Emotional status of children aged 7 to 17 of health workers and in the general population during the COVID-19 pandemic: A cross-sectional comparative study in Belgium.

Background: We assessed the mental health of children and adolescents aged 7 to 17 and their parents immediately after the first wave of the COVID-19 pandemic. Method: A survey online was conducted in Belgium between May 29th and August 31st 2020. Results: (1) Anxious and depressive symptoms were self-reported by one out of four children and hetero-reported by parents for one out of five children; (2) Anxiety scores were higher in children compared to adolescents; (3) Social introversion scores were significantly higher in adolescents compared to children; (4) No significant differences for anxio-depressive symptoms were found between healthcare worker parents and the other parents. Children's self- or hetero-reported symptoms were not found to be connected to parents' professional activities. Conclusions: This cross-sectional survey adds evidence to the impact the COVID-19 pandemic has had on children's and adolescents' emotional state, in particular on their levels of anxiety and depression.

Objectif: Nous avons évalué la santé mentale d'enfants et d'adolescents âgés de 7 à 17 ans et de leurs parents immédiatement après la première vague de la pandémie de COVID-19. Méthodologie: Une enquête en ligne a été réalisée en Belgique entre le 29 mai et le 31 août 2020. Résultats: (1) Les symptômes anxieux et dépressifs étaient auto-déclarés par un enfant sur quatre et hétéro-déclarés par les parents pour un enfant sur cinq ; (2) Les scores d'anxiété étaient plus élevés chez les enfants par rapport aux adolescents ; (3) Les scores d'introversion sociale étaient significativement plus élevés chez les adolescents par rapport aux enfants ; (4) Aucune différence significative pour les symptômes anxio-dépressifs n'a été trouvée entre les parents travailleurs de la santé et les autres parents. Les symptômes auto- ou hétéro-déclarés par les enfants ne se sont pas avérés être liés aux activités professionnelles des parents. Conclusions: Cette enquête transversale ajoute des preuves de l'impact de la pandémie de COVID-19 sur l'état émotionnel des enfants et des adolescents, en particulier sur leurs niveaux d'anxiété et de dépression.

Prevalence and Relationships between Alexithymia, Anhedonia, Depression and Anxiety during the Belgian COVID-19 Pandemic Lockdown.

Alexithymia and anhedonia are associated with psychiatric disorders, such as depression and anxiety. The COVID-19 pandemic lead to a significant deterioration in the mental health of the population. It is therefore important to examine the effects of lockdown on alexithymia and anhedonia and their relationships with anxiety and depression. We compared the scores and characteristics of 286 patients divided into two groups: one before lockdown (group 1, N = 127), the other during the progressive lockdown release (group 2, N = 159). The groups were homogeneous in terms of age, sex ratio, socio-professional categories, and somatic and psychiatric comorbidities. The groups were compared on the Toronto Alexithymia Scale (TAS-20) measuring alexithymia, the Beck Depression Inventory (BDI-II) measuring depression, the anhedonia subscale of the BDI-II measuring state-anhedonia and the State Trait Anxiety Inventory (STAI) measuring state and trait anxiety. The ratio of alexithymic subjects in group 1 is 22.83% to 33.33% in group 2 (p-value = 0.034). This suggests a significant increase in the number of alexithymic patients after lockdown. We did not observe any difference in the proportion of depressed and anxious subjects before or after lockdown. Among the different scales, higher scores were only found on the cognitive factor of alexithymia on group 2 comparatively to group 1. This study indicates an increase in the proportion of alexithymic subjects following lockdown. Unexpectedly, this was unrelated to depression, anxiety or anhedonia levels, which remained stable. Further studies are needed to confirm this result and to evaluate precisely which factors related to the lockdown context are responsible for such an increase.

Mental Health Outcomes in Healthcare Workers in COVID-19 and Non-COVID-19 Care Units: A Cross-Sectional Survey in Belgium.

BACKGROUND: The literature shows the negative psychological impact of the coronavirus disease 2019 (COVID-19) outbreak on frontline healthcare workers. However, few are known about the mental health of physicians and nurses working in general hospitals during the outbreak, caring for patients with COVID-19 or not. OBJECTIVES: This survey assessed differences in mental health in physicians and nurses working in COVID-19 or non-COVID-19 medical care units. DESIGN: A cross-sectional mixed-mode survey was used to assess burnout, insomnia, depression, anxiety, and stress. SETTING: A total of 1,244 physicians and nurses from five general hospitals in Belgium, working in COVID-19 care units (CCU), non-COVID-19 care units (NCCU), or both (CCU + NCCU) were informed of the study. PARTICIPANTS: Six hundred forty-seven healthcare workers participated in the survey (response rate = 52%). MEASUREMENTS: Validated instruments were used to assess the outcomes: the PFI (burnout/professional fulfillment), the ISI (insomnia), and the DASS-21 (depression, anxiety, and stress). RESULTS: Results showed high prevalence of burnout, insomnia, depression, and anxiety among participants. After adjusting for confounders, multivariate analysis of variance showed no differences between CCU, NCCU, and CCU + NCCU workers. Univariate general linear models showed higher level of burnout, insomnia, and anxiety among nurses in comparison to physicians. Being a nurse, young, isolated, with an increased workload were risk factors for worse mental health outcomes. LIMITATIONS: The mental health of the tested sample, before the outbreak, is unknown. Moreover, this cross-sectional design provides no information on the evolution of the mental health outcomes over time. CONCLUSION: Directly caring for patients with COVID-19 is not associated with worse mental health outcomes among healthcare workers in general hospitals. High prevalence of burnout, insomnia, depression, and anxiety among physicians and nurses requires special attention, and specific interventions need to be implemented. PROTOCOL REGISTRATION: ClinicalTrials.gov, identifier NCT04344145.