Perceptions, emotional reactions and needs of adolescent psychiatric inpatients during the COVID-19 pandemic: A qualitative analysis of in-depth interviews

Abstract

Background: The new coronavirus pandemic (COVID-19) has been accompanied by great psychological pressure on the entire population. However, little is known about how this pandemic could affect the more vulnerable population with severe mental illness.Aims: To explore adolescent psychiatric inpatients' perceptions, emotional reactions and needs during the first wave of the COVID-19 pandemic.Methods: Individual in-depth interviews were conducted with nine psychiatric inpatients aged 12-17 years. Five themes were initiated by interviewers through open-ended questions: (1) knowledge about the coronavirus pandemic, (2) changes in everyday routine, (3) feelings about the pandemic, (4) helpful thoughts and behaviors, and (5) practices of helping adolescents with their difficulties concerning the pandemic. A thematic analysis was conducted using line-by-line open coding.Results: Regarding their knowledge about the impact of the current pandemic, almost all adolescents focused on information about the nature of coronavirus and existing crisis management practices. Nearly all patients identified mainly negative changes due to the quarantine state, such as restrictions on social life and personal freedom, and excessive contact with family members during home isolation. With regard to their feelings, they acknowledged anxiety about harm to self and beloved ones, mood changes within the family nucleus, the unknown, and the management of the pandemic in other countries. Avoiding thought rumination about the coronavirus and its consequences, focusing on the positive, and looking into and towards the future were reported as helpful strategies for coping with difficult feelings. Additionally, a sense of belongingness insofar as they are not alone and share a common experience, seems central to the adolescents' arsenal of coping strategies. Confidence in the authorities and the community was another particularly interesting point that emerged during the interviews. Last, our findings indicated adolescents' benefit from receiving balanced health messaging, in addition to balanced thinking within their social and family environment.Conclusions: Better comprehension of possible mediating psychological pathways is needed in order to help clinicians, researchers and decision-makers develop psychosocial support interventions, to prevent the deterioration of mental disorders and overall functioning, as well as additional stress-related disorders.

The impact ofCOVID‐19 lockdown on children's and adolescents' mental health in Greece

“…An online survey of 442 Greek senior high school students conducted in April 2020 revealed a rise in depression and anxiety levels in the time of home confinement (Giannopoulou et al, 2021 ). A qualitative study investigating the impact of the pandemic through individual interviews with nine psychiatric inpatient adolescents in a paediatric hospital in Athens reported anxiety about harm to self and beloved ones (Giannakopoulos et al, 2020 ).…”

Impact of the COVID-19 Pandemic on the Experiences of Hospitalized Patients: A Scoping Review

“…Regarding the identification of feelings experienced during hospitalization, 71.9% (n = 23) of the articles indicated that the patients and family members experienced difficult moments 47 during the hospitalization period, with feelings of loneliness 16,17,21,31 and isolation 16,17,21,29,31,40,41 due to the restrictions regarding visits and companions and a lack of contact between professionals and patients. 20 Feelings such as sadness, 23,26,46 fear, 17,18,20,22,[24][25][26][27][28][29]32,33,46 anxiety, 17,22,28,38,41,46 worry, 17,[20][21][22][23][24]32,33,46 nervousness, 22 guilt, 26,46 anger, 23,…”

“…25 As for welcoming of the team during hospitalization, 68.8% (n = 22) of the articles addressed how the team was treated, highlighting attitudes of kindness, 17,31 empathy, 17,28 courtesy, 25 respect, 25,45 sympathy, 28,29 understanding, 29 compassion, 31 professionalism, 24,31 communication, 21 and attention and patience. 34 Attitudes like these were associated with an improvement in the patients' state of mind 17 and with a sense of security, 18,23,46 making a difference to patient satisfaction. [28][29][30][31] Furthermore, in one of the studies, 94.7% of the patients reported having received support from the maternity team.…”

“…Voice and video calls were described as a way of relieving the stress felt by absence of the family, 17,33 as well as reducing anxiety and isolation. 23,24 However, it was also reported that feelings such as uncertainty and sadness remained, even with the communication strategies. 46 The use of online games, 18 virtual reality, 36 telephone, 24 and television 29 was associated with the feeling of escape from reality, increasing comfort through contact with an environment other than the hospital.…”

A Qualitative Serial Analysis of Drawings by Thirteen-to Fifteen-Year-Old Adolescents in Sweden About the First Wave of the Covid-19 Pandemic

“…While studies relating to psychosocial effects of the pandemic on children and adolescents are prolific and continually increasing (see Chawla et al, 2021; Meherali et al, 2021), there are still notable knowledge gaps. Many studies are limited to needs of a specific group, often those with particular morbidities or life-situations (see Giannakopoulos et al, 2021; Mirlashari et al, 2021; Sharma et al, 2020; Tse et al, 2021). In addition, only a minority of studies are based on data generated directly by children or adolescents, with most instead relying on proxy reports from teachers, parents and other sources (Berasategi Sancho et al, 2021; Evans et al, 2020; Ferrari et al, 2021; Ferraro et al, 2021; Fitzpatrick et al, 2020).…”