The effects of COVID-19 on child mental health: Biannual assessments up to April 2022 in a clinical and two general population samples

Josjan Zijlmans; Jacintha M Tieskens; Hedy A van Oers; Hekmat Alrouh; Michiel A J Luijten; Rowdy de Groot; Daniël van der Doelen; Helen Klip; Rikkert M van der Lans; Ronald de Meyer; Malindi van der Mheen; I Hyun Ruisch; Germie van den Berg; Hilgo Bruining; Jan Buitelaar; Rachel van der Rijken; Pieter J Hoekstra; Marloes Kleinjan; Ramón J L Lindauer; Kim J Oostrom; Wouter Staal; Robert Vermeiren; Ronald Cornet; Lotte Haverman; Arne Popma; Meike Bartels; Tinca J C Polderman

doi:10.1002/jcv2.12150

The effects of COVID-19 on child mental health: Biannual assessments up to April 2022 in a clinical and two general population samples

JCPP Adv. 2023 Mar 30;3(2):e12150. doi: 10.1002/jcv2.12150. eCollection 2023 Jun.

Authors

Josjan Zijlmans^{1

2}, Jacintha M Tieskens³, Hedy A van Oers^{2

4}, Hekmat Alrouh⁵, Michiel A J Luijten^{2

4

6}, Rowdy de Groot^{2

7}, Daniël van der Doelen⁸, Helen Klip⁸, Rikkert M van der Lans³, Ronald de Meyer⁹, Malindi van der Mheen^{2

10

11}, I Hyun Ruisch¹², Germie van den Berg¹³, Hilgo Bruining¹⁰, Jan Buitelaar^{8

14}, Rachel van der Rijken⁹, Pieter J Hoekstra¹², Marloes Kleinjan^{15

16}, Ramón J L Lindauer^{10

11}, Kim J Oostrom^{2

4}, Wouter Staal⁸, Robert Vermeiren^{3

17}, Ronald Cornet^{2

7}, Lotte Haverman^{2

4}, Arne Popma^{1

2

11}, Meike Bartels^{2

5}, Tinca J C Polderman^{1

2

3

8

11

12}

Affiliations

¹ Department of Child and Adolescent Psychiatry & Psychosocial Care Amsterdam University Medical Center Vrije Universiteit Amsterdam Amsterdam The Netherlands.
² Amsterdam Public Health Amsterdam University Medical Center Mental Health Amsterdam The Netherlands.
³ LUMC Curium - Child and Adolescent Psychiatry Leiden University Medical Center Leiden The Netherlands.
⁴ Child and Adolescent Psychiatry & Psychosocial Care Amsterdam University Medical Center University of Amsterdam Emma Children's Hospital Amsterdam The Netherlands.
⁵ Department of Biological Psychology Vrije Universiteit Amsterdam Amsterdam The Netherlands.
⁶ Epidemiology and Data Science Amsterdam University Medical Center Vrije Universiteit Amsterdam Amsterdam The Netherlands.
⁷ Department of Medical Informatics Amsterdam University Medical Center University of Amsterdam Amsterdam The Netherlands.
⁸ Karakter Child and Adolescent Psychiatry University Centre Nijmegen The Netherlands.
⁹ Praktikon Nijmegen The Netherlands.
¹⁰ Department of Child and Adolescent Psychiatry Amsterdam University Medical Center University of Amsterdam Amsterdam The Netherlands.
¹¹ Levvel Academic Center for Child and Adolescent Psychiatry Amsterdam The Netherlands.
¹² Department of Child and Adolescent Psychiatry University Medical Center Groningen, University of Groningen Groningen The Netherlands.
¹³ Netherlands Youth Institute Utrecht The Netherlands.
¹⁴ Department of Cognitive Neuroscience Donders Institute for Brain, Cognition and Behaviour Radboudumc Nijmegen The Netherlands.
¹⁵ Trimbos Institute Utrecht The Netherlands.
¹⁶ Utrecht University Interdisciplinary Social Sciences Youth Studies Utrecht The Netherlands.
¹⁷ Youz Parnassia Psychiatric Institute The Hague The Netherlands.

Abstract

Background: The COVID-19 pandemic has had an acute impact on child mental and social health, but long-term effects are still unclear. We examined how child mental health has developed since the start of the COVID-19 pandemic up to 2 years into the pandemic (April 2022).

Methods: We included children (age 8-18) from two general population samples (N = 222-1333 per measurement and N = 2401-13,362 for pre-covid data) and one clinical sample receiving psychiatric care (N = 334-748). Behavioral questionnaire data were assessed five times from April 2020 till April 2022 and pre-pandemic data were available for both general population samples. We collected parent-reported data on internalizing and externalizing problems with the Brief Problem Monitor and self-reported data on Anxiety, Depressive symptoms, Sleep-related impairments, Anger, Global health, and Peer relations with the Patient-Reported Outcomes Measurement Information System (PROMIS®).

Results: In all samples, parents reported overall increased internalizing problems, but no increases in externalizing problems, in their children. Children from the general population self-reported increased mental health problems from before to during the pandemic on all six PROMIS domains, with generally worst scores in April 2021, and scores improving toward April 2022 but not to pre-pandemic norms. Children from the clinical sample reported increased mental health problems throughout the pandemic, with generally worst scores in April 2021 or April 2022 and no improvement. We found evidence of minor age effects and no sex effects.

Conclusions: Child mental health in the general population has deteriorated during the first phase of the COVID-19 pandemic, has improved since April 2021, but has not yet returned to pre-pandemic levels. Children in psychiatric care show worsening of mental health problems during the pandemic, which has not improved since. Changes in child mental health should be monitored comprehensively to inform health care and policy.

Keywords: COVID‐19; child mental health; general population; pandemic; psychiatric care.