Risks and Protective Factors Associated With Mental Health Symptoms During COVID-19 Home Confinement in Italian Children and Adolescents: The #Understandingkids Study

Abstract

Objective: To identify risk and protective factors for mental health symptoms associated with lifestyle changes caused by home confinement in pediatric subjects and in children and adolescents with a neuropsychiatric disorder.Study design: This was a prospective, cross-sectional study conducted from May 10 to May 31, 2020. Two online anonymous surveys were developed: population-based and clinical-based (children with neuropsychiatric disorders). Outcomes included emotional and behavioral symptoms, as assessed by psychometric scales (BPSC, PPSC, PSC, CES-DC and SCARED, respectively), and lifestyle changes during home confinement (i.e., physical activity, screen time, home schooling, reading).Results: The sample included 9,688 pediatric subjects, and 289 children and adolescents with a neuropsychiatric disorder. The presence of siblings was a protective factor in all ages. In pre- and school children: male sex, a diagnosis of autism, residency in highly affected areas, high parental educational level or job loss, and screen time (>2 h/day) were risk factors. Physical activity, home-schooling, reading, talking with other people were protective factors. Residency in highly affected areas, a diagnosis of mood disorder, parental job loss, and screen time, were associated with a worsening of the depressive symptoms, whereas physical activity, talking with other people, playing with parents were protective activities. Screen time was also a risk factor for anxiety symptoms, while physical activity, reading and talking with other people were protective factors.Conclusions: This study identified risk and protective factors for mental health symptoms associated with lifestyle changes caused by COVID-19 home confinement to promote mental well-being in pediatrics during pandemic times.

Stress-related psychopathology during the COVID-19 pandemic

“…Despite these challenges, higher levels of social support have been consistently associated with better mental health outcomes during the pandemic. Lower levels of depression and anxiety symptoms have been observed in adults who report higher levels of social support ( Grey et al, 2020 ; Özmete & Pak, 2020 ) and in children and adolescents who reported higher levels of social connectedness and spent more time talking to others during the early phase of the pandemic ( Magson et al, 2021 ; Oliva et al, 2021 ). A stress buffering role of social support has also been reported in several studies during the pandemic.…”

“…Parental support, in particular, has emerged as an important protective factor for both youths and young adults. The association of pandemic-related stressors with internalizing and externalizing problems was lower in young adults who experienced higher levels of parental support and had lower levels of parent-child conflict prior to the pandemic ( Skinner et al, 2021 ) and in children and adolescents who spent more time with their parents ( Oliva et al, 2021 ), who experienced lower conflict with parents ( Qu et al, 2021 ), and whose parents used more emotion coaching strategies ( Cohodes et al, 2021 ). Together these studies suggest that social support and connection are important protective factors that have the potential to facilitate resilience during the pandemic.…”

“…Higher engagement in physical activity is associated directly with better mental health and lower likelihood of developing stress-related mental health problems ( Ren, He, Bian, Shang, & Liu, 2021 ; Silva Moreira et al, 2021 ; Zhang, Zhang, Ma, & Di, 2020 ). Screen time use has increased dramatically among youth during the pandemic and has been linked to increases in mental health problems ( Nagata et al, 2021 ; Oliva et al, 2021 ). Conversely, the association between pandemic-related stressors and internalizing problems was reduced in children and adolescents who had low levels of passive screen time use and reduced consumption of news media about the pandemic ( Rosen et al, 2021 ).…”

Social Media Interventions Strengthened COVID-19 Immunization Campaign

“…Furthermore, there is now mounting evidence of persisting symptoms in children following acute Sars-Cov-2 infection, which has been named Long COVID, and studies that highlight how lifestyle changes during the COVID-19 pandemic have had a significant psychological impact on the pediatric population ( 3 , 4 ).…”

COVID-19 and Youth Psychopathological Distress in Umbria, Central Italy: A 2-Year Observational Study in a Real-World Setting

“…Lockdown measures had an unfavorable impact on adolescents and young adults, and a large amount of literature highlighted a greater risk for the occurrence of psychiatric symptoms due to a change in their lifestyles and habits ( 11 ) as well as lower levels of post-traumatic growth ( 12 ). For instance, the closure of schools has imposed distance learning as an alternative to maintain continuity in the education of children and adolescents ( 13 ). The subsequent prolonged social isolation threatened the psycho-physical wellbeing of youths, worsening or unmasking psychopathology ( 14 ).…”