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Laurent-Levinson C, Pellen AS, Pellerin H, Hanin C, Bouzy J, Devernay M, Milhiet V, Benarous X, Consoli A, Shi J, Levinson DF, Cohen D. Emotions and behaviours of child and adolescent psychiatric patients during the COVID-19 pandemic. BJPsych Open 2024; 10:e47. [PMID: 38362905 PMCID: PMC10897707 DOI: 10.1192/bjo.2023.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Previous pandemics have had negative effects on mental health, but there are few data on children and adolescents who were receiving ongoing psychiatric treatment. AIMS To study changes in emotions and clinical state, and their predictors, during the COVID-19 pandemic in France. METHOD We administered (by interview) the baseline Youth Self-Report version of the CoRonavIruS Health Impact Survey v0.3 (CRISIS, French translation) to 123 adolescent patients and the Parent/Caregiver version to evaluate 99 child patients before and during the first 'lockdown'. For 139 of these patients who received ongoing treatment in our centre, treating physicians retrospectively completed longitudinal global ratings for five time periods, masked to CRISIS ratings. RESULTS The main outcome measure was the sum of eight mood state items, which formed a single factor in each age group. Overall, this score improved for each age group during the first lockdown. Clinician ratings modestly supported this result in patients without intellectual disability or autism spectrum disorder. Improvement of mood states was significantly associated with perceived improvement in family relationships in both age groups. CONCLUSIONS Consistent with previous studies of clinical cohorts, our patients had diverse responses during the pandemic. Several factors may have contributed to the finding of improvement in some individuals during the first lockdown, including the degree of family support or conflict, stress reduction owing to isolation, limitations of the outcome measures and/or possible selection bias. Ongoing treatment may have had a protective effect. Clinically, during crises additional support may be needed by families who experience increased conflict or who care for children with intellectual disability.
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Affiliation(s)
- Claudine Laurent-Levinson
- Department of Child and Adolescent Psychiatry, Centre de Référence des Maladies Rares à Expression Psychiatrique, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, France; and Groupe de Recherche Clinique n 15 - Troubles Psychiatriques et Développement (PSYDEV), Faculty of Medicine, Sorbonne Université, Paris, France
| | - Anne-Sophie Pellen
- Department of Child and Adolescent Psychiatry, Centre de Référence des Maladies Rares à Expression Psychiatrique, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, France; and Groupe de Recherche Clinique n 15 - Troubles Psychiatriques et Développement (PSYDEV), Faculty of Medicine, Sorbonne Université, Paris, France
| | - Hugues Pellerin
- Department of Child and Adolescent Psychiatry, Centre de Référence des Maladies Rares à Expression Psychiatrique, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, France; and Groupe de Recherche Clinique n 15 - Troubles Psychiatriques et Développement (PSYDEV), Faculty of Medicine, Sorbonne Université, Paris, France
| | - Cyril Hanin
- Department of Child and Adolescent Psychiatry, Centre de Référence des Maladies Rares à Expression Psychiatrique, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, France; and Groupe de Recherche Clinique n 15 - Troubles Psychiatriques et Développement (PSYDEV), Faculty of Medicine, Sorbonne Université, Paris, France
| | - Juliette Bouzy
- Department of Child and Adolescent Psychiatry, Centre de Référence des Maladies Rares à Expression Psychiatrique, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Marie Devernay
- Unité de Médecine pour Adolescents, Armand-Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Vanessa Milhiet
- Groupe de Recherche Clinique n 15 - Troubles Psychiatriques et Développement (PSYDEV), Faculty of Medicine, Sorbonne Université, Paris, France; and Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Xavier Benarous
- Groupe de Recherche Clinique n 15 - Troubles Psychiatriques et Développement (PSYDEV), Faculté de Médecine Sorbonne Université, Paris, France; and Department of Child and Adolescent Psychopathology, Amiens University Hospital, Amiens, France
| | - Angèle Consoli
- Department of Child and Adolescent Psychiatry, Centre de Référence des Maladies Rares à Expression Psychiatrique, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, France; and Groupe de Recherche Clinique n 15 - Troubles Psychiatriques et Développement (PSYDEV), Faculty of Medicine, Sorbonne Université, Paris, France
| | - Jianxin Shi
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Douglas F Levinson
- Groupe de Recherche Clinique n 15 - Troubles Psychiatriques et Développement (PSYDEV), Faculty of Medicine, Sorbonne Université, Paris, France; and Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Centre de Référence des Maladies Rares à Expression Psychiatrique, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, France; Groupe de Recherche Clinique n 15 - Troubles Psychiatriques et Développement (PSYDEV), Faculty of Medicine, Sorbonne Université, Paris, France; and CNRS UMR 7222, Institute for Intelligent Systems and Robotics, Sorbonne University, Paris, France
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Impact of the COVID-19 pandemic on mental health and family situation of clinically referred children and adolescents in Switzerland: results of a survey among mental health care professionals after 1 year of COVID-19. J Neural Transm (Vienna) 2022; 129:675-688. [PMID: 35652976 PMCID: PMC9160518 DOI: 10.1007/s00702-022-02512-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/01/2022] [Indexed: 12/24/2022]
Abstract
The aim of this study was to assess the impact of the COVID-19 pandemic on mental well-being of clinically referred children and adolescents and on their families from the perspective of mental health care professionals in Switzerland during the first year of the pandemic. Psychiatrists and psychologists for children and adolescents participated in an anonymous survey conducted online in April/May 2021. The survey was completed by 454 mental health care professionals, most of them working in outpatient clinics for child and adolescent psychiatry or in independent practices. Most participants indicated an important increase of referrals for depression (86.8% of respondents), anxiety disorders (81.5%), crisis interventions (76.2%), psychosomatic disorders (66.1%), suicidality (63.8%), and behavioral addictions, e.g., excessive gaming (64.6%). In contrast, referrals or treatment demands for disorders such as autism spectrum disorder or psychosis showed no substantial change or a slight decrease, respectively. According to 69% of respondents, patients experienced the highest psychological burden in January/February/March 2021. Family problems very frequently reported by mental health professionals were parents' worries about loneliness/isolation of the child (49%), child's education and academic future (33%), increased media use due to missing options of recreational activities (37.6%), as well as multiple stresses of mothers (36.3%). To conclude, the pandemic has substantially changed the pattern of disorders and the number of clinical referrals of children and adolescents with mental health problems, which has serious consequences for the treatment supply in Switzerland.
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Werling AM, Walitza S, Eliez S, Drechsler R. The Impact of the COVID-19 Pandemic on Mental Health Care of Children and Adolescents in Switzerland: Results of a Survey among Mental Health Care Professionals after One Year of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063252. [PMID: 35328941 PMCID: PMC8953578 DOI: 10.3390/ijerph19063252] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 01/27/2023]
Abstract
Background: To assess the impact of the COVID-19 pandemic on treatment demand and supply in children and adolescents with mental disorders during the first year of the pandemic from the perspective of child and adolescent psychiatrists and psychologists in Switzerland. Methods: The survey was conducted anonymously, in German or French and online in April/May 2021. Mental health professionals working in child and adolescent psychiatry, psychotherapy services or independent practices were contacted by email. Results: N = 454 professionals completed the survey (176 child and adolescent psychiatrists and 276 psychologists). After an initial period of decreased demand during the lockdown in spring 2020, requests for treatment increased, considerably exceeding the demand pre-pandemic and reaching a peak in January/February/March 2021. The vast majority of professionals (78.2%) estimated that there was currently too little supply during the pandemic, which differed from the evaluation of the pre-pandemic situation (37%). A total of 65% of participants indicated that waiting time until the initiation of treatment increased during the pandemic, 41% reported their current workload to be somewhat higher and 44.5% much higher. Conclusions: For the first pandemic year, youth mental health professionals reported a large increase in the treatment demand and waiting time and a worrisome overload of treatment services.
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Affiliation(s)
- Anna Maria Werling
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, 8032 Zurich, Switzerland; (S.W.); (R.D.)
- Correspondence:
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, 8032 Zurich, Switzerland; (S.W.); (R.D.)
- Swiss Society for Child and Adolescent Psychiatry and Psychotherapy, 3008 Bern, Switzerland;
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057 Zurich, Switzerland
| | - Stephan Eliez
- Swiss Society for Child and Adolescent Psychiatry and Psychotherapy, 3008 Bern, Switzerland;
- Department of Psychiatry, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Renate Drechsler
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, 8032 Zurich, Switzerland; (S.W.); (R.D.)
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Werling AM, Walitza S, Gerstenberg M, Grünblatt E, Drechsler R. Media use and emotional distress under COVID-19 lockdown in a clinical sample referred for internalizing disorders: A Swiss adolescents' perspective. J Psychiatr Res 2022; 147:313-323. [PMID: 35124401 PMCID: PMC8811353 DOI: 10.1016/j.jpsychires.2022.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/19/2021] [Accepted: 01/03/2022] [Indexed: 11/18/2022]
Abstract
The COVID-19 outbreak has profoundly affected adolescents' life. Adolescents with pre-existing psychiatric disorders have been at particular risk of increased mental health problems and problematic media use. 178 patients, aged 12-18 years, referred before the COVID-19 outbreak to child and adolescent psychiatry, participated in an anonymous online survey on the impact of the lockdown on media use and mental well-being. The survey was conducted approximately one month after the first easing of restrictions following a six-week lockdown in Switzerland. Based on self-report, half of the patients had been diagnosed with internalizing disorders (ID; depression or anxiety disorder) and the other half with other disorders (non-ID, e.g. ADHD, autistic spectrum disorder). Patients with ID reported higher emotional distress during the lockdown, and a larger number of patients with ID indicated a deterioration of pre-existing symptoms compared to non-ID patients. Although more patients with ID than with non-ID indicated spending a large amount of time on social media, social media time per day in hours was not significantly higher in ID. Patients with ID indicated a higher impact of media use on well-being and mood in everyday life during the lockdown. Social media time was higher in worsened than in improved non-ID patients, while the opposite was found in ID patients, indicating a possible protective effect of media use at least for some ID patients. The results confirm positive as well as negative associations between mental health, emotional well-being and media use for adolescents with ID during the lockdown.
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Affiliation(s)
- Anna Maria Werling
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland.
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland
| | - Miriam Gerstenberg
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland
| | - Renate Drechsler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland
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Caffo E, Asta L, Scandroglio F. Predictors of mental health worsening among children and adolescents during the coronavirus disease 2019 pandemic. Curr Opin Psychiatry 2021; 34:624-630. [PMID: 34494973 PMCID: PMC8500206 DOI: 10.1097/yco.0000000000000747] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Restrictions put in place to contain the spread of coronavirus disease 2019 (COVID-19) have significantly affected the lives of children and adolescents worldwide. School closure, home confinement and social distancing have the potential to negatively impact the mental health of this population. Several risk factors seem to contribute to worsening mental health of children and adolescents, with an increase of anxiety and depression symptoms. This review aims at exploring research available on risk factors that may worsen the mental health among children and adolescents during the pandemic. RECENT FINDINGS Some of these predictors in worsening the effects are social isolation, screen time and excessive social media use, parental stress and poor parent-child relationship, low socioeconomic status, preexisting mental health conditions and/or disabilities. SUMMARY Further research is needed in order to understand mental health effects of the COVID-19 pandemic, as well as risk factors associated with negative consequences. New findings will help in targeting evidence-based interventions to prevent and mitigate the negative effects of COVID-19 on the mental health of children and adolescents.
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Affiliation(s)
- Ernesto Caffo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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