Monthly correlates of longitudinal child mental health during the COVID-19 pandemic according to children and caregivers

Abstract

Multiple reviews identify the broad, pervasive initial impact of the global COVID-19 pandemic on the mental health of children, who may be particularly vulnerable to long-term psychiatric sequelae of the ongoing pandemic. However, limited longitudinal research examines persistence of, or change in, children's distress or psychiatric symptomatology. From June 2020 through December 2021, we enrolled two cohorts of families of children aged 8-13 from Southwestern Ontario into a staggered baseline, longitudinal design that leveraged multi-informant report (N = 317 families). In each family, one child and one parent/guardian completed a baseline assessment, 6 monthly follow-up assessments, and one final follow-up assessment 9 months post-baseline. At each assessment, the child and parent/guardian completed the CoRonavIruS health Impact Survey and measures of child anxiety, depressive, irritability, and posttraumatic stress syndromes. Children's mental health, indexed by the severity of multiple syndromes, fluctuated over the study period. Elevated local monthly COVID-19 prevalence, hospitalization, and death rates were associated with monthly elevations in children's reported worry about contracting COVID-19 and stress related to stay-at-home orders. In turn, both elevated monthly worry about contracting COVID-19 and stress related to stay-at-home orders were associated with monthly elevations in child- and parent-/guardian-report of children's emotional distress and psychiatric syndromes. This study illustrates the importance of, and informs the potential design of, longitudinal research to track the mental health of children, who may be particularly vulnerable to broad psychosocial sequelae of health crises such as the COVID-19 pandemic.

Keywords: Anxiety; COVID-19 pandemic; Child; Depressive symptoms; Longitudinal studies.

Fig. 1

Change in child-reported distress (A), depressive symptomatology (B), and irritability (C). The x-axis reflects, at each month, the number of children who provided data, mean, standard deviation, and number and percent of children who exceeded any available clinical threshold

Fig. 2

Change in child-reported panic/somatic (A), social anxiety (B), and separation anxiety (C) syndrome severity. The x-axis reflects, at each month, the number of children who provided data, mean, standard deviation, and number and percent of children who exceeded any available clinical threshold

Fig. 3

Change in child-report of posttraumatic stress symptomatology (A), generalized anxiety symptomatology (B), worry about contracting COVID-19 (C), and stress related to stay-at-home orders or the cancelation of important events (C). For plots (A) and (B), the x-axis reflects, at each month, the number of children who provided data, the mean, standard deviation, and number and percent of children who exceeded any available clinical threshold. For plot (C), blue depicts worry about contracting COVID-19; red depicts stress related to stay-at-home orders or the cancelation of important events. The x-axis reflects the number of children who provided data; number and percent of children who reported attending school virtually; monthly mean and standard deviation of worry about contracting COVID-19; and monthly mean and standard deviation of stress related to stay-at-home orders or the cancelation of important events