Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK; South London and Maudsley NHS Foundation Trust, London, UK.
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK.
Neurosci Biobehav Rev. 2024 Jan;156:105502. doi: 10.1016/j.neubiorev.2023.105502. Epub 2023 Dec 7.
Prior studies reported mixed effects of the COVID-19 pandemic on the mental health of children and adolescents with ADHD, but they were mainly cross-sectional and without controls. To clarify the impact, we searched Web of Science, EMBASE, Medline, and PsychINFO until 18/11/2023 and conducted a systematic review of controlled longitudinal cohort studies (Prospero: CRD42022308166). The Newcastle-Ottawa scale was used to assess quality. We identified 6 studies. Worsening of mental health symptoms was more evident in ADHD or control group according to symptom considered and context. However, those with ADHD had more persistent elevated symptoms and remained an at-risk population. Sleep problems deteriorated more significantly in those with ADHD. Lower pre-COVID emotion regulation skills and greater rumination were associated with worse mental health outcomes, and longer screen time with poorer sleep. Quality was rated as low in most studies, mainly due to self-report outcome measures and no information on attrition rates. Despite these limitations, results suggest a predominantly negative impact on youths with ADHD and may guide clinical practice and policy.
先前的研究报告了 COVID-19 大流行对 ADHD 儿童和青少年心理健康的影响复杂，但这些研究主要是横断面研究，且没有对照组。为了阐明影响，我们检索了 Web of Science、EMBASE、Medline 和 PsychINFO，截至 2023 年 11 月 18 日，并对对照性纵向队列研究进行了系统评价（Prospéro：CRD42022308166）。采用纽卡斯尔-渥太华量表评估质量。我们确定了 6 项研究。根据所考虑的症状和背景，ADHD 或对照组的心理健康症状恶化更为明显。然而，ADHD 患者的症状持续升高，仍然是一个高危人群。ADHD 患者的睡眠问题恶化更为显著。COVID-19 前情绪调节技能较低和更多的反刍思维与更糟糕的心理健康结果相关，而屏幕时间更长则与睡眠质量更差相关。大多数研究的质量被评为低，主要是由于采用自我报告的结局测量，且没有关于失访率的信息。尽管存在这些局限性，结果表明 COVID-19 对 ADHD 青少年的影响主要是负面的，这可能为临床实践和政策提供指导。
