Mental health difficulties and related factors in Chinese children and adolescents during the COVID-19 pandemic: a cross-sectional study

Tongtong Li; Chunhao Li; Guoquan Zhang; Naijian Zhang; Jing Li; Qinghan Ren; Wen Li; Zhenshu Li; Guowei Huang; Jing Yan

doi:10.1016/j.jped.2024.03.004

Mental health difficulties and related factors in Chinese children and adolescents during the COVID-19 pandemic: a cross-sectional study

J Pediatr (Rio J). 2024 Apr 18:S0021-7557(24)00033-0. doi: 10.1016/j.jped.2024.03.004. Online ahead of print.

Authors

Tongtong Li¹, Chunhao Li², Guoquan Zhang¹, Naijian Zhang¹, Jing Li³, Qinghan Ren¹, Wen Li¹, Zhenshu Li¹, Guowei Huang⁴, Jing Yan⁵

Affiliations

¹ Tianjin Medical University, School of Public Health, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China.
² Southern Medical University, School of Public Health, Guangzhou, Guangdong 510515, China.
³ Tianjin Medical University, School of Public Health, Tianjin 300070, China; Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin 300384, China.
⁴ Tianjin Medical University, School of Public Health, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China. Electronic address: huangguowei@tmu.edu.cn.
⁵ Tianjin Medical University, School of Public Health, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China. Electronic address: yanjing@tmu.edu.cn.

PMID: 38642590
DOI: 10.1016/j.jped.2024.03.004

Abstract

Objective: To examine the mental health status and related factors in children and adolescents, and to assess age groups and sexes differences in factors influencing mental health.

Methods: This cross-sectional study was performed on Chinese children aged 6-18 years from November 2021 to January 2022. Mental health difficulties were accessed by the Strengths and Difficulties Questionnaire. Multivariate logistic regression was used to analyze factors associated with mental health status. Multiple linear regression was used to evaluate factors associated with the scores of the Strengths and Difficulties Questionnaire.

Results: The prevalence of mental health difficulties was 12.98% (n =1348). Age (OR, 0.909, [95%CI, 0.830-0.996]), sex (OR, 1.424, [95%CI, 1.033-1.963]) and screen time on weekdays ("≥2" h/d vs "< 1" h/d: OR, 2.001, [95%CI, 1.300-3.080]) were related factors for mental health difficulties. For children (year ≤ 12), the strongest related factor for mental health difficulties was screen time on weekdays ("≥ 2" h/d vs "< 1" h/d: OR, 1.821 [95%CI, 1.203-2.755]). The risk of mental health difficulties in females with ≥ 2 h/d screen time on weekends was 3.420 times higher than those with < 1 h/d (OR, 3.420, [95%CI, 1.923-6.081]).

Conclusion: The prevalence of mental health difficulties among children and adolescents was relatively high. The lower age, female sex and excessive screen time were associated with a higher risk of mental health difficulties. The factors influencing mental health varied by different age groups and sexes. Thus, specific measures for different age groups and sexes should be adopted to mitigate the impact.

Keywords: Adolescents; COVID-19; Children; Cross-sectional study; Mental health; Screen time.