Introduction
Methods
Search strategy and selection criteria
Data extraction
Strategy for data synthesis
Quality appraisal
Results
Search results
Study characteristics
Lead Author/year | Country | Study design | Sample size | Sex (F%) | Age (Mean ± SD, Range) | School closure mentioned | Length of lockdown | Key findings |
---|---|---|---|---|---|---|---|---|
Abawi et al. 2020 [1] | Netherlands | Cross-sectional | 75 | 52% | 10.5, 7–15 | ★★ | 32.0% of children reported COVID-19 related anxiety. 25.0% of the families imposed their own quarantine measures. Many of the included families found that previous service contact helped to alleviate anxiety | |
Abdulah et al. 2020 [2] | Iraqi Kurdistan | Cross-sectional | 15 | 53% | 6–13 | N.A | Being at home during the COVID-19 outbreak was seen to result in high levels of stress in children. Children expressed fear about coronavirus. Due to home confinement and social distancing, children also experienced loneliness, stress, sadness, and depression | |
Achterberg et al. 2020 [3] | Netherlands | Longitudinal | 151 | 10–13 | N.A | Children’s externalising behaviour changes were mediated by perceived stress (p < 0.001): higher scores before lockdown were related to higher stress during the lockdown, Perceived stress in children was associated with negative coping strategies (p = 0.006). Children’s stress levels were influenced by prior and current parental over-reactivity (p = 0.001) | ||
Adibelli et al. 2020 [4] | Turkey | Cross-sectional | 597 | 56% | 9.9 ± 2.0, 7–13 | ★★ | The emotional well-being (p < 0.001), self-esteem (p < 0.001), family (p < 0.01), school (p < 0.05) sub-dimensions and total (p < 0.05) scores of children who tended to use the internet were found to be lower. Emotional well-being (p < 0.001), family (p < 0.01), friends (p < 0.05) sub-dimensions of the children of the parents who feel fear/anxiety about coronavirus becoming a pandemic were lower | |
Alves et al. 2020 [5] | America | Longitudinal | 64 | 63% | 11.8 ± 1.3, 9–15 | Y | ★ | Positive affect was associated with lower state anxiety, even when adjusting for child age, sex, SES, and BMI z-scores (β = − 0.40, p < 0.001). Negative effect was correlated with sedentary time (r = 0.28, p = 0.02) and leisure screen time (r = 0.40, p = 0.001) |
Amorim et al. 2020 [6] | Portugal | Cross-sectional | 99 | 69% | 10.8 ± 3.1 | N.A | 72.1% of parents reported a change in behaviour in children with ASD compared to 32.1% in the control group (p < 0.05). The changes of behaviour in children with ASD were reported to be due to anxiety (41.7%), irritability (16.7%), obsessions (11.1%), hostility (5.6%), and impulsivity (2.8%). Children with ASD and their parents reported higher anxiety levels compared to controls (p < 0.05) | |
Asanov et al. 2021 [7] | Ecuador | Cross-sectional | 1320 | 53% | 15.9, 14–18 | Y | ★★★ | 16.0% of students have mental health scores that are indicative of depression. School closure and social isolation are the key stressors identified by students |
Baptista et al. 2020 [10] | Portugal, Brazil | Cross-sectional | 253 | 48% | 7.5, 3–15 | Y | ★★★ | 72.2% of parents report changes in their child's routine during social distancing. Sleep breathing disorders (p = 0.019), sleep–wake transition disorders (p = 0.022) were reported |
Bentenuto et al. 2021 [11] | Italy | Cross-sectional | 164 | 26% | 3–17 | N.A | Significant increases in child's externalising behaviours were seen. In children with NDDs, the decrease in therapeutic/rehabilitation support predicted higher externalising behaviours | |
Bignardi et al. 2020 [12] | UK | Longitudinal | 168 | 55% | 7.6–11.6 | Y | ★★ | Children’s depressive symptoms increased (p < 0.001), as relative to before lockdown. Non-significant, small changes were seen in anxiety and emotional problems |
Cauberghe et al. 2020 [16] | Belgium | Cross-sectional | 2165 | 67% | 15.5 ± 1.6, 13–19 | Y | N.A | Adolescents who were anxious used social media to adapt to COVID-19 more than as a method of keeping in contact with friends and family (p < 0.001). The indirect effect of anxiety was seen to have a significantly positive effect on happiness via active coping (p < 0.0016). Those who felt lonelier were more likely to use social media to deal with the lack of social contact (p = 0.004). Humorous coping was found to be positively related to feelings of happiness and not influenced by anxiety or loneliness (p = 0.008) |
Cetin et al. 2020 [17] | Turkey | Cross-sectional | 76 | 30% | 10.1 ± 2.2 | Y | ★★ | Sleep problems mediated the relationship between PTSD symptoms and severity of ADHD symptoms and the relationship between chronotype and the severity of ADHD symptoms |
Chen et al. 2020a [19] | China | Longitudinal | 543 | 51% | 10.9 ± 0.7 | Y | N.A | At follow-up there were greater levels of psychological distress for school children. A significant predictor of psychological distress at baseline and follow up was seen to be problematic internet-related behaviours. Other significant predictors for psychological distress at follow up were follow up illness status, perceived academic performance, and problematic smartphone-app usage (p < 0.001) |
Chen et al. 2020b [18] | China | Cross-sectional | 1036 | 49% | 6–15 | Y | N.A | 11.8% of participants showed depression, 18.9% of participants showed anxiety and 6.6% of participants showed anxiety and depression. Female adolescents showed higher risk of depression and anxiety during COVID-19. Adolescents (13–15 years) were seen to be more depressed than younger children |
Chen et al. 2020 [20] | China | Cross-sectional | 7772 | 52% | 12–18 | N.A | A significant difference was seen in anxiety symptoms for participants who were from Wuhan compared to other urban areas (p = 0.004). Participants’ gender, a relative being infected, and online education were seen to have direct positive predictive value for depressive and anxiety symptoms (p < 0.001). Having relatives who participated in COVID-19 related work predicted developing depressive symptoms (p < 0.05) | |
Commodari et al. .2020 [25] | Italy | Cross-sectional | 978 | 65% | 16.6 ± 1.2, 13–20 | ★★ | Females showed less self-confidence levels than males (p < 0.001). Students reported feeling tense (40.0%), sad (42.6%), and irritable (49.6%). 55.9% reported difficulties concentrating and 55.6% reported difficulties sleeping. 13.4% reported eating difficulties where they forgot to eat or skipped meals. 18.7% reported disturbances in heartbeat (18.7%). Significant predictors of negative feelings were female gender (β = 0.284, p < 0.001), age (β = 0.119 p < 0.001), living in a red zone (β = 0.090, p = 0.004), perceived seriousness (β = 0.085, p = 0.007), fear of getting COVID-19 (β = 0.091, p = 0.005), and compliance with government measures (β = 0.152, p = 0.001) | |
Conti et al. 2020 [27] | Italy | Longitudinal | 141 | 17% | 1.5—18 | ★★ | Within the 1.5–5-year-old population, anxiety (p < 0.05) increased. Within the 6–18-year-old population, obsessive–compulsive (p < 0.05) and thought problems increased (p < 0.05). In the regression models, younger age in the 1.5–5-year-old population was seen as “protective” (p < 0.05). During lockdown, familial financial hardship was associated with an increase in psychiatric symptoms in the 6–18-year-old population (p < 0.05) | |
Cusinato et al. 2020 [30] | Italy | Cross-sectional | 463 | 44% | 9.7 ± 3.3, 5–17 | Y | ★★ | Females obtained higher prosocial behaviour scores than boys (p < 0.001) |
Di Giorgio et al. 2020 [34] | Italy | Cross-sectional | 245 | 48% | 4.1, 2–5 | ★★ | Children went to bed on average ~ 53 min later (p < 0.0001) and woke up ~ 66 min later (p < 0.0001) during the lockdown. An increase in emotion symptoms (p = 0.011), conduct problems (p = 0.003) and hyperactivity/inattention issues (p < 0.0001) was seen in children during the lockdown | |
Ezpeleta et al. 2020 [38] | Spain | Longitudinal | 226 | 52% | 13.9 ± 0.3 | Y | ★★ | The mental health of adolescents’ during the COVID-19 lockdown was associated with the activities and routines adolescents' kept up (p = 0.005), the quality of their relationships with friends (p = 0.001), parents (p < 0.001), and siblings (p = 0.006), how adults around them were affected by the lockdown (p = 0.002), the physical environment in which they were locked down (p = 0.023), how they reacted to the lockdown in terms of feelings and behaviours (p = 0.017), and how the disease affected the immediate family (p = 0.002) |
Francisco et al. 2020 [39] | Italy, Spain, Portugal | Cross-sectional | 1480 | 47% | 9.2 ± 4.3, 3–18 | ★★ | Approximately one-third of children report being restless, nervous, worried, uneasy, lonely, and anxious. 52.2% report being bored and > 40% irritable. The mean number of hours of sleep during weekdays significantly increased during home confinement for the total sample (p < 0.001, r = 0.30) | |
Giannopoulou et al. 2021[41] | Greece | Cross-sectional | 442 | 68% | 16–18 | Y | ★★ | The prevalence of a positive screen for depression (PHQ-9 score ≥ 11) rose from 48.5% to 63.8% where those scoring within the severe depression range (PHQ-9 ≥ 20) rose from 10 to 27%. The prevalence of a positive screen for anxiety (GAD-7 score ≥ 11) rose from 23.8% to 49.5%, where those scoring within severe anxiety range (GAD-7 ≥ 17) rose from 3.8% to 20.5% |
Gimenez-Dasi et al. 2020 [42] | Spain | Longitudinal | 167 | 42% | 7.0 ± 2.6. 3–11 | ★★ | Significant differences were seen in the attention (p = 0.02), willingness to study (p < 0.001), emotional regulation problems (p < 0.001), and hyperactivity and impulsivity (p < 0.001) scales from before to after confinement | |
Graell et al. 2020 [44] | Spain | Cross-sectional | 365 | 88% | 14.5 ± 2.3, 7–15 | ★★ | 41.9% of the children and adolescents experienced reactivation of eating disorder (ED) symptoms despite treatment (p = 0.005). Adolescents experienced a more pronounced reactivation of ED and non-ED symptoms than children, and severe patients (25.0%) presented a risk of self-harm and suicide. There was less weight loss monitoring in children during confinement (p = 0.02). On admission, 45.5% of patients presented irritability and 22.7% presented mood disturbances, due to confinement | |
Idoiaga et al. 2020a [47] | Spain | Cross-sectional | 250 | 52% | 7.1 ± 2.6, 3–12 | ★★ | Lockdown was reported to result in mixed emotions in children; ranging from happy and relaxed to fear, nervousness, worry, loneliness, sadness, boredom, and anger. Children expressed difficulty due to the deprivation of fresh air and outdoor exercise in lockdown, resulting in a more sedentary state | |
Idoiaga et al. 2020b [48] | Spain | Cross-sectional | 228 | 52% | 7.1 ± 2.6, 3–12 | Y | ★★ | Children experienced conflicting emotions due to lockdown as being scared, nervous, lonely, sad and angry, but also feeling safe, calm, and happy. Older children who are 6–12 years of age report more concern over the highly contagious nature of COVID-19, and experience sadness, fear, concern and nervous when asked about coronavirus |
Kılınçel et al. 2020 [51] | Turkey | Cross-sectional | 745 | 70% | 16.8 ± 1.7, 12–18 | Y | N.A | Young people experienced anxiety and loneliness due to the closure of schools and home-quarantine due to the pandemic (p = 0.001). In the group that mostly used the television as a source of information about COVID-19, the state anxiety scores were higher (OR = 2.4). Adolescents previously referred for psychiatric treatment had higher anxiety scores (OR = 4.4) |
Larsen et al. 2020 [53] | Norway | Longitudinal | 442 | 55% | 11.4 ± 2.6 | ★★ | Results showed significant associations between emotional, somatic/cognitive, and worry reactions and COVID-19 related predictors: home school experience, family stress and instability, missing friends and worry about virus infection (p < 0.001). Older children reported more negative reactions | |
Lecuelle et al. 2020 [54] | France | Longitudinal/Retrospective | 92 | 29.6 months | ★★ | The lockdown reduced the frequency (p = 0.02) and length (p = 0.01) of naps. Nocturnal sleep duration increased (p < 0 .001). Frequency of parasomnia increased from 6.0 to 7.1 (p = 0.003) | ||
Liang et al. 2020 [56] | Italy | Cross-sectional | 1074 | 48% | 9.0 ± 2.0, 6–12 | Y | N.A | 89.7% of children were affected during quarantine. The symptoms of anxiety differed significantly between the two regions (p < 0.001). Children in northern areas appeared to be more worried (p < 0.001), more preoccupied with death (p < 0.001), more easily alarmed (p < 0.01), and more afraid of COVID-19 infection (p < 0.001), compared to central areas. There were also significant differences seen regarding mood symptoms (p < .01). Children in the northern areas were sadder (p < 0.001) and more bored (p < 0.01) in comparison to children in central areas |
Liebana-Presa et al. 2020 [57] | Spain | Cross-sectional | 300 | 62 | 14.0 ± 1.0, 13–17 | ★★ | There was a strong correlation between the physiological and emotional manifestations in stress (r = 0.778). Regarding the intention to use cannabis, the component of attitude toward its use is significantly correlated with stress: emotional manifestations (r = 0.260), physiological (r = 0.300) and behavioural (r = 0.412) | |
Liu et al. 2020 [59] | China | Cross-sectional | 1264 | 44% | 9.8, 7–12 | Y | N.A | Amongst children, prosocial behaviours prevalence was 10.3%, followed by conduct problems (7.0%), peer problems (6.6%), hyperactivity-inattention (6.3%) and emotional problems (4.7%). Children who did physical activity had a lower hyperactivity-inattention risk (OR: 0.44 for 1–2 days/week; OR: 0.56 for more than 2 days/week) and less prosocial behaviours problems (OR: 0.65 for 1–2 days/week; OR: 0.55 for more than 2 days/week), compared to children who did not exercise |
Magson et al. 2020 [62] | Australia | Longitudinal | 248 | 51% | 14.4 ± 0.5, 13–16 | Y | N.A | Adolescents reported a significant increase in the experience of depressive symptoms (p < 0.001) and anxiety (p < 0.001), alongside a decrease in life satisfaction (p < 0.001) from baseline to follow-up. An increase in depression at follow-up was associated with COVID-19 related worries (p < 0.001), online learning difficulties (p < 0.001), and increased conflict with parents (p = 0.007). An increase in anxiety at follow up was associated with gender (p = 0.041), COVID-19 distress (p = 0.042), media (p = 0.035), and social disconnection (p < 0.001) |
Majeed et al. 2020 [63] | Pakistan | Cross-sectional | 63 | 51% | 13–17 | Y | N.A | Most adolescents showed symptoms of depression, anxiety, and anger. Females reported more somatic complaints (p = 0.01), whereas males reported more anger problems (p = 0.01). Severe irritability and expressions of anger were reported |
Mallik et al. 2021 [64] | Bangladesh | Cross sectional | 552 | N.A | 10.4 ± 4.1, 4–17 | N.A | Pre-lockdown, females reported more emotional disorders (9.4%) than boys (5.4%) (p < 0.05). A significant association between boys with conduct disorder during the lockdown period (p < 0.05) was seen. During lockdown, the prevalence of conduct disorder among the boys and girls were 32.8% and 25.5%, respectively. Hyperactivity significantly increased amongst boys during lockdown (p < 0.001) | |
Morgul et al. 2020 [72] | UK | Cross-sectional | 927 | N.A | 5–11 | Y | ★★ | Children were more bored (73.8%), lonely (64.5%), sad (43.4%), frustrated (61.4%), irritable (57.1%), restless (52.9%), worried (52.4%), angry (48.6%), anxious (45.2%), and were more argumentative with the rest of the family (29.7%) during the lockdown compared to the pre-COVID-19 period. During the lockdown, children spent significantly more time using screens (p < 0.001), and less time doing physical activity (p < 0.001) and sleeping (p = 0.001) |
Mourouvaye et al. 2020 [73] | France | Longitudinal | 234 | 72% | 13.4 ± 1.8, 7–17 | ★★ | We found a significant decrease in the incidence of admissions for suicide behaviour during the lockdown (IRR: 0.46, 95% CI: 0.24 to 0.86) | |
Nonweilier et al. 2020 [74] | UK | Cross-sectional | 371 | 29% | 4–15 | ★★ | Young people with neurodevelopmental disorders, compared to neurotypical controls, had a higher prevalence of emotional symptoms (42% vs. 15%) (p < 0.001) and conduct problems (28% vs. 9%) (p < 0.001), and fewer prosocial behaviours (54% vs. 22%) (p < 0.001). Participants with ADHD showed inflated conduct problems (p < 0.01), while participants with ASD showed decreased prosocial behaviours (p = 0.04). Females with ASD had higher emotional symptoms compared to males (p < 0.001) | |
Orgilés et al. 2020 [75] | Spain & Italy | Cross-sectional | 1143 | 48% | 9.1 ± 4.2, 3–18 | Y | N.A | During quarantine, 85.7% of the parents reported perceived changes in their children´s emotional state and behaviours. In children, the most frequent symptoms seen were difficulty concentrating (76.6%) (p < 0.001), boredom (52%), irritability (39%) (p < 0.05), restlessness (38.8%) (p < 0.001), nervousness (38%) (p < 0.001), feelings of loneliness (31.3%) (p < 0.001), uneasiness (30.4%) (p < 0.001), and worries (30.1%) |
Patra et al. 2020 [78] | India | Cross-sectional | 225 | 38% | 11.0 | Y | N.A | > 90% of parents reported improvements in their child’s physical and psychological health. 30% of parents reported worsening of child behaviour regarding "anger". 3% of children worsened in the domains of "neatness ability" and "eating behaviour" |
Pisano et al. 2020 [79] | Italy | Cross-sectional | 5989 | 4–10 | Y | N.A | 54% of children showed increased irritability, intolerance to rules, whims and excessive demands, 21% presented mood changes and 20% reported sleep problems. 34.3% displayed nervousness when the pandemic was mentioned at home or on TV. 31% seemed calmer and 50% seemed wiser and more thoughtful. 93% seemed able to adapt to the pandemic restrictions | |
Pons et al. 2020 [80] | Spain | Cross-sectional | 544 | 49% | 15.9 ± 1.5 | ★★★ | Young athletes reported higher anxious/depressive (3.5 ± 1.0) (p < 0.001) and social dysfunction (3.5 ± 1.5) (p < 0.001) symptoms. 54.8% of the sample reported a low negative impact of lockdown on life-spheres and few mental health issues. 30.0% of the participants reported a medium negative impact on life-spheres and moderate mental health issues. 15.3% of the sample showed a high negative impact of the COVID-19 lockdown with high mental health issues | |
Radwan et al. 2020 [82] | Palestine | Cross-sectional | 942 | 66% | 6–18 | Y | ★★ | 78.1% of students were psychologically affected. Female students were more psychologically affected, experiencing significantly greater fear than male students (p < 0.001). This study showed a significant positive correlation between social media and spreading panic about COVID-19 (r = 0.891, p < 0.001) and the effect of social media panic depending on a student’s age and gender (p < 0.001) |
Ren et al. 2020 [83] | China | Cross-sectional | 1487 | 51% | 13.1 ± 1.6, 10–17 | Y | ★★ | Adolescents’ depressive symptoms after quarantine was impacted by the presence of cases in their community during the quarantine (p < 0.001); this was especially the case in older adolescents (p < 0.001). All types of routine were associated with a decrease in adolescent depressive symptoms (p < 0.001) |
Romero et al. 2020 [85] | Spain | Longitudinal | 1049 | 50% | 7.3 ± 2.4, 3–12 | Y | ★★ | Child adjustment was influenced by parents’ perceived distress and emotional response to the COVID-19 crisis, parenting distress and specific parenting practices. Preschool children (aged 3 to 6 years old) showed a higher increase in conduct problems and hyperactivity as compared to their school-aged counterparts. Older children (aged 10 to 12 years old) showed the lowest increase in hyperactivity. Child’s conduct problems and hyperactivity were negatively affected by age (ß = − 0.10, p < 0.01 and ß = − 0.09, p < 0.05) |
Sama et al. 2020 [86] | India | Cross-sectional | 310 | 42% | Children | ★★ | 73.1% of the children were having signs of increased irritation and 51.2% of children reported increased signs of anger; 18.7% of parents reported symptoms of depression and 17.6% of parents also mentioned the symptoms of anxiety amongst their children. These factors were also affected by the changes in the child's diet, sleep, weight, and the increased usage of the electronic equipment | |
Saurabh et al. 2020 [87] | India | Cross-sectional | 121 | 15% | 15.4, 9–18 | N.A | Children and adolescents in quarantine experienced greater psychological distress than non-quarantined children and adolescents. The most common feelings reported during the quarantine were 69% experienced worry, 66% experienced helplessness, and 62% experienced fear | |
Shah et al. 2020a [89] | India | Cross-sectional | 423 | 46% | 12.3 ± 1.6, 11–15 | Y | N.A | 30.7% of children experienced psychosocial problems, of which, 25.2% had anxiety or depressive symptoms due to lockdown. The common reasons for which were fear of acquiring COVID-19 infection (60%), not able to attend school (56%), and not able to meet friends (80%). 5.4% of young people felt hopeless, 25.2% seemed to be having less fun, and 23.4% were feeling sad or unhappy. 24.3% reported worrying a lot and 12.5% were ‘down on oneself.’ 58% of children were happy to spend more time with family and 33% did not feel any anything unusual. Increased use of social media was associated with higher risk of anxiety or depressive symptoms [OR = 1.83, p = 0.001] |
Shah et al. 2020b [88] | India | Longitudinal | 48 | 10% | 9.8 ± 3.7 | Y | N.A | During the lockdown period, there was worsening of symptoms of ADHD shown by an increase in the activity level (50.1%), irritability (45.8%), and disturbing/disruptive behaviour (47.7%) in children. Regarding the behaviour of family members, there was increase in irritability (37.5%), and shouting at the child (43.8%), verbal abuse (25%), and punishing the child (27.1%). Additionally, there was an increase in praising (67.6%) and spending time with the child (72.9%). Children also reported an increase in anxiety (29.1%), feelings of boredom (35.4%), demanded more time from the parents (35.5%), and were distressed for not being able to go out of the home (39.6%) |
Smirni et al. 2020 [90] | Italy | Cross-sectional | 148 | 57% | 17.9 ± 1.2, 17–19 | N.A | Anxiety scores were high for older adolescents during the COVID-19 pandemic. > 50% items on the SAS tool reached a high anxiety score. The most anxiety-provoking symptom for older adolescents was breathing difficulties | |
Spinelli et al. 2020 [91] | Italy | Cross-sectional | 854 | 50% | 7.1 ± 3.4, 2–14 | ★★ | Quarantine’s impact on children’s behavioural and emotional problems is mediated by parent’s individual and dyadic stress. Parent stress is significantly correlated with hyper-inattention in children (R:0.44, p < 0.001) | |
Tang et al. 2020 [94] | China | Cross-sectional | 4342 | 49% | 11.9 ± 2.3, 6–17 | ★★ | Anxiety (24.9%), depression (19.7%), and stress (15.2%) were common during the pandemic. Children who had discussions with their parents about COVID-19 experienced less depression (p < 0.001), anxiety (p < 0.001), and stress (p < 0.001) | |
Troncone et al. 2020 [96] | Italy | Cross-sectional | 414 | 57% | 13 ± 3, 8–19 | Y | ★★ | 8.7% of participants with Type 1 diabetes and 13.4% of controls had scores indicating the disordered eating behaviours. Female gender (p < 0.0001) was found to be a significant predictor of disordered eating behaviours |
Waite et al. 2020 [100] | UK | Longitudinal | 2673 | 48% | 4–16 | ★★ | Pre-adolescent children exhibited a deterioration in mental health symptoms resulting in a 10% increase in meeting probably caseness criteria for emotional symptoms, a 20% increase in hyperactivity/inattention and a 35% increase in conduct problems. Changes amongst adolescents were smaller, resulting in a 4% increase in hyperactivity/inattention, 8% increase in conduct problems, and a 3% reduction in caseness criteria for emotional symptoms. Children and adolescents in low-income households, those with special educational needs and/or neurodevelopmental disorders, exhibited elevated symptoms and caseness at both time points | |
Wiguna et al. 2020 [103] | Indonesia | Cross-sectional | 113 | 47% | 14.7 ± 2.2, 11–17 | Y | ★★ | The number of adolescents that perceived their own significantly worsening mental wellbeing increased during COVID-19 pandemic, in comparison to before the pandemic (p < 0.05). There were significant associations between having mental health information and conduct behaviour (OR: 10.34, 95% CI: 1.27–78.86); Subjective anxiety due to COVID-19 pandemic and pro-social behaviour problems (OR: 2.37, 95% CI: 1.00–5.63), parental support and total difficulties (OR: 0.09, 95% CI: 0.14–0.60) and pro-social behaviour problems (OR: 0.09, 95% CI: 0.01–0.82); friends support during COVID-19 pandemic and conduct behaviour (OR: 0.20, 95% CI: 0.04–1.00) |
Xiang et al. 2020 [106] | China | Longitudinal | 2427 | 49% | 6–17 | Y | ★★ | Mean depression scores significantly decreased during school closure (p < 0.01). Children in middle school showed a greater decrease in depression scores than those in primary school (p = 0.09), whereas a lower depression score during school closure was consistently observed across sexes and household income categories |
Xie et al. 2020 [107] | China | Cross-sectional | 1784 | 43% | 7–12 | Y | ★★ | 23% of students reported depressive symptoms and 19% of anxiety symptoms. Students in Wuhan had more severe depressive symptoms than students in Huangshi (p = 0.02). Students who experienced slight to no worry about being affected by COVID-19 had lower depressive symptoms than those who reported higher worry (p < 0.001). Those reporting not being optimistic about COVID-19 had more severe depressive symptoms (p < 0.001) |
Yeasmin et al. 2020 [109] | Bangladesh | Cross-sectional | 384 | 5–15 | Y | N.A | 43% of children were found to have met the subthreshold for depression, anxiety, and sleep disorder. 31% of children experienced mild disturbances regarding depression, anxiety, and sleeping disorder. 19% reported a moderate mental disturbance regarding depression, anxiety, and sleeping (p < 0.001). 7% reported a severe mental disturbance regarding depression, anxiety, and sleeping disorder. Mental disturbances in children were correlated with parent's stress and abnormal behaviour | |
Yue et al. 2020 [110] | China | Cross-sectional | 1360 | 46% | 10.6 | N.A | 1.8% of children experienced moderate anxiety, 2.2% reported depression, and 3.2% of children met diagnostic criteria for PTSD. For children, excessive media exposure was a risk factor for anxiety and PTSD (p < 0.05) | |
Zhang et al. 2020 [111] | China | Longitudinal | 1241 | 42% | 12.6 ± 1.4, 9–16 | Y | ★★ | The prevalence of mental health outcomes among students in May 2020 after lockdown increased significantly from levels early on in the pandemic in November 2019: depressive symptoms (24.9% vs 18.5%; OR:1.50, p = .001), nonsuicidal self-injury (42.0% vs 31.8%; OR: 1.35, p < .001), suicide ideation (29.7% vs 22.5%; OR: 1.32, p = .008), suicide plan (14.6% vs 8.7%; OR: 1.71, p < .001), and suicide attempt (6.4% vs 3.0%; OR: 1.74, p < .001) |
Zijlmans et al. 2020 [112] | Netherlands | Cross-sectional | 1183 | 8–18 | Y | ★★ | The psychiatric sample reported significantly more problems than the general population sample on all measures except anxiety and peer relationships (p < 0.05). A friend or relative affected by COVID-19 and a COVID-19 related change in work situation negatively moderated outcomes and was associated with more anxiety and depressive symptoms (p < 0.01). Higher age was significantly associated with higher anxiety (p < 0.01). Male gender was significantly associated with lower anxiety and depressive symptoms (p < 0.01) |