Mostly worse, occasionally better: impact of COVID-19 pandemic on the mental health of Canadian children and adolescents

Feb 27, 2021European child & adolescent psychiatry

COVID-19 pandemic's mostly negative but sometimes positive effects on the mental health of Canadian children and teens

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Abstract

67-70% of children/adolescents experienced deterioration in at least one mental health domain during the first wave of COVID-19.

A significant proportion, 19-31%, of children/adolescents reported improvement in at least one mental health domain.
Deterioration in mental health was observed across various age groups and was more pronounced in those with pre-existing psychiatric diagnoses.
Rates of deterioration varied by mental health domain: depression (37-56%), anxiety (31-50%), irritability (40-66%), attention (40-56%), hyperactivity (23-56%), and obsessions/compulsions (13-30%).
Increased stress from social isolation was linked to deterioration in all assessed mental health domains.
Economic concerns were associated with improvements in anxiety, attention, and obsessions/compulsions.
The impact of pre-existing psychiatric diagnoses was mixed, causing deterioration in some domains for certain children while also leading to improvements in others.

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This large cross-sectional study examined the impact of COVID-19 emergency measures on child/adolescent mental health for children/adolescents with and without pre-existing psychiatric diagnoses. Using adapted measures from the CRISIS questionnaire, parents of children aged 6-18 (N = 1013; 56% male; 62% pre-existing psychiatric diagnosis) and self-reporting children/adolescents aged 10-18 (N = 385) indicated changes in mental health across six domains: depression, anxiety, irritability, attention, hyperactivity, and obsessions/compulsions. Changes in anxiety, irritability, and hyperactivity were calculated for children aged 2-5 years using the Strengths and Difficulties Questionnaire. COVID-19 exposure, compliance with emergency measures, COVID-19 economic concerns, and stress from social isolation were measured with the CRISIS questionnaire. Prevalence of change in mental health status was estimated for each domain; multinomial logistic regression was used to determine variables associated with mental health status change in each domain. Depending on the age group, 67-70% of children/adolescents experienced deterioration in at least one mental health domain; however, 19-31% of children/adolescents experienced improvement in at least one domain. Children/adolescents without and with psychiatric diagnoses tended to experience deterioration during the first wave of COVID-19. Rates of deterioration were higher in those with a pre-exiting diagnosis. The rate of deterioration was variable across different age groups and pre-existing psychiatric diagnostic groups: depression 37-56%, anxiety 31-50%, irritability 40-66%, attention 40-56%, hyperactivity 23-56%, obsessions/compulsions 13-30%. Greater stress from social isolation was associated with deterioration in all mental health domains (all ORs 11.12-55.24). The impact of pre-existing psychiatric diagnosis was heterogenous, associated with deterioration in depression, irritability, hyperactivity, obsession/compulsions for some children (ORs 1.96-2.23) but also with improvement in depression, anxiety, and irritability for other children (ORs 2.13-3.12). Economic concerns were associated with improvement in anxiety, attention, and obsessions/compulsions (ORs 3.97-5.57). Children/adolescents with and without pre-existing psychiatric diagnoses reported deterioration. Deterioration was associated with increased stress from social isolation. Enhancing social interactions for children/adolescents will be an important mitigation strategy for current and future COVID-19 waves.

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Mostly worse, occasionally better: impact of COVID-19 pandemic on the mental health of Canadian children and adolescents

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