Psychological Symptom Progression in School-Aged Children After COVID-19 Home Confinement: A Longitudinal Study

Xinyan Xie; Qi Liu; Kaiheng Zhu; Qi Jiang; Yanan Feng; Pei Xiao; Xiaoqian Wu; Ranran Song

doi:10.3389/fpsyt.2022.809107

Psychological Symptom Progression in School-Aged Children After COVID-19 Home Confinement: A Longitudinal Study

Front Psychiatry. 2022 Apr 13:13:809107. doi: 10.3389/fpsyt.2022.809107. eCollection 2022.

Authors

Xinyan Xie¹, Qi Liu¹, Kaiheng Zhu¹, Qi Jiang¹, Yanan Feng¹, Pei Xiao¹, Xiaoqian Wu¹, Ranran Song¹

Affiliation

¹ Department of Maternal and Child Health and Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract

Background: The long-term mental health effects of coronavirus disease 2019 (COVID-19) in children are rarely reported. We aimed to investigate the progression of depressive and anxiety symptoms among a cohort of children in the initial epicenter of COVID-19 in China.

Methods: Two waves of surveys were conducted in the same two primary schools in Wuhan and Huangshi, Hubei province: Wave 1 from 28 February to 5 March, 2020 (children had been confined to home for 30-40 days) and Wave 2 from 27 November to 9 December, 2020 (schools had reopened for nearly 3 months). Depressive and anxiety symptoms were estimated using the Children's Depression Inventory - Short Form (CDI-S) and the Screen for Child Anxiety Related Emotional Disorders (SCARED), respectively. ΔCDI-S and ΔSCARED scores between Wave 2 and Wave 1 were calculated and further categorized into tertiles. Multivariable linear regression and multinomial logistic regression models were then applied.

Results: A total of 1,224 children completed both surveys. The prevalence of mental health outcomes at Wave 2 increased significantly compared to Wave 1, specifically depressive symptoms (age-standardized prevalence rates: 37.5 vs. 21.8%) and anxiety symptoms (age-standardized prevalence rates: 24.0 vs. 19.6%). Higher ΔSCARED scores were observed in females and children in Wuhan, and children with experience of neglect had higher ΔCDI-S (β = 1.12; 95% CI = 0.67-1.58) and ΔSCARED (β = 6.46; 95% CI = 4.73-8.19) scores compared with those without experience of neglect. When the Δ scores were further categorized into tertiles, similar results were found.

Conclusions: The prevalence of depressive and anxiety symptoms after schools resumed was increased compared with that during the home quarantine period, even though the COVID-19 pandemic was under control. Females and children in Wuhan, and also children with experience of neglect were at increased risk of mental health disorders.

Keywords: anxiety symptom; coronavirus disease 2019; depressive symptom; longitudinal study; school-aged children.