Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
Department of Epidemiology and Public Health, University College London, London, UK.
Soc Psychiatry Psychiatr Epidemiol. 2024 Jan;59(1):175-186. doi: 10.1007/s00127-023-02517-w. Epub 2023 Jun 23.
Emotional and behavioral problems in children and young people (CYP) have increased over the pandemic. Those with pre-existing mental disorders are more vulnerable but have been understudied. We investigated emotional and behavioral outcomes in this population; differences across diagnostic groups; and social, educational, and clinical determinants.
We invited 5386 caregivers and CYP (aged 5-17) under child mental health services pre-pandemic to complete an online survey on CYP's emotional/behavioral symptoms and pandemic-related circumstances, and integrated responses with clinicodemographic information extracted from electronic health records. We compared four parent-rated outcomes (total emotional/behavioral scores and emotional/behavioral changes as compared to before the pandemic) across the three most common diagnostic groups in our population (Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD) and emotional disorders (EmD)). We then estimated the association of clinicodemographic and pandemic-related characteristics with emotional/behavioral outcomes.
A total of 1741 parents (32.3%) completed the survey. Parents of CYP with ADHD or ASD reported more behavioral difficulties (t(591) = 5.618 (0.001); t(663) = 6.527 (0.001)); greater emotional deterioration (t(591) = 2.592 (0.009); t(664) = 4.670 (< 0.001); and greater behavioral deterioration (t(594) = 4.529 (< 0.001); t(664) = 5.082 (< 0.001)) as compared to the EmD group. Those with ASD and EmD showed more emotional difficulties than ADHD (t(891) = - 4.431 (< 0.001); t(590) = - 3.254 (0.001)). Across diagnoses, poor parental mental health and challenges with education were most strongly associated with worse outcomes.
Within our clinical population, CYP with ADHD/ASD were the most adversely affected during lockdown. Enhancing clinical service provision that tackles parental stress and supports education may help mitigate the impact of future restrictions.
儿童和青少年（CYP）的情绪和行为问题在大流行期间有所增加。那些患有先前存在的精神障碍的人更容易受到影响，但研究较少。我们调查了这一人群的情绪和行为结果；不同诊断组之间的差异；以及社会、教育和临床决定因素。
我们邀请了 5386 名儿童心理健康服务机构的照顾者和 CYP（年龄 5-17 岁）在大流行前完成了一项关于 CYP 情绪/行为症状和大流行相关情况的在线调查，并将综合反应与从电子健康记录中提取的临床人口统计学信息进行了整合。我们比较了我们人群中三个最常见的诊断组（注意力缺陷多动障碍（ADHD）、自闭症谱系障碍（ASD）和情绪障碍（EmD））的四个父母评定结果（总情绪/行为评分和与大流行前相比的情绪/行为变化）。然后，我们估计了临床人口统计学和大流行相关特征与情绪/行为结果的关联。
共有 1741 名家长（32.3%）完成了调查。患有 ADHD 或 ASD 的 CYP 父母报告了更多的行为问题（t（591）=5.618（0.001）；t（663）=6.527（0.001））；情绪恶化更大（t（591）=2.592（0.009）；t（664）=4.670（<0.001）；行为恶化更大（t（594）=4.529（<0.001）；t（664）=5.082（<0.001））与 EmD 组相比。那些患有 ASD 和 EmD 的人比 ADHD 的人表现出更多的情绪问题（t（891）=-4.431（<0.001）；t（590）=-3.254（0.001））。在所有诊断中，父母心理健康状况不佳和教育方面的挑战与更差的结果最密切相关。
在我们的临床人群中，ADHD/ASD 的 CYP 在封锁期间受到的影响最大。加强解决父母压力和支持教育的临床服务提供，可能有助于减轻未来限制的影响。
