The impact of COVID-19 lockdown on child and adolescent mental health: systematic review

AbstractCOVID-19 was declared a pandemic in March 2020, resulting in many countries worldwide calling for lockdowns. This study aimed to review the existing literature on the effects of the lockdown measures established as a response to the COVID-19 pandemic on the mental health of children and adolescents. Embase, Ovid, Global Health, PsycINFO, Web of Science, and pre-print databases were searched in this PRISMA-compliant systematic review (PROSPERO: CRD42021225604). We included individual studies reporting on a wide range of mental health outcomes, including risk and protective factors, conducted in children and adolescents (aged ≤ 19 years), exposed to COVID-19 lockdown. Data extraction and quality appraisal were conducted by independent researchers, and results were synthesised by core themes. 61 articles with 54,999 children and adolescents were included (mean age = 11.3 years, 49.7% female). Anxiety symptoms and depression symptoms were common in the included studies and ranged 1.8–49.5% and 2.2–63.8%, respectively. Irritability (range = 16.7–73.2%) and anger (range = 30.0–51.3%), were also frequently reported by children and adolescents. Special needs and the presence of mental disorders before the lockdown, alongside excessive media exposure, were significant risk factors for anxiety. Parent–child communication was protective for anxiety and depression. The COVID-19 lockdown has resulted in psychological distress and highlighted vulnerable groups such as those with previous or current mental health difficulties. Supporting the mental health needs of children and adolescents at risk is key. Clinical guidelines to alleviate the negative effects of COVID-19 lockdown and public health strategies to support this population need to be developed.

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Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2020.05.009 ◽

2020 ◽

Vol 59 (11) ◽

pp. 1218-1239.e3 ◽

Cited By ~ 52

Author(s):

Maria Elizabeth Loades ◽

Eleanor Chatburn ◽

Nina Higson-Sweeney ◽

Shirley Reynolds ◽

Roz Shafran ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Children And Adolescents ◽

Social Isolation ◽

The Impact

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Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073432 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3432

Author(s):

Salima Meherali ◽

Neelam Punjani ◽

Samantha Louie-Poon ◽

Komal Abdul Rahim ◽

Jai K. Das ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Children And Adolescents ◽

Behavioral Problems ◽

Well Being ◽

School Closure ◽

Social Distancing ◽

Psychosocial Services ◽

The Impact

Background: The COVID‑19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID‑19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children’s and adolescent’s mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children’s and adolescents’ mental health. Methodology: We conducted the systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included experimental randomized and nonrandomized controlled trials, observational studies, and qualitative studies. Results: Of the 5828 articles that we retrieved, 18 articles met the inclusion criteria. We thematically analyzed them and put the major findings under the thematic areas of impact of the pandemic on children’s and adolescents’ mental health. These studies reported that pandemics cause stress, worry, helplessness, and social and risky behavioral problems among children and adolescents (e.g., substance abuse, suicide, relationship problems, academic issues, and absenteeism from work). Interventions such as art-based programs, support services, and clinician-led mental health and psychosocial services effectively decrease mental health issues among children and adolescents. Conclusion: Children and adolescents are more likely to experience high rates of depression and anxiety during and after a pandemic. It is critical that future researchers explore effective mental health strategies that are tailored to the needs of children and adolescents. Explorations of effective channels regarding the development and delivery of evidenced-based, age-appropriate services are vital to lessen the effects and improve long-term capacities for mental health services for children and adolescents. Key Practitioner Message: The COVID-19 pandemic’s physical restrictions and social distancing measures have affected each and every domain of life. Although the number of children and adolescents affected by the disease is small, the disease and the containment measures such as social distancing, school closure, and isolation have negatively impacted the mental health and well-being of children and adolescents. The impact of COVID-19 on the mental health of children and adolescents is of great concern. Anxiety, depression, disturbances in sleep and appetite, as well as impairment in social interactions are the most common presentations. It has been indicated that compared to adults, this pandemic may continue to have increased long term adverse consequences on children’s and adolescents’ mental health. As the pandemic continues, it is important to monitor the impact on children’s and adolescents’ mental health status and how to help them to improve their mental health outcomes in the time of the current or future pandemics.

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Psychological burden of quarantine in children and adolescents: A rapid systematic review and proposed solutions

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.5.3088 ◽

2020 ◽

Vol 36 (5) ◽

Cited By ~ 6

Author(s):

Nazish Imran ◽

Irum Aamer ◽

Muhammad Imran Sharif ◽

Zubair Hassan Bodla ◽

Sadiq Naveed

Keyword(s):

Mental Health ◽

Systematic Review ◽

Children And Adolescents ◽

Stress Disorder ◽

Acute Stress ◽

Adjustment Disorder ◽

Rapid Review ◽

Post Traumatic Stress ◽

Psychological Burden ◽

The Impact

As COVID-19 grips the world, many people are quarantined or isolated resulting in adverse consequences for the mental health of youth. This rapid review takes into account the impact of quarantine on mental health of children and adolescents, and proposes measures to improve psychological outcomes of isolation. Three electronic databases including PubMed, Scopus, and ISI Web of Science were searched. Two independent reviewers performed title and abstract screening followed by full-text screening. This review article included 10 studies. The seven studies before onset of COVID 19 about psychological impact of quarantine in children have reported isolation, social exclusion stigma and fear among the children. The most common diagnoses were acute stress disorder, adjustment disorder, grief, and post-traumatic stress disorder. Three studies during the COVID-19 pandemic reported restlessness, irritability, anxiety, clinginess and inattention with increased screen time in children during quarantine. These adverse consequences can be tackled through carefully formulated multilevel interventions. doi: https://doi.org/10.12669/pjms.36.5.3088 How to cite this:Imran N, Aamer I, Sharif MI, Bodla ZH, Naveed S. Psychological burden of quarantine in children and adolescents: A rapid systematic review and proposed solutions. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.3088 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Smartphone Addiction and Associated Health Outcomes in Adult Populations: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182212257 ◽

2021 ◽

Vol 18 (22) ◽

pp. 12257

Author(s):

Zubair Ahmed Ratan ◽

Anne-Maree Parrish ◽

Sojib Bin Zaman ◽

Mohammad Saud Alotaibi ◽

Hassan Hosseinzadeh

Keyword(s):

Mental Health ◽

Systematic Review ◽

Health Outcomes ◽

Mental Health Outcomes ◽

Smartphone Addiction ◽

Inclusion Criteria ◽

Physical And Mental Health ◽

Cross Sectional ◽

Wide Range ◽

The Impact

Background: Smartphones play a critical role in increasing human–machine interactions, with many advantages. However, the growing popularity of smartphone use has led to smartphone overuse and addiction. This review aims to systematically investigate the impact of smartphone addiction on health outcomes. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to carry out the systematic review. Five electronic databases including Medline, Web of Science, PsycINFO, PubMed, and Scopus were searched to identify eligible studies. Eligible studies were screened against predetermined inclusion criteria and data were extracted according to the review questions. This review is registered in PROSPERO (CRD42020181404). The quality of the articles was assessed using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: A total of 27 of 2550 articles met the inclusion criteria. All of the studies were cross-sectional and focused on physical, mental, and neurological health outcomes. The majority of the studies focused on mental health outcomes and consistent associations were observed between smartphone addiction and several mental health outcomes. Anxiety and depression were commonly found to mediate mental health problems. A wide range of physical health sequelae was also associated with smartphone addiction. Furthermore, there was an association between smartphone addiction and neurological disorders. Conclusions: Our findings suggest that there are consistent associations between smartphone addiction and physical and mental health, especially mental health. Social awareness campaigns about smartphone addiction and its impact on physical and mental health are needed. Further studies, especially randomized controlled trials, are warranted to validate the impacts of smartphone addiction.

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Anxiety and depressive symptomatology among children and adolescents exposed to the COVID-19 pandemic - meta-analysis

Vojnosanitetski pregled ◽

10.2298/vsp210521092d ◽

2021 ◽

pp. 92-92

Author(s):

Sanja Djurdjevic ◽

Ghigliazza Conde ◽

Vesna Dukanac ◽

Ana Djurdjevic

Keyword(s):

Mental Health ◽

Systematic Review ◽

Depressive Symptoms ◽

Children And Adolescents ◽

Depressive Symptomatology ◽

Well Being ◽

Anxiety Symptoms ◽

Strong Impact ◽

Positive Correlations ◽

The Impact

Background/Aim: Children and adolescents are the sensitive groups for the development of mental disorders during the crisis. The aim of this systematic review is to assess the impact of the COVID-19 pandemic regarding anxiety and depressive symptomatology in this population. Method: Investigation is based on a Systematic Review followed by PRISMA protocol including Ovid MEDLINE, Embase, Global Health and APA Psyc Info data bases to identify relevant studies reporting anxiety and depressive symptoms among children and adolescents during the COVID-19 pandemic. 27 articles were included. Results: Anxiety symptoms increased from 28.3% before the pandemic to 49.5% during confinement (GAD-7 ? 11) (McNemar test p <0.0001). More depression symptomatology was found as well; weight and sleep changes are disturbances in children and adolescents? mental health. Additionally, female teenagers were experiencing grater declines in mood disorders than male teenagers during the COVID-19 crisis. On one hand, different positive correlations between anxiety and other variables, were found, such as clinical depressive symptoms and anxiety (3/14), smartphone and internet addiction (2/14), lower levels of family income (2/14), perceived threats (2/14), higher grades at school (2/14), loneliness (1/14). On the other hand, positive correlations were reported between depression and children and adolescents that were socially disconnected (3/17). Finally, mothers with higher levels of education and income were associated with more happiness (2/17). Conclusions: COVID-19 has a strong impact in children?s and adolescents? mental health regarding depression and anxiety symptoms. Prevention programs focused on coping strategies should also be considered to be delivered in elementary schools, middle schools and high schools. Mental health should become a priority matter for governments and the current pandemic could be an opportunity to highlight the importance of mental well-being and to invest in the betterment of clinical trainings, treatments and mental health research.

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Mental Health of Children and Adolescents Amidst COVID 19 and Past Pandemics: A Rapid Systematic Review

10.20944/preprints202103.0149.v1 ◽

2021 ◽

Author(s):

Salima Meherali ◽

Neelam Punjani ◽

Samantha Louie-Poon ◽

Komal Abdul Rahim ◽

Jai Das ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Children And Adolescents ◽

Behavioral Problems ◽

Health Issues ◽

Children And Adolescent ◽

Psychosocial Services ◽

Age Appropriate ◽

Meta Analyses ◽

The Impact

Background: The COVID 19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID 19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children’s and adolescent’s mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children’s and adolescent’s mental health. Methodology: We conducted the systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included experimental randomized, nonrandomized controlled trials; observational studies; and qualitative studies. Results: Of the 5,828 articles that we retrieved, 18 articles met the inclusion criteria. We thematically analyzed and put up the major findings under the thematic areas of impact of pandemic on children and adolescent’s mental health. These studies reported that pandemics cause stress, worry, helplessness, and social and risky behavioral problems among children and adolescents (e.g., substance abuse, suicide, relationship problems, academic issues, absenteeism from work). Interventions such as art-based programs, support services, and clinician-led mental health and psychosocial services effectively decrease mental health issues among children and adolescents. Conclusion: Children and adolescents are more likely to experience high rates of depression and anxiety during and after a pandemic. It is critical that future researchers explore effective mental health strategies that are tailored to the needs of children and adolescents. Explorations of effective channels regarding the development and delivery of evidence-based, age-appropriate services are vital to lessen the effects and improve long-term capacities for mental health services for children and adolescents.

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Nutrition of Children With Cancer in Brazil: A Systematic Review

JCO Global Oncology ◽

10.1200/jgo.19.00285 ◽

2020 ◽

pp. 242-259 ◽

Cited By ~ 1

Author(s):

Karina Viani ◽

Luiza Albuquerque ◽

Ronald D. Barr ◽

Elena J. Ladas

Keyword(s):

Systematic Review ◽

Children And Adolescents ◽

Latin American ◽

Data Extraction ◽

Research Priorities ◽

Poor Quality ◽

High Quality Research ◽

The North ◽

Meta Analyses ◽

The Impact

PURPOSE The objective of this systematic review was to describe nutrition-related publications on children and adolescents diagnosed with cancer in Brazil. METHODS The methodology followed that of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Medline, LILACS (the Latin American & Caribbean Health Sciences Literature), and Embase were searched in April 2019, and data extraction and rating of methodologic study quality (according to the National Institutes of Health quality score assessment) were performed independently by reviewers. RESULTS Twenty-seven studies met the inclusion criteria, reporting on 3,509 patients from 1994 to 2018. Most of the studies (74%) were of poor quality in methodology and reporting. Different cancer diagnoses were included in 52% of studies, whereas acute leukemia was the exclusive focus in 41%. The majority of the articles (70%) were from institutions in the Southeast Region of Brazil, mainly the state of São Paulo (74%); no publications were from the North Region of the country. Twelve studies addressed nutritional status and body composition, reporting an abundance of malnourished patients in the Brazilian population of children and adolescents with cancer. Six studies on micronutrients pointed to possible deficiencies in this population, with a yet unclear but promising role for supplementation during treatment. CONCLUSION Evidence indicates that there is great interest in the impact of nutrition on childhood cancer treatment and clinical outcomes in Brazil. However, there is a need to focus on high-quality research, particularly with multicentric/national studies. This will help establish research priorities and better planned clinical interventions, adapted to each region of the country.

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Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228479 ◽

2020 ◽

Vol 17 (22) ◽

pp. 8479

Author(s):

Finiki Nearchou ◽

Clodagh Flinn ◽

Rachel Niland ◽

Sheena Siva Subramaniam ◽

Eilis Hennessy

Keyword(s):

Mental Health ◽

Systematic Review ◽

Methodological Quality ◽

Data Extraction ◽

Psychological Impact ◽

Selection Procedure ◽

Youth Mental Health ◽

Future Research ◽

Meta Analyses ◽

The Impact

The psychological impact of the COVID-19 pandemic has been widely discussed during the past few months, with scholars expressing concern about its potential debilitating consequences on youth mental health. Hence, this research aimed to provide a systematic review of the evidence on the COVID-19 pandemic’s impact on youth mental health. We conducted a mixed methods integrated review to identify any empirical study that focused on young people ≤ 18 years old. Eight databases were systematically searched to identify studies of any type of research design. The selection procedure followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The protocol of this systematic review was registered with PROSPERO (protocol ID: CRD4202019375). Twelve studies deemed eligible for data extraction (n = 12,262). The findings show that COVID-19 has an impact on youth mental health and is particularly associated with depression and anxiety in adolescent cohorts. The quality appraisal indicated that all studies were of low or moderate methodological quality. The COVID-19 pandemic is affecting young people’s lives, and thus generating robust research evidence to inform policy decisions is essential. Hence, the methodological quality of future research should be drastically improved.

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The Impact of Epidemics and Pandemics on the Mental Health of Healthcare Workers: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136695 ◽

2021 ◽

Vol 18 (13) ◽

pp. 6695

Author(s):

Ottilia Cassandra Chigwedere ◽

Anvar Sadath ◽

Zubair Kabir ◽

Ella Arensman

Keyword(s):

Mental Health ◽

Systematic Review ◽

Healthcare Workers ◽

Stress Disorder ◽

Acute Stress ◽

Hospital Setting ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Wide Range ◽

The Impact

Background: There is increasing evidence that healthcare workers (HCWs) experience significant psychological distress during an epidemic or pandemic. Considering the increase in emerging infectious diseases and the ongoing COVID-19 pandemic, it is timely to review and synthesize the available evidence on the psychological impact of disease outbreaks on HCWs. Thus, we conducted a systematic review to examine the impact of epidemics and pandemics on the mental health of HCWs. Method: PubMed, PsycInfo, and PsycArticles databases were systematically searched from inception to June-end 2020 for studies reporting the impact of a pandemic/epidemic on the mental health of HCWs. Results: Seventy-six studies were included in this review. Of these, 34 (45%) focused on SARS, 28 (37%) on COVID-19, seven (9%) on MERS, four (5%) on Ebola, two (3%) on H1N1, and one (1%) on H7N9. Most studies were cross-sectional (93%) and were conducted in a hospital setting (95%). Common mental health symptoms identified by this review were acute stress disorder, depression, anxiety, insomnia, burnout, and post-traumatic stress disorder. The associated risk factors were working in high-risk environments (frontline), being female, being a nurse, lack of adequate personal protective equipment, longer shifts, lack of knowledge of the virus, inadequate training, less years of experience in healthcare, lack of social support, and a history of quarantine. Conclusion: HCWs working in the frontline during epidemics and pandemics experience a wide range of mental health symptoms. It is imperative that adequate psychological support be provided to HCWs during and after these extraordinary distressful events.

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The relationship between buildings and health: a systematic review

Journal of Public Health ◽

10.1093/pubmed/fdy138 ◽

2018 ◽

Vol 41 (2) ◽

pp. e121-e132 ◽

Cited By ~ 15

Author(s):

Janet Ige ◽

Paul Pilkington ◽

Judy Orme ◽

Ben Williams ◽

Emily Prestwood ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Assessment Tool ◽

Grey Literature ◽

Strong Association ◽

Evidence Base ◽

Vulnerable Groups ◽

Quantitative Studies ◽

The Impact

Abstract Background The built environment exerts one of the strongest directly measurable effects on physical and mental health, yet the evidence base underpinning the design of healthy urban planning is not fully developed. Method This study provides a systematic review of quantitative studies assessing the impact of buildings on health. In total, 7127 studies were identified from a structured search of eight databases combined with manual searching for grey literature. Only quantitative studies conducted between January 2000 and November 2016 were eligible for inclusion. Studies were assessed using the quality assessment tool for quantitative studies. Results In total, 39 studies were included in this review. Findings showed consistently that housing refurbishment and modifications, provision of adequate heating, improvements to ventilation and water supply were associated with improved respiratory outcomes, quality of life and mental health. Prioritization of housing for vulnerable groups led to improved wellbeing. However, the quality of the underpinning evidence and lack of methodological rigour in most of the studies makes it difficult to draw causal links. Conclusion This review identified evidence to demonstrate the strong association between certain features of housing and wellbeing such as adequate heating and ventilation. Our findings highlight the need for strengthening of the evidence base in order for meaningful conclusions to be drawn.

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