Quality of life and mental health in children and adolescents during the first year of the COVID-19 pandemic: results of a two-wave nationwide population-based study

European Child & Adolescent Psychiatry - Tập 32 - Trang 575-588 - 2021
Ulrike Ravens-Sieberer1, Anne Kaman1, Michael Erhart1,2,3, Christiane Otto1, Janine Devine1,4, Constanze Löffler1, Klaus Hurrelmann5, Monika Bullinger6, Claus Barkmann1, Nico A. Siegel7, Anja M. Simon7, Lothar H. Wieler8, Robert Schlack9, Heike Hölling9
1Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
2Alice Salomon University of Applied Sciences, Berlin, Germany
3Apollon University of Applied Sciences, Bremen, Germany
4Argora Clinic, Psychosomatic Clinic and Outpatient Center, Berlin, Germany
5Hertie School, Berlin, Germany
6Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
7Infratest dimap, Berlin, Germany
8Robert Koch Institute, Berlin, Germany
9Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany

Tóm tắt

The COVID-19 pandemic has disrupted the lives of children and adolescents worldwide. The German COPSY study is among the first population-based longitudinal studies to examine the mental health impact of the pandemic. The objective of the study was to assess changes in health-related quality of life (HRQoL) and mental health in children and adolescents and to identify the associated risk and resource factors during the pandemic. A nationwide longitudinal survey was conducted with two waves during the pandemic (May/June 2020 and December 2020/January 2021). In total, n = 1923 children and adolescents aged 7 to 17 years and their parents participated (retention rate from wave 1 to wave 2: 85%). The self-report and parent-proxy surveys assessed HRQoL (KIDSCREEN-10), mental health problems (SDQ with the subscales emotional problems, conduct problems, hyperactivity, and peer problems), anxiety (SCARED), depressive symptoms (CES-DC, PHQ-2) and psychosomatic complaints (HBSC-SCL). Mixed model panel regression analyses were conducted to examine longitudinal changes in mental health and to identify risk and resource factors. The HRQoL of children and adolescents decreased during the pandemic, and emotional problems, peer-related mental health problems, anxiety, depressive and psychosomatic symptoms increased over time, however the change in global mental health problems from wave 1 to wave 2 was not significant, and some changes were negligible. Socially disadvantaged children and children of mentally burdened parents were at particular risk of impaired mental health, while female gender and older age were associated with fewer mental health problems. A positive family climate and social support supported the mental health of children and adolescents during the pandemic. Health promotion, prevention and intervention strategies could support children and adolescents in coping with the pandemic and protect and maintain their mental health.

Tài liệu tham khảo

Fore HH (2020) A wake-up call: COVID-19 and its impact on children’s health and wellbeing. Lancet Glob Health 8(7):e861–e862. https://doi.org/10.1016/S2214-109X(20)30238-2 Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S (2021) Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a meta-analysis. JAMA Pediatr. https://doi.org/10.1001/jamapediatrics.2021.2482 Ma L, Mazidi M, Li K, Li Y, Chen S, Kirwan R, Zhou H, Yan N, Rahman A, Wang W, Wang Y (2021) Prevalence of mental health problems among children and adolescents during the COVID-19 pandemic: a systematic review and meta-analysis. J Affect Disord 293:78–89. https://doi.org/10.1016/j.jad.2021.06.021 Ravens-Sieberer U, Kaman A, Erhart M, Devine J, Schlack R, Otto C (2021) Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. Eur Child Adolesc Psychiatry. https://doi.org/10.1007/s00787-021-01726-5 Lee J (2020) Mental health effects of school closures during COVID-19. Lancet Child Adolesc Health 4(6):421–421. https://doi.org/10.1016/S2352-4642(20)30109-7 Thomas EY, Anurudran A, Robb K, Burke TF (2020) Spotlight on child abuse and neglect response in the time of COVID-19. Lancet Public Health 5(7):e371 Amerio A, Brambilla A, Morganti A, Aguglia A, Bianchi D, Santi F, Costantini L, Odone A, Costanza A, Signorelli C, Serafini G, Amore M, Capolongo S (2020) COVID-19 lockdown: housing built environment’s effects on mental health. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph17165973 Holmes EA, O’Connor RC, Perry VH, Tracey I, Wessely S, Arseneault L, Ballard C, Christensen H, Cohen Silver R, Everall I, Ford T, John A, Kabir T, King K, Madan I, Michie S, Przybylski AK, Shafran R, Sweeney A, Worthman CM, Yardley L, Cowan K, Cope C, Hotopf M, Bullmore E (2020) Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry 7(6):547–560. https://doi.org/10.1016/S2215-0366(20)30168-1 Bignardi G, Dalmaijer ES, Anwyl-Irvine AL, Smith TA, Siugzdaite R, Uh S, Astle DE (2020) Longitudinal increases in childhood depression symptoms during the COVID-19 lockdown. Arch Dis Child 106(8):791–797. https://doi.org/10.1136/archdischild-2020-320372 Waite P, Pearcey S, Shum A, Raw JAL, Patalay P, Creswell C (2021) How did the mental health symptoms of children and adolescents change over early lockdown during the COVID-19 pandemic in the UK? JCPP Adv 1:e12009. https://doi.org/10.1111/jcv2.12009 Hawes MT, Szenczy AK, Olino TM, Nelson BD, Klein DN (2021) Trajectories of depression, anxiety and pandemic experiences; a longitudinal study of youth in New York during the Spring-Summer of 2020. Psychiatry Res 298:113778. https://doi.org/10.1016/j.psychres.2021.113778 Otto C, Reiss F, Voss C, Wüstner A, Meyrose A-K, Hölling H, Ravens-Sieberer U (2020) Mental health and well-being from childhood to adulthood: design, methods and results of the 11-year follow-up of the BELLA study. Eur Child Adolesc Psychiatry. https://doi.org/10.1007/s00787-020-01630-4 Moor I, Winter K, Bilz L, Bucksch J, Finne E, John N, Kolip P, Paulsen L, Ravens-Sieberer U, Schlattmann M, Sudeck G, Brindley C, Kaman A, Richter M (2020) The 2017/18 Health Behaviour in School-aged Children (HBSC) study: Methodology of the World Health Organization’s child and adolescent health study. J Health Monit 5(3):88–102. https://doi.org/10.25646/6904 Brauns H, Scherer S, Steinmann S (2003) The CASMIN educational classification in international comparative research. In: Hoffmeyer-Zlotnik J, Wolf C (eds) Advances in cross-national comparison: a European working book for demographic and socio-economic variables. Springer, Boston, pp 221–244. https://doi.org/10.1007/978-1-4419-9186-7_11 Krause KR, Chung S, Adewuya AO, Albano AM, Babins-Wagner R, Birkinshaw L, Brann P, Creswell C, Delaney K, Falissard B, Forrest CB, Hudson JL, Ishikawa S-i, Khatwani M, Kieling C, Krause J, Malik K, Martínez V, Mughal F, Ollendick TH, Ong SH, Patton GC, Ravens-Sieberer U, Szatmari P, Thomas E, Walters L, Young B, Zhao Y, Wolpert M (2021) International consensus on a standard set of outcome measures for child and youth anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder. Lancet Psychiatry 8(1):76–86. https://doi.org/10.1016/S2215-0366(20)30356-4 Ravens-Sieberer U, The European KIDSCREEN Group (2006) The KIDSCREEN Questionnaires quality of life questionnaires for children and adolescents: handbook. Pabst Science Publisher, Lengerich Ravens-Sieberer U, Auquier P, Erhart M, Gosch A, Rajmil L, Bruil J, Power M, Duer W, Cloetta B, Czemy L, Mazur J, Czimbalmos A, Tountas Y, Hagquist C, Kilroe J (2007) The KIDSCREEN-27 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Q Life Res 16(8):1347–1356. https://doi.org/10.1007/s11136-007-9240-2 Ravens-Sieberer U, Erhart M, Rajmil L, Herdman M, Auquier P, Bruil J, Power M, Duer W, Abel T, Czemy L, Mazur J, Czimbalmos A, Tountas Y, Hagquist C, Kilroe J (2010) Reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents’ well-being and health-related quality of life. Q Life Res 19(10):1487–1500. https://doi.org/10.1007/s11136-010-9706-5 Ravens-Sieberer U, Gosch A, Rajmil L, Erhart M, Bruil J, Power M, Duer W, Auquier P, Cloetta B, Czemy L, Mazur J, Czimbalmos A, Tountas Y, Hagquist C, Kilroe J (2008) The KIDSCREEN-52 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Value Health 11(4):645–658. https://doi.org/10.1111/j.1524-4733.2007.00291.x Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38(5):581–586. https://doi.org/10.1111/j.1469-7610.1997.tb01545.x Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40(11):1337–1345. https://doi.org/10.1097/00004583-200111000-00015 Woerner W, Becker A, Rothenberger A (2004) Normative data and scale properties of the German parent SDQ. Eur Child Adolesc Psychiatry 13:3–10. https://doi.org/10.1007/s00787-004-2002-6 Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S, Baugher M (1999) Psychometric properties of the screen for child anxiety related emotional disorders (SCARED): a replication study. J Am Acad Child Adolesc Psychiatry 38(10):1230–1236. https://doi.org/10.1097/00004583-199910000-00011 Barkmann C, Erhart M, Schulte-Markwort M, The BELLA Study Group (2008) The German version of the centre for epidemiological studies depression scale for children: psychometric evaluation in a population-based survey of 7 to 17 years old children and adolescents - results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl 1):116–124. https://doi.org/10.1007/s00787-008-1013-0 Kroenke K, Spitzer RL, Williams JB (2003) The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care 41(11):1284–1292. https://doi.org/10.1097/01.Mlr.0000093487.78664.3c Löwe B, Kroenke K, Gräfe K (2005) Detecting and monitoring depression with a two-item questionnaire (PHQ-2). J Psychosom Res 58(2):163–171. https://doi.org/10.1016/j.jpsychores.2004.09.006 Haugland S, Wold B (2001) Subjective health complaints in adolescence—reliability and validity of survey methods. J Adolesc 24(5):611–624. https://doi.org/10.1006/jado.2000.0393 Ravens-Sieberer U, Erhart M, Torsheim T, Hetland J, Freeman J, Danielson M, Thomas C (2008) An international scoring system for self-reported health complaints in adolescents. Eur J Public Health 18(3):294–299. https://doi.org/10.1093/eurpub/ckn001 Schneewind K, Beckmann M, Hecht-Jackl A (1985) Familienklima-Skalen. Bericht 8.1 und 8.2. Ludwig Maximilians Universität, Institut für Psychologie-Persönlichkeitspsychologie und Psychodiagnostik, München Otto C, Haller AC, Klasen F, Hölling H, Bullinger M, Ravens-Sieberer U (2017) Risk and protective factors of health-related quality of life in children and adolescents: results of the longitudinal BELLA study. PLoS ONE 12(12):e0190363. https://doi.org/10.1371/journal.pone.0190363 Donald CA, Ware JE (1984) The measurement of social support. Res Community Ment Health 4:325–370 Moser A, Stuck AE, Silliman RA, Ganz PA, Clough-Gorr KM (2012) The eight-item modified Medical Outcomes Study Social Support Survey: psychometric evaluation showed excellent performance. J Clin Epidemiol 65(10):1107–1116. https://doi.org/10.1016/j.jclinepi.2012.04.007 Sherbourne CD, Stewart AL (1991) The MOS social support survey. Soc Sci Med 32(6):705–714. https://doi.org/10.1016/0277-9536(91)90150-b Wooldridge J (2002) Econometric analysis of cross section and panel data, 2nd edn. The MIT Press, London Ravens-Sieberer U, Kaman A, Otto C, Adedeji A, Devine J, Erhart M, Napp A-K, Becker M, Blanck-Stellmacher U, Löffler C, Schlack R, Hurrelmann K (2020) Mental health and quality of life in children and adolescents during the COVID-19 pandemic—results of the COPSY study. Dtsch Arztebl Int 117:828–829. https://doi.org/10.3238/arztebl.2020.0828 Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Erlbaum Associates, Hillsdale Thorisdottir IE, Asgeirsdottir BB, Kristjansson AL, Valdimarsdottir HB, Jonsdottir Tolgyes EM, Sigfusson J, Allegrante JP, Sigfusdottir ID, Halldorsdottir T (2021) Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: a longitudinal, population-based study. Lancet Psychiatry. https://doi.org/10.1016/s2215-0366(21)00156-5 Chaplin TM, Aldao A (2013) Gender differences in emotion expression in children: a meta-analytic review. Psychol Bull 139(4):735–765. https://doi.org/10.1037/a0030737 Betsch C, Wieler LH, Habersaat K (2020) Monitoring behavioural insights related to COVID-19. Lancet 395(10232):1255–1256. https://doi.org/10.1016/s0140-6736(20)30729-7 Reiss F (2013) Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med 90:24–31. https://doi.org/10.1016/j.socscimed.2013.04.026 Hoebel J, Michalski N, Wachtler B, Diercke M, Neuhauser H, Wieler LH, Hˆvener C (2021) Socioeconomic differences in the risk of infection during the second SARS-CoV-2 wave in Germany. Dtsch Arztebl Int 118(15):269–270. https://doi.org/10.3238/arztebl.m2021.0188 McLaughlin KA, Gadermann AM, Hwang I, Sampson NA, Al-Hamzawi A, Andrade LH, Angermeyer MC, Benjet C, Bromet EJ, Bruffaerts R, Caldas-de-Almeida JM, de Girolamo G, de Graaf R, Florescu S, Gureje O, Haro JM, Hinkov HR, Horiguchi I, Hu C, Karam AN, Kovess-Masfety V, Lee S, Murphy SD, Nizamie SH, Posada-Villa J, Williams DR, Kessler RC (2012) Parent psychopathology and offspring mental disorders: results from the WHO World Mental Health Surveys. Br J Psychiatry 200(4):290–299. https://doi.org/10.1192/bjp.bp.111.101253 Kaman A, Otto C, Klasen F, Westenhöfer J, Reiss F, Hölling H, Ravens-Sieberer U (2021) Risk and resource factors for depressive symptoms during adolescence and emerging adulthood - A 5-year follow-up using population-based data of the BELLA study. J Affect Disord 280(Pt A):258–266. https://doi.org/10.1016/j.jad.2020.11.036