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.

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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.

http://www.jahonline.org/article/S1054139X22005183/pdf

Child and Adolescent Mental Health During the COVID-19 Pandemic: Results of the Three-Wave Longitudinal COPSY Study

Despite extensive investigations of the Depression Anxiety Stress Scales-21 (DASS-21) since its development in 1995, its factor structure and other psychometric properties still need to be firmly established, with several calls for revising its item structure. Employing confirmatory factor analysis (CFA), this study examined the factor structure of the DASS-21 and five shortened versions of the DASS-21 among psychiatric patients (N = 168) and the general public (N = 992) during the COVID-19 confinement period in Saudi Arabia. Multigroup CFA, Mann Whitney W test, Spearman's correlation, and coefficient alpha were used to examine the shortened versions of the DASS-21 (DASS-13, DASS-12, DASS-9 (two versions), and DASS-8) for invariance across age and gender groups, discriminant validity, predictive validity, item coverage, and internal consistency, respectively. Compared with the DASS-21, all three-factor structures of the shortened versions expressed good fit, with the DASS-8 demonstrating the best fit and highest item loadings on the corresponding factors in both samples (χ2(16, 15) = 16.5, 67.0; p = 0.420, 0.001; CFI = 1.000, 0.998; TLI = 0.999, 0.997; RMSEA = 0.013, 0.059, SRMR = 0.0186, 0.0203). The DASS-8 expressed configural, metric, and scalar invariance across age and gender groups. Its internal consistency was comparable to other versions (α = 0.94). Strong positive correlations of the DASS-8 and its subscales with the DASS-21 and its subscales (r = 0.97 to 0.81) suggest adequate item coverage and good predictive validity of this version. The DASS-8 and its subscales distinguished the clinical sample from the general public at the same level of significance expressed by the DASS-21 and other shortened versions, supporting its discriminant validity. Neither the DASS-21 nor the shortened versions distinguished patients diagnosed with depression and anxiety from each other or from other psychiatric conditions. The DASS-8 represents a valid short version of the DASS-21, which may be useful in research and clinical practice for quick identification of individuals with potential psychopathologies. Diagnosing depression/anxiety disorders may be further confirmed in a next step by clinician-facilitated examinations. Brevity of the DASS-21 would save time and effort used for filling the questionnaire and support comprehensive assessments by allowing the inclusion of more measures on test batteries.

The Depression Anxiety Stress Scale 21: Development and Validation of the Depression Anxiety Stress Scale 8-Item in Psychiatric Patients and the General Public for Easier Mental Health Measurement in a Post COVID-19 World.

Objective This study attempted to address the limited knowledge regarding the impact of screen time (ST) on lifestyle behaviors in Indian adolescents during the ongoing COVID-19 pandemic. The objectives were to 1) evaluate frequency and duration of using screens, and screen addiction behaviors in 10–15 years old adolescents in Mumbai during the COVID-19 pandemic and 2) examine the association of ST with lifestyle behaviors- eating habits, snacking patterns, physical activity (PA) levels, sleep quality and depression symptoms. Methods An online survey was completed between January and March 2021. Eating habits, snacking patterns, time spent in different screen-based activities, and screen addiction behaviors were reported. The PA levels, sleep quality, and depression symptoms were evaluated using the Physical Activity Questionnaire for Children/Adolescents (PAQ C/A), Pittsburg Sleep Quality Index (PSQI), and Patient Health Questionnaire-2 (PHQ-2) respectively. Multiple linear regression analyses were performed to determine the impact of ST on lifestyle behaviors. Results Adolescents (n = 1298, Mage 13.2(1.1), 53.3% boys) reported the mean weekday and weekend ST as 442.3 (201.5) minutes/d and 379.9 (178.2) minutes/d respectively. Overall, 33.4% spent > 6hours/d for studying or doing homework, 65.4% used social networking sites for at least 2–3 hours/d, and 70.7% agreed that ST had taken up the majority of their leisure time. Only 12% engaged in moderate to vigorous PA (PAQ C/A scores <2). More than half (52.5%) reported PSQI >5 indicating poor sleep quality and 8.6% scored ≥ 3 on PHQ-2 to suggest a risk of depression. A higher ST was associated with lower PA and increased sleep problems and a greater screen addiction was inversely associated with the eating habit, PA, and sleep-related variables. Conclusion The study draws attention to a high prevalence of excess ST and its impact on eating habits, PA levels, and sleep quality in Indian adolescents during the COVID-19 pandemic. Targeted health promotion interventions that encourage judicious use of screens for education and entertainment and emphasize the adverse health effects of excess ST are required.

https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0264951&type=printable

Impact of screen time during COVID-19 on eating habits, physical activity, sleep, and depression symptoms: A cross-sectional study in Indian adolescents

This study aimed to assess the levels of mental wellbeing and potential for clinical need in a sample of UK university students aged 18–25 during the COVID-19 pandemic. We also tested the dose-response relationship between the severity of lockdown restrictions and mental wellbeing. We carried out a prospective shortitudinal study (one month between baseline and follow up) during the pandemic to do this and included 389 young people. We measured a range of facets of mental wellbeing, including depression, depressogenic cognition (rumination), wellbeing, stress and sleep disturbance. Our primary outcome was ‘probable depression’ as indexed by a score of ≥10 on the patient health questionnaire (PHQ-8). The prevalence of probable depression was significantly higher than pre-pandemic levels (55%) and did not decrease significantly over time (52%). Higher levels of lockdown severity were prospectively associated with higher levels of depressive symptoms. Nearly all students had at least one mental wellbeing concern at either time point (97%). The evidence suggests that lockdown has caused a wellbeing crisis in young people. The associated long-term mental, social, educational, personal and societal costs are as yet unknown but should be tracked using further longitudinal studies.

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Mental Health and Wellbeing in Young People in the UK during Lockdown (COVID-19)

Prevalence of mental health problems among children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis.

Depressive symptoms prevalence, associated family factors, and gender differences: A national cohort study of middle school students in China.

OBJECTIVE This study aimed to examine the associations of overweight and obesity (ov/ob) and changes in weight status with academic performance among Chinese adolescents. METHODS Self-reported weight and height were collected from adolescents (n = 10,279) each year from seventh grade (baseline, 2013-2014) to ninth grade (2015-2016). Academic performance included standardized scores on math, Chinese, and English examinations and responses to a school-life experience scale. RESULTS All adolescents with ov/ob had lower academic performance than their counterparts without overweight (β = -0.46 to -0.08; P < 0.05), except for school-life experience for boys. All adolescents with obesity had lower academic performance than their counterparts without obesity (β = -0.46 to -0.17; P < 0.01), except for English test scores for boys. Changes in weight status between grades 7 and 9 impacted academic performance at grade 9. Adolescents with ov/ob throughout grades 7 to 9 and those who developed ov/ob from normal weight had lower test scores (β = -0.80 to -0.25; P < 0.05) than those who maintained normal weight. Those who developed ov/ob after having normal weight had poorer school-life experiences (β = -0.55 to -0.25; P < 0.05). CONCLUSIONS Ov/ob and maintaining and developing ov/ob had adverse academic impacts on adolescents. Relevant stakeholders should consider detrimental impacts of obesity on academic outcomes.

Weidong Wang

Papers

Prevalence of mental health problems among children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis.

Depressive symptoms prevalence, associated family factors, and gender differences: A national cohort study of middle school students in China.

Overweight and Obesity Impair Academic Performance in Adolescence: A National Cohort Study of 10,279 Adolescents in China.