University of Bath, United Kingdom.
University of Bath, United Kingdom.
J Am Acad Child Adolesc Psychiatry. 2020 Nov;59(11):1218-1239.e3. doi: 10.1016/j.jaac.2020.05.009. Epub 2020 Jun 3.
OBJECTIVE: Disease containment of COVID-19 has necessitated widespread social isolation. We aimed to establish what is known about how loneliness and disease containment measures impact on the mental health in children and adolescents. METHOD: For this rapid review, we searched MEDLINE, PsycInfo, and Web of Science for articles published between January 1, 1946, and March 29, 2020. Of the articles, 20% were double screened using predefined criteria, and 20% of data was double extracted for quality assurance. RESULTS: A total of 83 articles (80 studies) met inclusion criteria. Of these, 63 studies reported on the impact of social isolation and loneliness on the mental health of previously healthy children and adolescents (n = 51,576; mean age 15.3 years). In all, 61 studies were observational, 18 were longitudinal, and 43 were cross-sectional studies assessing self-reported loneliness in healthy children and adolescents. One of these studies was a retrospective investigation after a pandemic. Two studies evaluated interventions. Studies had a high risk of bias, although longitudinal studies were of better methodological quality. Social isolation and loneliness increased the risk of depression, and possibly anxiety at the time at which loneliness was measured and between 0.25 and 9 years later. Duration of loneliness was more strongly correlated with mental health symptoms than intensity of loneliness. CONCLUSION: Children and adolescents are probably more likely to experience high rates of depression and most likely anxiety during and after enforced isolation ends. This may increase as enforced isolation continues. Clinical services should offer preventive support and early intervention where possible and be prepared for an increase in mental health problems.
目的:COVID-19 的疾病控制需要广泛的社会隔离。我们旨在确定孤独感和疾病控制措施如何影响儿童和青少年的心理健康。
方法:为了进行快速审查,我们在 MEDLINE、PsycInfo 和 Web of Science 上搜索了 1946 年 1 月 1 日至 2020 年 3 月 29 日期间发表的文章。在这些文章中,有 20%是根据预先确定的标准进行双重筛选的,有 20%的数据是进行双重提取以确保质量的。
结果:共有 83 篇文章(80 项研究)符合纳入标准。其中,63 项研究报告了社会隔离和孤独感对以前健康的儿童和青少年心理健康的影响(n=51576;平均年龄 15.3 岁)。所有研究均为观察性研究,61 项为纵向研究,43 项为横断面研究,评估健康儿童和青少年的自我报告孤独感。其中一项研究是大流行后的回顾性调查。两项研究评估了干预措施。这些研究存在高偏倚风险,尽管纵向研究的方法质量更好。社会隔离和孤独感增加了抑郁的风险,并且在测量孤独感时以及 0.25 到 9 年后可能会增加焦虑的风险。孤独感的持续时间与心理健康症状的相关性强于孤独感的强度。
结论:在强制隔离结束时和之后,儿童和青少年可能更有可能经历较高水平的抑郁,最有可能经历焦虑。随着强制隔离的继续,这种情况可能会加剧。临床服务应尽可能提供预防性支持和早期干预,并为心理健康问题的增加做好准备。
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