Takahashi Fumito, Honda Hideo
Institute of Education Shinshu University Nagano Japan.
Department of Child and Adolescent Developmental Psychiatry Shinshu University School of Medicine Matsumoto Japan.
JCPP Adv. 2021 Apr;1(1):e12007. doi: 10.1111/jcv2.12007. Epub 2021 Apr 28.
Several empirical studies have investigated negative mental health outcomes related to the spread of infectious diseases, including coronavirus disease 2019 (COVID-19). However, little is known about children's emotional/behavioral problems, especially externalizing problems, during such situations. This prospective cohort study aimed to investigate pandemic-related emotional/behavioral problems and their risk factors among schoolchildren in Japan.
A total of 4800 parents with children in grades 1-12 participated in a two-wave longitudinal survey. Wave 1 and Wave 2 were conducted on March 4-8 and May 15-18, 2020, respectively. Survey items included demographic information, parental depression, children's diagnoses of neurodevelopmental disorders, the total length of school closure, and emotional/behavioral problems. Children's emotional/behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ), which has cutoff points to differentiate clinical-level problems, which were the primary focus of this study.
The proportions of clinical-level problems were higher at Wave 2 (emotional symptoms = 24.8%, conduct problems = 22.7%, hyperactivity/inattention = 36.8%, peer relationship problems = 36.2%, and lack of prosocial behavior = 23.5%) compared to Wave 1. Lower grade-level and lower annual family income predicted the increased proportions of children's clinical-level emotional symptoms, hyperactivity/inattention, and prosocial behavior at Wave 2. The total length of school closure was not a significant predictor of subsequent emotional/behavioral problems. The highest proportion of clinical-level problems at Wave 2 for the four SDQ subscales was observed in children with neurodevelopmental disorders.
The number of schoolchildren with severe emotional/behavioral problems increased during the COVID-19 pandemic. Appropriate prevention and early intervention programs should be provided, especially for children who are in lower grade levels, have low family incomes, or have neurodevelopmental disorders.
多项实证研究调查了与传染病传播相关的负面心理健康结果，包括2019冠状病毒病（COVID-19）。然而，在此类情况下，对于儿童的情绪/行为问题，尤其是外化问题，我们知之甚少。这项前瞻性队列研究旨在调查日本学童中与疫情相关的情绪/行为问题及其风险因素。
共有4800名有1至12年级孩子的家长参与了一项两阶段的纵向调查。第一阶段和第二阶段分别于2020年3月4日至8日和5月15日至18日进行。调查项目包括人口统计学信息、父母抑郁情况、儿童神经发育障碍诊断、学校关闭总时长以及情绪/行为问题。使用优势与困难问卷（SDQ）评估儿童的情绪/行为问题，该问卷设有区分临床水平问题的临界值，而这正是本研究的主要关注点。
与第一阶段相比，第二阶段临床水平问题的比例更高（情绪症状=24.8%，品行问题=22.7%，多动/注意力不集中=36.8%，同伴关系问题=36.2%，亲社会行为缺乏=23.5%）。较低的年级水平和较低的家庭年收入预示着第二阶段儿童临床水平的情绪症状、多动/注意力不集中和亲社会行为比例会增加。学校关闭的总时长并非后续情绪/行为问题的显著预测因素。在神经发育障碍儿童中，观察到第二阶段四个SDQ子量表临床水平问题的比例最高。
在COVID-19大流行期间，患有严重情绪/行为问题的学童数量有所增加。应提供适当的预防和早期干预项目，特别是针对低年级、家庭收入低或患有神经发育障碍的儿童。
