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 Table of Contents  
EDITORIAL
Year : 2021  |  Volume : 22  |  Issue : 1  |  Page : 1-3

Impact of COVID-19 pandemic on child and adolescent mental health


Professor and Head, Department of Child and Adolescent Psychiatry, NIMHANS, Bengaluru, Karnataka, India

Date of Web Publication01-Jun-2021

Correspondence Address:
Dr. John Vijay Sagar Kommu
Department of Child and Adolescent Psychiatry, NIMHANS, Bengaluru - 560 029, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/amh.amh_62_21

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How to cite this article:
Kommu JV. Impact of COVID-19 pandemic on child and adolescent mental health. Arch Ment Health 2021;22:1-3

How to cite this URL:
Kommu JV. Impact of COVID-19 pandemic on child and adolescent mental health. Arch Ment Health [serial online] 2021 [cited 2021 Nov 28];22:1-3. Available from: https://www.amhonline.org/text.asp?2021/22/1/1/317423




  Introduction Top


Coronavirus disease 2019 (COVID-2019) is an acute respiratory disease caused by a novel coronavirus named severe acute respiratory syndrome coronavirus 2.[1] The World Health Organization has declared the novel coronavirus outbreak a public health emergency of international concern.[2] As of April 19, 2021, there are 19 lakh COVID-19 active cases in India.[3] Infection rates are less in children compared to adults and it has been reported that 15%–35% are asymptomatic.[4] The impact of COVID-19 on the lives of children and adolescents has been unprecedented.[5]

COVID-19 has caused several disruptions in the day-to-day functioning of families. There is an increase in unemployment causing immense economic hardship, reduction in social support for families, potential worsening of parental physical or psychological illnesses, increased burden of caretaking children staying at home, lack of social contacts due to travel restrictions, fear of infection, and health issues and quarantine due to COVID infection.

The impact of COVID-19 on the mental health of children is influenced by several factors that include: the developmental age of the child, current educational status, having special needs, preexisting mental health condition, being economically underprivileged, and child/parent being quarantined due to infection or fear of infection.[6] There is a complex interplay of these biological, environmental, and social factors.[7]


  Impact of COVID-19 on Fetal Development Top


Although there is no evidence that pregnant women are at increased risk of COVID-19 and for transmission of virus to the fetus from the mother, maternal stress during pregnancy either due to infection in self or a family member can result in an adverse impact on fetal development.[8],[9]


  Impact of COVID-19 on the Mental Health of Preschoolers Top


Preschoolers (children aged 3–6 years) are vulnerable to delay of development in socioemotional and language domains as there is an increased risk of experiential deprivation due to the COVID-19 pandemic. Closure of play areas, daycare centers, playschools, anganwadi centers, etc., has led to a situation where the preschooler spends all the time in the home context. Given their developmental level, preschoolers have a limited understanding of the situation that has arisen due to COVID-19 (COVID precautions and restrictions). They may repeatedly question their parents/caregivers. Effective communication about COVID-19 by parents to their children in simple language can alleviate fears and anxiety to a large extent.[10] There are online resources available for parents/caregivers to explain COVID-19 to their young children.[11],[12] Symptoms of anxiety, withdrawn behavior, clinging to caregiver, poor appetite, reduced attention span, and disturbed sleep are common in this age group.[6]


  Impact of COVID-19 on Mental Health of School-going Children and Adolescents Top


School closures have resulted in the confinement of children and adolescents at home. The daily routine has become unstructured with children spending excess time in the use of gadgets such as laptops and mobile phones. This has led to an increased risk of behavioral addictions such as gaming addiction and also the risk of cyberbullying and online sexual exploitation. Children often report feelings of boredom, anger, frustration, and sadness. Parents/caregivers report behavioral changes such as aggression directed toward them as well as other family members. There are reports of increased rates of depression and anxiety disorders in several recent studies.[13],[14],[15],[16],[17] However, there are methodological limitations of the available studies that include a lack of pre-COVID-19 comparative baseline data, lack of data on clinically-elevated symptom distress, and a lack of longitudinal research.[18]

The adverse impact of COVID-19 on mental health is more likely to be severe for children who fall in the high-risk group. These include children from lower socioeconomic status, children with preexisting mental illness, children with chronic medical conditions, children with neurodevelopmental disorders, children living in child care institutions, and children of frontline workers.[19],[20] For children with preexisting mental health issues, school routines are important coping mechanisms and school closures would increase the risk of relapse.[21] Children with neurodevelopmental disorders are deprived of holistic interventions due to the closure of many therapy centers and special schools. This has led to the persistence of developmental deficits, exacerbation of challenging behaviors, and increased caregiver burden. COVID-19 pandemic has also resulted in an increased risk of childhood adversities such as child abuse (emotional/physical/sexual), child labor, child trafficking, and child marriage. These adversities will result in a severe impact on the mental health on affected children.[22]


  Role of Mental Health Professionals Top


Mental health professionals can play a vital role in mitigating the adverse impact of COVID-19 on the mental health of children and adolescents. Some of the approaches include: education of children and their parents/caregivers about COVID-19 and the symptoms of psychological distress, providing of tele-support through COVID help-lines, effective liaison with parents, teachers, child protection agencies, development of resource material (handouts, audio messages, videos, manuals, etc.,) for psychosocial support of children and parents, effective utilization of hybrid model of in-person consultation and teleconsultation for immediate evaluation, and management of psychiatric disorders and follow-up of children who have been on treatment, special focus on children from the high-risk groups, and specific support to parents and teachers through online programs.


  Conclusion Top


Children and adolescents constitute 39% of our country's population. There is a vulnerable group for psychiatric disorders and the recent COVID-19 pandemic has accentuated this risk. There is an urgent need to include specific mental health interventions for children and adolescents as part of ongoing efforts to support the mental health of the people enduring the adverse impact of the COVID-19 pandemic.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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World Health Organization. Timeline: WHO's COVID-19 Response; 2021. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline/#! [Last accessed on 2021 Apr 19].  Back to cited text no. 2
    
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Ministry of Health and Family Welfare, Government of India. COVID-19 Active Cases in India; 2021. Available from: https://www.mohfw.gov.in/. [Last accessed on 2021 Apr 19].  Back to cited text no. 3
    
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Alsohime F, Temsah MH, Al-Nemri AM, Somily AM, Al-Subaie S. COVID-19 infection prevalence in pediatric population: Etiology, clinical presentation, and outcome. J Infect Public Health 2020;13:1791-6.  Back to cited text no. 4
    
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Shen K, Yang Y, Wang T, Zhao D, Jiang Y, Jin R, et al. Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: Experts' consensus statement. World J Pediatr 2020;16:223-31.  Back to cited text no. 5
    
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de Figueiredo CS, Sandre PC, Portugal LC, Mázala-de-Oliveira T, da Silva Chagas L, Raony Í, et al. COVID-19 pandemic impact on children and adolescents' mental health: Biological, environmental, and social factors. Prog Neuropsychopharmacol Biol Psychiatry 2021;106:110171.  Back to cited text no. 7
    
8.
Wang CL, Liu YY, Wu CH, Wang CY, Wang CH, Long CY. Impact of COVID-19 on Pregnancy. Int J Med Sci 2021;18:763-7.  Back to cited text no. 8
    
9.
Kinsella MT, Monk C. Impact of maternal stress, depression and anxiety on fetal neurobehavioral development. Clin Obstet Gynecol 2009;52:425-40.  Back to cited text no. 9
    
10.
Dalton L, Rapa E, Stein A. Protecting the psychological health of children through effective communication about COVID-19. Lancet Child Adolesc Health 2020;4:346-7.  Back to cited text no. 10
    
11.
Deutsche Gesellschaft Für Psychologie DGPs. Psychological Consequences of Corona and What to do about It. Explained for Children in 3 Minute. Available from: https://www.youtube.com/watch?v=gZFyjs4gNUs. [Last accessed on 2021 Apr 19; Last update on 2020 Apr 03].  Back to cited text no. 11
    
12.
Mental Health America. How to Talk to Your Anxious Child or Teen about Coronavirus; 2021. Available from: https://mhanational.org/blog/how-talk-your-anxious-child-or-teen-about-coronavirus. [Last accessed on 2021 Apr 19].  Back to cited text no. 12
    
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Jiao WY, Wang LN, Liu J, Fang SF, Jiao FY, Pettoello-Mantovani M, et al. Behavioral and emotional disorders in children during the COVID-19 epidemic. J Pediatr 2020;221:264-6.  Back to cited text no. 13
    
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Liu S, Liu Y, Liu Y. Somatic symptoms and concern regarding COVID-19 among Chinese college and primary school students: A cross-sectional survey. Psychiatry Res 2020;289:113070.  Back to cited text no. 14
    
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Xie X, Xue Q, Zhou Y, Zhu K, Liu Q, Zhang J, et al. Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei province, China. JAMA Pediatr 2020;174:898-900.  Back to cited text no. 15
    
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Zhou SJ, Zhang LG, Wang LL, Guo ZC, Wang JQ, Chen JC, et al. Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19. Eur Child Adolesc Psychiatry 2020;29:749-58.  Back to cited text no. 16
    
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Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: A narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health 2020;14:20.  Back to cited text no. 19
    
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22.
Ramaswamy S, Seshadri S. Children on the brink: Risks for child protection, sexual abuse, and related mental health problems in the COVID-19 pandemic. Indian J Psychiatry 2020;62:S404-13.  Back to cited text no. 22
  [Full text]  



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