Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD, Amsterdam, The Netherlands.
Epidemiology and Data Science, Vrije Universiteit, Amsterdam UMC, Amsterdam, The Netherlands.
Qual Life Res. 2021 Oct;30(10):2795-2804. doi: 10.1007/s11136-021-02861-x. Epub 2021 May 15.
During the COVID-19 pandemic in the Netherlands, governmental regulations resulted in a lockdown for adults as well as children/adolescents. Schools were closed and contact with other people was limited. In this cross-sectional, population-based study, we aimed to investigate the mental/social health of children/adolescents during COVID-19 lockdown.
Two representative samples of Dutch children/adolescents (8-18 years) before COVID-19 (2018, N = 2401) and during lockdown (April 2020, N = 844) were compared on the Patient-Reported Outcomes Measurement Information System (PROMIS) domains: global health, peer relationships, anxiety, depressive symptoms, anger, sleep-related impairment by linear mixed models and calculating relative risks (RR (95% CI)) for the proportion of severe scores. Variables associated with worse mental/social health during COVID-19 were explored through multivariable regression models. The impact of COVID-19 regulations on the daily life of children was qualitatively analyzed.
Participants reported worse PROMIS T-scores on all domains during COVID-19 lockdown compared to before (absolute mean difference range 2.1-7.1 (95% CI 1.3-7.9). During lockdown, more children reported severe Anxiety (RR = 1.95 (1.55-2.46) and Sleep-Related Impairment (RR = 1.89 (1.29-2.78) and fewer children reported poor Global Health (RR = 0.36 (0.20-0.65)). Associated factors with worse mental/social health were single-parent family, ≥ three children in the family, negative change in work situation of parents due to COVID-19 regulations, and a relative/friend infected with COVID-19. A large majority (> 90%) reported a negative impact of the COVID-19 regulations on daily life.
This study showed that governmental regulations regarding lockdown pose a serious mental/social health threat on children/adolescents that should be brought to the forefront of political decision-making and mental healthcare policy, intervention, and prevention.
在荷兰 COVID-19 大流行期间，政府法规对成年人和儿童/青少年实施了封锁。学校关闭，与他人的接触受到限制。在这项横断面、基于人群的研究中，我们旨在调查 COVID-19 封锁期间儿童/青少年的精神/社会健康状况。
在 COVID-19 之前（2018 年，N=2401）和封锁期间（2020 年 4 月，N=844），对两个具有代表性的荷兰儿童/青少年样本（8-18 岁）使用患者报告的结果测量信息系统（PROMIS）领域进行比较：全球健康、同伴关系、焦虑、抑郁症状、愤怒、通过线性混合模型和计算严重分数的相对风险（RR（95%CI））来衡量睡眠相关障碍。通过多变量回归模型探讨与 COVID-19 期间精神/社会健康状况较差相关的变量。通过定性分析儿童 COVID-19 法规对日常生活的影响。
与 COVID-19 之前相比，参与者在封锁期间报告的 PROMIS T 评分在所有领域都更差（绝对平均差异范围为 2.1-7.1（95%CI 1.3-7.9）。在封锁期间，更多的孩子报告严重的焦虑（RR=1.95（1.55-2.46）和睡眠相关障碍（RR=1.89（1.29-2.78），而更少的孩子报告全球健康状况不佳（RR=0.36（0.20-0.65））。与精神/社会健康状况较差相关的因素包括单亲家庭、家庭中≥3 个孩子、由于 COVID-19 法规父母工作情况发生负面变化、以及亲戚/朋友感染 COVID-19。绝大多数（>90%）报告 COVID-19 法规对日常生活产生负面影响。
本研究表明，政府关于封锁的法规对儿童/青少年的精神/社会健康构成了严重威胁，应成为政治决策和精神保健政策、干预和预防的首要任务。
