−1.53]; NS), whereas it remained high in patients aged 10 to 19 years (aOR = 2.40[1.89−3.05]; p < 0.0001 vs. aOR = 3.12[2.48−3.98]; p < 0.0001). Furthermore, our results suggest that the pandemic may have had a particular effect on the mental health of young women with AN, with both a sharp increase in hospitalizations and a high risk of self-harming behaviors.

Living with Infection Risk and Job Insecurity during COVID-19: The Relationship of Organizational Support, Organizational Commitment, and Turnover Intention

The COVID-19 outbreak caused a stressful process for hospitality employees in terms of both being infected and experiencing the risk of losing their jobs. Stressful working conditions increase employees' turnover intentions (TI). This study aims to analyze the relationship among perceived organizational support (POS), organizational commitment (OC), and turnover intention (TI) within the context of employees' infection status and perceived job insecurity (JI). In this context, the study tests a moderated mediation research model. Having adopted a quantitative research method, data were acquired from 490 respondents who work at five-star accommodation companies in Alanya, Turkey. Findings show that the impact of POS on OC and IT differ according to employees' infection status during the COVID-19 outbreak and their perceived JI. The findings of the study reveal empirical results in understanding employee attitudes toward companies alongside perceived job insecurity for those who are infected as well as for those who are not. Moreover, the study presents theoretical and practical contributions to reduce the negative impact of job insecurity and risk of infection on turnover intentions, which have been considered to be main sources of stress throughout the pandemic.

Child, adolescent, and parent mental health in general population during a year of COVID-19 pandemic in belgium: a cross-sectional study

BACKGROUND

This study aims to evaluate the mental health status of children, adolescents and their parents during the first year of COVID-19 pandemic in Belgium.

METHOD

Analysis compared results before and during the second national lockdown, which started on November 2nd 2020. A cross-sectional online survey was conducted between May 2020 and April 2021.

RESULTS

Two hundred and eighteen adults and 273 children fully completed the survey. Almost one in five children (17.9%) presented moderate-to-severe scores of depression. Adolescents presented a higher level of depression than children (p = 0.007). The rate of moderate-to-severe depression scores (10.8% to 21%, p = 0.007) and internalized symptoms increased during the second lockdown (p < 0.001). Parents' depression (p < 0.001) and anxiety (p = 0.027) levels also increased during the second lockdown. Logistic regression showed that the use of psychotropic medication in parents and parents' depression scores were risk factors for children to have worse depression scores.

CONCLUSION

The second lockdown appears to worsen the effects of the pandemic on children's and parents' mental health. There is a need to implement specific interventions targeting both children/adolescents and their parents to support them during lockdown periods and improve mental health outcomes.

Substance Use Among Youth During the COVID-19 Pandemic: a Systematic Review

PURPOSE OF REVIEW

To review the literature on the trends in substance use among youth during the coronavirus SARS-CoV-2 (COVID-19) pandemic.

RECENT FINDINGS

The pandemic has given rise to concerns about the mental health and social well-being of youth, including its potential to increase or exacerbate substance use behaviors. This systematic review identified and included 49 studies of use across alcohol, cannabis, tobacco, e-cigarettes/vaping, and other drugs, and unspecified substances. The majority of studies across all categories of youth substance use reported reductions in prevalence, except in the case of other drugs and unspecified drug and substance use, which included three studies that reported an increase in use and three studies that reported decrease in use. Overall, the results of this review suggest that the prevalence of youth substance use has largely declined during the pandemic. Youth substance use in the post-pandemic years will require monitoring and continued surveillance.