Mental Health of Children With Attention Deficit and Hyperactivity Disorder and Their Parents During the COVID-19 Lockdown: A National Cross-Sectional Study

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has caused a real disruption of children's lives. Children with neurodevelopmental disorders and their parents seem to be particularly vulnerable to adverse mental health effects due to lockdown policies. This study explores the psychological state of children with Attention Deficit Hyperactivity Disorder (ADHD) and their parents during the first lockdown in France. A national prospective cross-sectional parent-reported study was conducted using an online survey disseminated through different social networks of French ADHD associations during the first lockdown. The survey consisted of open-ended, multiple-choice questions and standardized questionnaires such as the Strengths and Difficulties Questionnaire (SDQ), the coping self-report questionnaire (Brief COPE) and the Patient Health Questionnaire-2 (PHQ-2). A total of 538 parents completed the online survey between the 6th and the 15th of April 2020. These results suggest that most children (65.29%) did not experience a worsening of their behavior but still had pathological levels of hyperactivity (56.47%) and behavioral (57.60%) symptoms at the time of the first lockdown. In addition, some parents (26.27%) showed responses indicating possible major depressive disorder. Positive parental coping strategies were associated with both improved child behavior and fewer parental depressive symptoms. Strengthening parents' coping strategies may be an effective intervention to protect both parents and children with ADHD from the negative psychological effects of lockdown. In times of pandemic, psychological care modalities must evolve to provide quality online interventions for families of children with ADHD.

Patient visits and prescriptions for attention-deficit/hyperactivity disorder from 2017–2021: Impacts of COVID-19 pandemic in primary care

“…A Canadian online survey to caregivers of children with ADHD aged 5-18 years (n = 587 surveys) revealed that during the COVID pandemic, parents reported that their children with ADHD experienced greater ADHD symptoms, depression and anxiety [13]. This finding of worsening ADHD symptoms in children diagnosed with ADHD during the COVID pandemic is consistent with other international studies from China [23] and France [24]. A systematic review of 12 studies (before February 25, 2021) from 9 countries involving 3,028 participants aged 4-27 years diagnosed with ADHD reported increased ADHD symptoms and psychological difficulties during the COVID pandemic [15].…”

The indirect health impacts of the COVID-19 pandemic on children and adolescents: A review

“…The median quality score was 8 (range 3 (Buzzi et al, 2020) to 9 (Bram et al, 2020; Zheng et al, 2020)). Ten studies assessed the mental health outcomes in children and adolescents during COVID-19 (Bobo et al, 2020; Buzzi et al, 2020; Chen et al, 2020; Colizzi et al, 2020; Pınar Senkalfa et al, 2020; Saddik et al, 2020; Saurabh and Ranjan, 2020; Xie et al, 2020; Zheng et al, 2020; Zhou et al, 2020), mostly focused on depression and anxiety rates (Chen et al, 2020; Pınar Senkalfa et al, 2020; Saddik et al, 2020; Xie et al, 2020; Zheng et al, 2020; Zhou et al, 2020). Four studies assessed the impact on vaccination rates (Bramer, 2020; Chandir et al, 2020; McDonald et al, 2020; Santoli et al, 2020) and another four assessed impacts on health care use, including paediatric emergency healthcare department visits (Angoulvant et al, 2020; Bram et al, 2020; Bressan et al, 2020; Li et al, 2020).…”

“…Vulnerable groups. Specific groups of children were examined in three studies (Bobo et al, 2020;Colizzi et al, 2020;Pınar Senkalfa et al, 2020). The first assessed children with cystic fibrosis (CF), and found that they experienced lower levels of anxiety than children without CF (Pınar Senkalfa et al, 2020).…”

Online News Media Portrayal of ADHD on the Websites of BBC and CNN International during the COVID‐19 Pandemic

“…As it was shown in the extract, the term neurodivergent was used interchangeably with mental illness without any explanation. Overall, cnn.com less covered ADHD-related neurodiversity compared to bbc.com as its total neurodiversity score ( 5) is far less than bbc.com's (14). On the other hand, although bbc.com incorporated more neurodiversity frames, it rarely featured the neurodiversity terms such as neurodiverse or neurodivergent.…”

“…Increased adverse outcomes of the infection, higher rates of hospitalization, and mortality from COVID-19 have been associated with ADHD [10]. ADHD as a potential risk factor for COVID-19 infection [11] has been analyzed particularly in terms of the cross-infuence of ADHD and COVID-19, negative efects, and exacerbated symptoms [12][13][14][15]. Another study revealed the efects of digital media use on children and adolescents with ADHD on the core symptoms, worse attention, oppositional defant, behavior and emotional problems, and more self-reported anxiety and depression [16].…”