The effects of COVID-19 on child mental and social health: biannual assessments up to April 2022 in a clinical and two general population samples

Abstract

Background The COVID-19 pandemic has had an acute impact on child mental and social health, but long-term effects are still unclear. We examined how child mental health has developed since the start of the COVID-19 pandemic up to two years into the pandemic (April 2022). Methods We included children (age 8-18) from two general population samples (N = 222-1,333 per measurement and N = 2,401-13,362 for pre-covid data) and one clinical sample receiving psychiatric care (N = 334-748). Behavioral questionnaire data were assessed five times from April 2020 till April 2022 and pre-pandemic data were available for both general population samples. We collected parent-reported data on internalizing and externalizing problems with the Brief Problem Monitor and self-reported data on Anxiety, Depressive symptoms, Sleep-related impairments, Anger, Global health, and Peer relations with the Patient-Reported Outcomes Measurement Information System (PROMIS). Results In all samples, parents reported overall increased internalizing problems, but no increases in externalizing problems, in their children. Children from the general population self-reported increased mental health problems from before to during the pandemic on all six PROMIS domains, with generally worst scores in April 2021, and scores improving towards April 2022 but not to pre-pandemic norms. Children from the clinical sample reported increased mental health problems throughout the pandemic, with generally worst scores in April 2021 or April 2022 and no improvement. We found evidence of minor age effects and no sex effects. Conclusions Child mental health in the general population has deteriorated during the first phase of the COVID-19 pandemic, has improved since April 2021, but has not yet returned to pre-pandemic levels. Children in psychiatric care show worsening of mental health problems during the pandemic, which has not improved since. Changes in child mental health should be monitored comprehensively to inform health care and policy.

Changes in child and adolescent mental health across the COVID-19 pandemic (2018-2023): Insights from general population and clinical samples in the Netherlands

“…Children also reported increased mental health problems post-pandemic, especially in anxiety and depression, to a lesser extent in sleep-related impairment and global health, and least in anger. Thus, the previously observed trend towards pre-pandemic levels of mental health (Zijlmans et al, 2023; Deng et al, 2023) did not continue in our samples. These findings can be interpreted in several ways.…”

“…The Dutch consortium Child and Adolescent Mental Health and WellBeing in times of the COVID-19 pandemic (CAMHWB-19) studied two general population samples and one clinical sample of (parents of) children aged 8-18 years. We previously reported on the first five pandemic time points of this study, ranging from April 2020 to April 2022 (Zijlmans et al 2023). More details on the two general population samples, (the Netherlands Twin Register (NTR) and the KLIK group which collected samples using an online panel agency), as well as the clinical sample of children receiving psychiatric care, DREAMS (Dutch REsearch in child and Adolescent Mental health), can be found in this previous report (Zijlmans et al 2023).…”

“…Here, we aimed to extend our findings and assess whether the observed trend towards pre-pandemic levels of mental health in the general population (Zijlmans et al 2023), and the observed increase in internalizing mental health problems in children in psychiatric care has continued, halted, or reversed. Therefore, we collected mental health data at two additional post-pandemic time points (November/December 2022 and March/April 2023) in children from the general population and in children receiving psychiatric care and compared these with data from before the COVID-19 pandemic.…”

“…Previously, we examined the trajectory of child mental health in three large clinical or general population samples from the start of the COVID-19 pandemic up to two years into it (Zijlmans et al 2023). Our findings showed that in the general population in particular internalizing mental problems were most prevalent during the initial year, had since started to improve, but had not yet returned to pre-pandemic levels by April 2022.…”

The impact of the COVID-19 pandemic on psychiatric emergency consultations in adolescents

“…In literature, the impact of the pandemic on externalizing symptoms is not clear. Some studies found no changes in externalizing problems [30,31] or substance abuse [32], others found pre-existing ADHD symptoms to worsen during the lockdown [33]. However, more parental supervision may have enabled some families to cope with adolescents with externalizing problems in the home situation, thereby reducing the number of emergency interventions needed.…”