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. 2023 Apr;32(4):575-588.
doi: 10.1007/s00787-021-01889-1. Epub 2021 Oct 12.

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

Ulrike Ravens-Sieberer #  1 , Anne Kaman #  2 , Michael Erhart  2   3   4 , Christiane Otto  2 , Janine Devine  2   5 , Constanze Löffler  2 , Klaus Hurrelmann  6 , Monika Bullinger  7 , Claus Barkmann  2 , Nico A Siegel  8 , Anja M Simon  8 , Lothar H Wieler  9 , Robert Schlack  10 , Heike Hölling  10
Affiliations

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

Ulrike Ravens-Sieberer et al. Eur Child Adolesc Psychiatry. 2023 Apr.

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.

Keywords: Anxiety; COVID-19; Children and adolescents; Depression; Mental health; Quality of life.

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Conflict of interest statement

None of the authors has a conflict of interest to disclose.

Figures

Fig. 1
Fig. 1
Numbers of participating families, children and adolescents in wave 1 and wave 2 of the COPSY study
Fig. 2
Fig. 2
Health-related quality of life of children and adolescents measured prior to the COVID-19 pandemic (BELLA study), in wave 1 (n = 1586) and in wave 2 (n = 1625) of the COPSY study. Significant differences in HRQoL prior vs. wave 1, prior vs. wave 2 and wave 1 vs. wave 2
Fig. 3
Fig. 3
Mental health problems, anxiety symptoms and depressive symptoms measured prior to the COVID-19 pandemic (BELLA study), in wave 1 and in wave 2 of the COPSY study. Significant differences in mental health problems prior vs. wave 1 and prior vs. wave 2; significant differences in anxiety prior vs. wave 1, prior vs. wave 2 and wave 1 vs. wave 2; significant differences in depression prior vs. wave 2 and wave 1 vs. wave 2
Fig. 4
Fig. 4
Psychosomatic complaints at least once per week measured prior to the COVID-19 pandemic (BELLA study), in wave 1 and in wave 2 of the COPSY study. Significant differences in stomachache, feeling low, and headache prior vs. wave 1, prior vs. wave 2 and wave 1 vs. wave 2; significant difference in sleeping problems and irritability prior vs. wave 1 and prior vs. wave 2
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