1
|
Wendel F, Bender S, Breitinger E, Coenen M, Hummel J, Immich G, Kirschneck M, Klünder V, Kunzler AM, Lieb K, Movsisyan A, Li LY, Ravens-Sieberer U, Rehfuess E, Voss S, Jung-Sievers C. 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. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02280-y. [PMID: 37573565 DOI: 10.1007/s00787-023-02280-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
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.
Collapse
Affiliation(s)
- Flora Wendel
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany.
- Pettenkofer School of Public Health, Munich, Germany.
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Eva Breitinger
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Julia Hummel
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Gisela Immich
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Michaela Kirschneck
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Vera Klünder
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Angela M Kunzler
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Institute for Evidence in Medicine, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Ani Movsisyan
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Lydia Y Li
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Stephan Voss
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Caroline Jung-Sievers
- Institute for Medical Information Processing, Biometry and Epidemiology IBE, Faculty of Medicine, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| |
Collapse
|
2
|
Burkhart K, Agarwal N, Kim S, Neudecker M, Ievers-Landis CE. A Scoping Review of Trauma-Informed Pediatric Interventions in Response to Natural and Biologic Disasters. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1017. [PMID: 37371249 DOI: 10.3390/children10061017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/23/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
A scoping review was performed of trauma-informed psychological interventions to treat anxiety, depression, and posttraumatic stress symptoms in youth in response to natural/biologic disasters. The specific aims were to identify psychosocial interventions used in response to natural/biologic disasters, report the interventions' effectiveness, describe limitations, and provide treatment recommendations and future directions. Of the 45 studies extracted, 28 were on natural disasters and 17 on biologic disasters with the majority related to the COVID-19 pandemic. The most commonly implemented interventions were Cognitive Behavioral Therapy (CBT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and eye movement desensitization and reprocessing (EMDR). The UCLA Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI) and the Strengths and Difficulties Questionnaire (SDQ) were the most frequently used measures. Methodological rigor was varied, with 60% randomized, controlled trials. Overall, there was a significant decrease in posttraumatic stress symptoms, distress, anxiety, and depression regardless of whether the participant received CBT, TF-CBT, or EMDR. Generally, there was not a significant decrease in anxiety and depression with yoga, cognitive fear-reduction, emotion-based drawing, and community health education. Recommendations for future directions include larger-scale studies with group and on-line interventions that include younger children with moderation analyses by gender and race/ethnicity.
Collapse
Affiliation(s)
- Kimberly Burkhart
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, 10524 Euclid Ave., Cleveland, OH 44106, USA
| | - Neel Agarwal
- Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA
| | - Sehyun Kim
- Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA
| | - Mandy Neudecker
- Rainbow Babies and Children's Hospital, 1100 Euclid Ave., Cleveland, OH 44106, USA
| | - Carolyn E Ievers-Landis
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, 10524 Euclid Ave., Cleveland, OH 44106, USA
| |
Collapse
|
3
|
Adithy A, Emily de Wit E, Bunders-Aelen J. EMDR in the Time of the COVID-19 Pandemic in India: A Short Report. JOURNAL OF EMDR PRACTICE AND RESEARCH 2022. [DOI: 10.1891/emdr-2021-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
During the period of COVID-19 pandemic from the start of 2020 till late 2021, mental health services—seeking and providing—have gone through various changes and adaptations. In this article, we report on EMDR psychotherapy service providers in India, and how they adapted to the changing circumstances during this time, using a narrative enquiry approach.
Collapse
|