Pedreira Massa José Luis
Psiquiatra y Psicoterapeuta de Infancia y Adolescencia. Profesor de Psicopatología, Grado Criminología (UNED). Profesor de Salud Pública, Grado Trabajo Social (UNED). ORCID: https://orcid.org/0000-0002-5640-013X.
Rev Esp Salud Publica. 2020 Oct 16;94:e202010141.
The pandemic produced by COVID-19 has a significant impact on society and has also affected childhood and adolescence, which, in general, has been the most silenced group. This article addresses the contents that affect the mental health of children and adolescents in the heart of the COVID-19 pandemic, it is located in the "fourth wave of care" in category F54 of the ICD-10 ("Behavioral and psychological factors in disorders or diseases classified elsewhere"). The presentation mechanism is: reactive-adaptive to the pandemic; triggering factor, before a previous affective-emotional instability; decompensation of a pre-existing process. The clinical features have had their initial phase, fundamentally, in confinement: somatoform disorders, behavioral disorders, emotional symptoms, reactivation of child abuse and dysfunctional grief reactions. The most prevalent symptoms are of the anxious or anxious-depressive type. The response to chronic stress, including that of low profile and intensity but maintained over time, has significant repercussions for childhood and adolescence. Few percentage that present prominent mental disorders, but we must recognize that when projected to the whole the child-adolescent population, there could be a significant number that could be subsidiary of a more specific help. The return to schooling is going to represent another important moment, the repercussions of confinement being of capital importance, especially in terms of addictive behaviors with information and communication technologies. Intervention by professionals trained in childhood and adolescent mental health is a priority to avoid unwanted clinical evolutions or iatrogenesis.
由新冠病毒引发的疫情对社会产生了重大影响，也波及了儿童和青少年群体，总体而言，这是最受忽视的群体。本文探讨了在新冠疫情核心阶段影响儿童和青少年心理健康的内容，它属于国际疾病分类第十版（ICD - 10）F54类（“其他分类的疾病或病症中的行为和心理因素”）中的“第四波护理”范畴。呈现机制为：对疫情的反应性适应；触发因素，存在先前的情感 - 情绪不稳定；既往存在的过程失代偿。临床特征最初主要体现在隔离期间：躯体形式障碍、行为障碍、情绪症状、儿童虐待行为的复发以及功能失调性悲伤反应。最常见的症状是焦虑或焦虑抑郁型。对慢性应激的反应，包括低强度但长期持续的应激，对儿童和青少年有重大影响。出现明显精神障碍的比例较小，但我们必须认识到，若将其推广至整个儿童青少年群体，可能会有相当数量的人需要更具体的帮助。返校将是另一个重要时刻，隔离的影响至关重要，尤其是在信息和通信技术成瘾行为方面。受过儿童和青少年心理健康培训的专业人员进行干预是当务之急，以避免不良的临床进展或医源性问题。
