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      Quality of life and mental health in children and adolescents during the first year of the COVID-19 pandemic: results of a two-wave nationwide population-based study

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          Abstract

          Background

          The COVID-19 pandemic has disrupted the lives of children and adolescents worldwide. The German COPSY study is among the first population-based longitudinal studies to examine the mental health impact of the pandemic. The objective of the study was to assess changes in health-related quality of life (HRQoL) and mental health in children and adolescents and to identify the associated risk and resource factors during the pandemic.

          Methods

          A nationwide longitudinal survey was conducted with two waves during the pandemic (May/June 2020 and December 2020/January 2021). In total, n = 1923 children and adolescents aged 7 to 17 years and their parents participated (retention rate from wave 1 to wave 2: 85%). The self-report and parent-proxy surveys assessed HRQoL (KIDSCREEN-10), mental health problems (SDQ with the subscales emotional problems, conduct problems, hyperactivity, and peer problems), anxiety (SCARED), depressive symptoms (CES-DC, PHQ-2) and psychosomatic complaints (HBSC-SCL). Mixed model panel regression analyses were conducted to examine longitudinal changes in mental health and to identify risk and resource factors.

          Results

          The HRQoL of children and adolescents decreased during the pandemic, and emotional problems, peer-related mental health problems, anxiety, depressive and psychosomatic symptoms increased over time, however the change in global mental health problems from wave 1 to wave 2 was not significant, and some changes were negligible. Socially disadvantaged children and children of mentally burdened parents were at particular risk of impaired mental health, while female gender and older age were associated with fewer mental health problems. A positive family climate and social support supported the mental health of children and adolescents during the pandemic.

          Discussion

          Health promotion, prevention and intervention strategies could support children and adolescents in coping with the pandemic and protect and maintain their mental health.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00787-021-01889-1.

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          Most cited references43

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          Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science

          Summary The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.
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            The Strengths and Difficulties Questionnaire: A Research Note

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              The Patient Health Questionnaire-2: validity of a two-item depression screener.

              A number of self-administered questionnaires are available for assessing depression severity, including the 9-item Patient Health Questionnaire depression module (PHQ-9). Because even briefer measures might be desirable for use in busy clinical settings or as part of comprehensive health questionnaires, we evaluated a 2-item version of the PHQ depression module, the PHQ-2. The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past 2 weeks, scoring each as 0 ("not at all") to 3 ("nearly every day"). The PHQ-2 was completed by 6000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-2 depression severity increased from 0 to 6, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-2 score > or =3 had a sensitivity of 83% and a specificity of 92% for major depression. Likelihood ratio and receiver operator characteristic analysis identified a PHQ-2 score of 3 as the optimal cutpoint for screening purposes. Results were similar in the primary care and obstetrics-gynecology samples. The construct and criterion validity of the PHQ-2 make it an attractive measure for depression screening.
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                Author and article information

                Contributors
                ravens-sieberer@uke.de
                Journal
                Eur Child Adolesc Psychiatry
                Eur Child Adolesc Psychiatry
                European Child & Adolescent Psychiatry
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1018-8827
                1435-165X
                12 October 2021
                12 October 2021
                : 1-14
                Affiliations
                [1 ]GRID grid.13648.38, ISNI 0000 0001 2180 3484, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, , University Medical Center Hamburg-Eppendorf, ; Hamburg, Germany
                [2 ]GRID grid.448744.f, ISNI 0000 0001 0144 8833, Alice Salomon University of Applied Sciences, ; Berlin, Germany
                [3 ]GRID grid.424704.1, ISNI 0000 0000 8635 9954, Apollon University of Applied Sciences, ; Bremen, Germany
                [4 ]Argora Clinic, Psychosomatic Clinic and Outpatient Center, Berlin, Germany
                [5 ]GRID grid.424677.4, ISNI 0000 0004 0548 4745, Hertie School, ; Berlin, Germany
                [6 ]GRID grid.13648.38, ISNI 0000 0001 2180 3484, Department of Medical Psychology, , University Medical Center Hamburg-Eppendorf, ; Hamburg, Germany
                [7 ]Infratest Dimap, Berlin, Germany
                [8 ]GRID grid.13652.33, ISNI 0000 0001 0940 3744, Robert Koch Institute, ; Berlin, Germany
                [9 ]GRID grid.13652.33, ISNI 0000 0001 0940 3744, Department of Epidemiology and Health Monitoring, , Robert Koch Institute, ; Berlin, Germany
                Author information
                http://orcid.org/0000-0002-2031-095X
                Article
                1889
                10.1007/s00787-021-01889-1
                8506100
                34636964
                45d51e61-716e-4d87-aadf-48a3d7699538
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 10 May 2021
                : 29 September 2021
                Funding
                Funded by: Kroschke Child Foundation
                Funded by: Fritz and Hildegard Berg Foundation
                Funded by: Universitätsklinikum Hamburg-Eppendorf (UKE) (5411)
                Categories
                Original Contribution

                Clinical Psychology & Psychiatry
                covid-19,mental health,quality of life,anxiety,depression,children and adolescents

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