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Kaman A, Devine J, Wirtz MA, Erhart M, Boecker M, Napp AK, Reiss F, Zoellner F, Ravens-Sieberer U. Trajectories of mental health in children and adolescents during the COVID-19 pandemic: findings from the longitudinal COPSY study. Child Adolesc Psychiatry Ment Health 2024; 18:89. [PMID: 39026337 PMCID: PMC11264697 DOI: 10.1186/s13034-024-00776-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 07/01/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Mental health and health-related quality of life (HRQoL) in children and adolescents deteriorated during the COVID-19 pandemic. The aim of this population-based longitudinal study was to explore whether distinct mental health trajectories in youths can be identified over the course of the pandemic. METHODS Mental health problems (MHP), psychosomatic symptoms and HRQoL were assessed at five time points between May 2020 and October 2022 in 744 children and adolescents aged 7 to 20 years using established instruments. We used generalized mixture modeling to identify distinct mental health trajectories and fixed-effects regressions to analyse covariates of the identified profiles of change. RESULTS We found five distinct linear latent trajectory classes each for externalising MHP and psychosomatic symptoms and four trajectory classes for internalising MHP. For HRQoL, a single-class solution that indicates a common development process proved to be optimal. The largest groups remained almost stable at a low internalising and externalising symptom level (64 to 74%) and consistently showed moderate psychosomatic symptoms (79%), while 2 to 18% showed improvements across the pandemic. About 10% of the youths had consistently high internalising problems, while externalising problems deteriorated in 18% of youths. Class membership was significantly associated with initial HRQoL, parental and child burden, personal resources, family climate and social support. CONCLUSIONS The mental health of most children and adolescents remained resilient throughout the pandemic. However, a sizeable number of youths had consistently poor or deteriorating mental health. Those children and adolescents need special attention in schools and mental health care.
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Affiliation(s)
- Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Janine Devine
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Markus Antonius Wirtz
- Department of Research Methods, Freiburg University of Education, Freiburg im Breisgau, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Alice Salomon University of Applied Science, Berlin, Germany
| | - Maren Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital, Aachen, Germany
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany
| | - Ann-Kathrin Napp
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fionna Zoellner
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Chang TM, Chen Y, Yang KD, Wang JY, Lin CY, Chang YJ, Chen CH, Tsai YG. Asthma control associated with anxiety and depression in asthmatic children following post-acute COVID-19. Pediatr Allergy Immunol 2024; 35:e14168. [PMID: 38873913 DOI: 10.1111/pai.14168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Poor asthma control may adversely affect mental health. Our study investigates the correlation between inadequate asthma control, exhaled nitric oxide (FENO) levels, and anxiety and depression among pediatric asthma patients with COVID-19. METHODS This prospective case-control study enrolled 520 asthmatic children (8-15 years), including 336 patients diagnosed with COVID-19 after rapid antigen testing at home and 184 age-matched asthmatic patients without COVID-19 infection. FENO and spirometry were performed 1 month after COVID-19 infection. Scores for Child Anxiety-Related Disorders (SCARED) and depression screen derived from Patient Health Questionnaire-9 (PHQ-9) to assess their mental health status. Childhood asthma control test (C-ACT), FENO levels, and spirometry were correlated with the SCARED and PHQ-9 questionnaires. RESULTS SCARED subscales, including generalized anxiety disorder, social anxiety disorder, school avoidance, and depression scores from PHQ-9, exhibited a significant increase in asthmatic patients diagnosed with COVID-19 (p < .05). Among asthmatic children with SARS-CoV-2 infection, the poor asthma control group exhibited the highest SCARED and PHQ-9 measurements (p < .01). Multiple linear regression analysis indicated that reduced C-ACT scores and elevated FENO levels in asthmatic children with COVID-19 were significant risk factors for both anxiety and depression scores (p < .05). Lower C-ACT scales were associated with high scores of SCARED (r = -0.471) and PHQ-9 (r = -0.329) in asthmatic children (p < .001). CONCLUSIONS The current study emphasizes the need for healthcare professionals to closely monitor asthma control in asthmatic children to prevent heightened risks of depression and anxiety during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Tung-Ming Chang
- Department of Pediatrics, Changhua Christian Children's Hospital, Changhua, Taiwan
- Child Development Center, Changhua Christian Children's Hospital, Changhua, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Yun Chen
- Child Development Center, Changhua Christian Children's Hospital, Changhua, Taiwan
| | - Kuender D Yang
- Department of Pediatrics, Mackay Memorial Hospital, New Taipei City, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jiu-Yao Wang
- Allergy, Immunology, and Microbiome (A.I.M.) Research Center, China Medical University, Taichung, Taiwan
- Department of Allergy, Immunology and Rheumatology, China Medical University Children's Hospital, Taichung, Taiwan
| | - Ching-Yuang Lin
- Department of Allergy, Immunology and Rheumatology, China Medical University Children's Hospital, Taichung, Taiwan
- Clinical Immunological Center, Division of Pediatric Nephrology, China Medical University Children's Hospital, Taichung, Taiwan
| | - Yu-Jun Chang
- Epidemiology and Biostatistics and Big Data Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Chang-Hua Chen
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Internal Medicine, Division of Infectious Diseases, Changhua Christian Hospital, Changhua, Taiwan
| | - Yi-Giien Tsai
- Department of Pediatrics, Changhua Christian Children's Hospital, Changhua, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- School of Medicine, Kaohsiung Medical University, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Orban E, Li LY, Gilbert M, Napp AK, Kaman A, Topf S, Boecker M, Devine J, Reiß F, Wendel F, Jung-Sievers C, Ernst VS, Franze M, Möhler E, Breitinger E, Bender S, Ravens-Sieberer U. Mental health and quality of life in children and adolescents during the COVID-19 pandemic: a systematic review of longitudinal studies. Front Public Health 2024; 11:1275917. [PMID: 38259801 PMCID: PMC10800626 DOI: 10.3389/fpubh.2023.1275917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
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.
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Affiliation(s)
- Ester Orban
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Li
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ann-Kathrin Napp
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sabine Topf
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maren Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Child and Adolescent Psychiatry, Child Neuropsychology Section, University Hospital RWTH Aachen, Aachen, Germany
| | - Janine Devine
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiß
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Flora Wendel
- Faculty of Medicine, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Caroline Jung-Sievers
- Faculty of Medicine, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Vanessa Sophie Ernst
- Institute for Community Medicine, Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Marco Franze
- Institute for Community Medicine, Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Eva Möhler
- Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Eva Breitinger
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Jing X, Meng H, Li Y, Lu L, Yao Y. Associations of Psychological Capital, Coping Style and Emotional Intelligence with Self-Rated Health Status of College Students in China During COVID-19 Pandemic. Psychol Res Behav Manag 2022; 15:2587-2597. [PMID: 36133628 PMCID: PMC9482953 DOI: 10.2147/prbm.s383743] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022] Open
Abstract
Background COVID-19 lockdown can lead to mental health problem, and the problem is heterogeneous across individuals. In this study, we aimed to explore the association between the self-reported health status, emotional coping style, emotional intelligence and positive psychological state of college students during the COVID-19 pandemic in China. Methods The questionnaires of Self-rated Health Measurement Scale (SRHMS), Emotional Intelligence Scale (EIS), Psychological Capital Questionnaire (PCQ), Simplified Coping Style Questionnaire (SCSQ) were used for online survey. The study included 367 undergraduates. Results Undergraduate sex, sibling and birth of place were associated with either psychological capital scores or emotional intelligence. Online time per day had significantly negative associations with self-rated health and psychological capital scores. Multivariate analysis showed that the interaction between emotional intelligence, psychological capital and coping styles was statistically significant (β = −0.112, p = 0.045) in health status with psychological capital ranking the top (β = 0.428). Mediation analysis showed that psychological capital and coping style modified the effect of emotional intelligence on health status. Conclusion Psychological capital and coping style modified the effect of emotional intelligence on health status in college students during the COVID-19 pandemic. In this pandemic emergency, a comprehensive intervention, such as positive coping styles with optimistic emotional perception and understanding as well as social support, is an important measure against the pandemic-induced mental health problem in college students in China.
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Affiliation(s)
- Xiangzhi Jing
- School of Medicine, Xinyang Vocational and Technical College, Xinyang, People's Republic of China
| | - Hongling Meng
- School of Mathematics and Statistics, Zhengzhou Normal University, Zhengzhou, People's Republic of China
| | - Yuping Li
- School of Mathematics and Statistics, Zhengzhou Normal University, Zhengzhou, People's Republic of China
| | - Lingeng Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, School of Medicine, Yale University, New Haven, CT, USA
| | - Yongcheng Yao
- School of Mathematics and Statistics, Zhengzhou Normal University, Zhengzhou, People's Republic of China
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