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. 2021 Apr;1(1):e12007.
doi: 10.1111/jcv2.12007. Epub 2021 Apr 28.

Prevalence of clinical-level emotional/behavioral problems in schoolchildren during the coronavirus disease 2019 pandemic in Japan: A prospective cohort study

Fumito Takahashi  1 , Hideo Honda  2
Affiliations

Prevalence of clinical-level emotional/behavioral problems in schoolchildren during the coronavirus disease 2019 pandemic in Japan: A prospective cohort study

Fumito Takahashi et al. JCPP Adv. 2021 Apr.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: COVID‐19; adolescents; children; hyperactivity; inattention; mental health; school closure.

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Conflict of interest statement

No conflicts declared.

Figures

FIGURE 1
FIGURE 1
Increases in the proportions of clinical‐level problems measured by the Parent‐Report SDQ Note: Error bar means 95% confidence interval
See this image and copyright information in PMC

References

    1. American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
    1. Bao, Y. , Sun, Y. , Meng, S. , Shi, J. , & Lu, L. (2020). 2019‐nCoV epidemic: Address mental health care to empower society. The Lancet, 395(10224), e37–e38. 10.1016/S0140-6736(20)30309-3 - DOI - PMC - PubMed
    1. Colizzi, M. , Sironi, E. , Antonini, F. , Ciceri, M. L. , Bovo, C. , & Zoccante, L. (2020). Psychosocial and behavioral impact of COVID‐19 in autism spectrum disorder: An online parent survey. Brain Sciences, 10(6), 341. - PMC - PubMed
    1. Courtney, D. , Watson, P. , Battaglia, M. , Mulsant, B. H. , & Szatmari, P. (2020). COVID‐19 impacts on child and youth anxiety and depression: Challenges and opportunities. The Canadian Journal of Psychiatry, 65, 688, 0706743720935646. 10.1177/0706743720935646 - DOI - PMC - PubMed
    1. Ding, Y. , Yan, H. , & Guo, W. (2020). Clinical characteristics of children with COVID‐19: A meta‐analysis. Frontiers in Pediatrics, 8, 431. 10.3389/fped.2020.00431 - DOI - PMC - PubMed