ABSTRACT
Objective: To examine whether established patient-reported outcome measures are suitable for capturing the impact of ARPKD in children and their families. Method(s): We assessed 44 children with ARPKD (40 families) with respect to patients' health-related quality of life ((hr- QOL) using PedsQLTM ESRD module) and mental health (strength and difficulties questionnaire (SDQ)) as well as family and caregiver burden (Impact on family score (IFS) und Ulm inventory of parental caregiver QOL (ULQIE)) and compared them to published data and 36 healthy control children matched for age and time. Result(s): Patients were aged 9.5 +/- 5.9 years (vs. controls 8.8 +/- 5.0, p = ns) and 21 (48%) were female (vs. 19 controls (53%), p = ns). Mean eGFR was 81 ml/min*1.73m2 (range 4 - 165);7 received dialysis and 11 had functioning kidney transplants (KTX, 2 combined with liver transplants). Eight patients had developmental delay secondary to medical complications, while chronic illness was an exclusion criterion for healthy controls. 61 caregivers of affected children had same gender-distribution (61% vs. 60% mothers) and age (both 42 +/- 7 years) and number of dependent children (1.8 +/- 0.9 vs. 2.0 +/- 0.8) as 57 caregivers of healthy children. The mean proxy reported PedsQL Total score was 77.5 +/- 10.6 (range 59 - 96). It correlated significantly to eGFR (r = 0.5, p < 0.01, (also within the subpopulations pre- and post-KTX)). Parents reported greater mental health problems in affected than in control children with a higher SDQ total score mainly due to higher scores in the hyperactivity and peerinteraction subscales. ULQIE revealed that parents of affected children had significantly lower levels of physical functioning, self-fulfillment and general QOL, but despite higher emotional burden scores they indicated similar satisfaction with family life. Impact on family scores were in a similar range to those of children with moderate to severe disabilities. Conclusion(s): The good spread of PedsQLTM ESRD-scores and their correlation to renal function indicates that it captures significant aspects of ARPKD, however, it may need further adjustment to include liver complications. All four chosen instruments revealed significant impact of ARPKD on hrQOL and mental health of affected children as well as family life and parental wellbeing in comparison to healthy controls. More problems with peer-interactions may also be due to more stringent shielding of chronically ill children from social contacts during the COVID pandemic compared to healthy children.
ABSTRACT
Behavioural strengths and psychosocial problems in children and adolescents between the ages of 3 and 15 are reported. The survey is based on a household-representative sample of 2,421 parents or guardians providing information on their everyday family-life in summer 2021 by online-questionnaire. 704 of the respondents participated again in the spring of 2022. In result, the behaviour of a quarter of the children and adolescents is described as psychosocially borderline/abnormal over the survey period (SDQ total). About a third of children and adolescents have emotional problems, behavioural problems or problems with their peers (respective SDQ-subscales). The proportion of primary-school children with emotional problems increases from summer 2021 to the following spring. Families in which children with disabilities live are disproportionally more affected. The results are discussed with regard to the SDQ standard values available for Germany, as well as the families' self-reported supportneeds and their planned use of professional support-services. Given the psychosocial burden of children, adolescents and their families presented here, which become apparent well after the closures of day-care centres and schools, or other contact-restricting measures to contain the pandemic, have ended, it remains of interest to observe how their well-being will further develop over time.
Subject(s)
Pandemics , Problem Behavior , Humans , Child , Adolescent , Child, Preschool , Surveys and Questionnaires , Self Report , Germany , Parents/psychologyABSTRACT
Background. Autoimmune rheumatic diseases (ARD) include various chronic conditions with high morbidity and mortality rates, and an increased risk of infections, including the new COVID-19. It is possible that adolescents with ARD have higher levels of psychological distress which may affect their mental health and life conditions. The objectives were to assess mental health and life conditions in adolescents with autoimmune rheumatic diseases (ARD) and healthy controls in social isolation, emphasizing some demographic aspects and daily routine of adolescents with juvenile dermatomyositis (JDM) during the COVID-19 quarantine. Methods. A cross-sectional study, performed from July 2020 to October 2020, included 155 ARD adolescents and 105 healthy controls. Online survey composed by self-reported strengths and difficulties questionnaire (SDQ) and a semi-structured questionnaire was filled in regarding demographic data, daily home and school routine, physical activities and COVID-19 information during the pandemic. Results. The patients included in the study presented the following underlying diseases: 15% JDM, 29% juvenile systemic lupus erythematosus (JSLE) and 56% juvenile idiopathic arthritis (JIA). Among adolescents with JDM, 71% were female, 54% Caucasian and the median age was 14 years (range 10-18). Regarding school data, 92% JDM participants attended school before pandemic, 75% studied in public schools and up to 17% did not present home schooling during the quarantine. All JDM patients agreed with stay-home policy after pandemic outbreak, and they reported change in life routine (96%), sleep problems (29%), sleep after midnight (75%) and increased screen time (87%). Worsening of family financial situation (37%) and increased family violence (8%) were also observed. Concerning mental health assessment, it was verified that one third of JDM subjects presented abnormal total difficulties and emotional scores of SDQ. No differences were found regarding sex, ethnicity and current age between ARD patients and controls (p>0.05). The frequencies of abnormal SDQ total (32% vs. 32%, p=0.901) and emotional (38% vs. 35%, p=0.653) were similar in both groups. Logistic regression analyses in ARD patients demonstrated that female (OR=2.4;95%CI 1.0-6.0;p=0.044) was associated with severe emotional SDQ dysfunction, whereas poor sleep quality was considered risk factor for both worse total SDQ (OR 2.6;95% CI 1.2-5.5;p=0.009) and emotional SDQ scores (OR=4.6;95%CI 2.2-9.7;p<0.001). Comparisons between ARD patients with and without current prednisone use showed higher median scores of peer problems in the first group [3(0-10) vs. 2(0-7), p=0.049]. The median and frequencies of SDQ scores and domains were similar between JDM, JSLE and JIA (p>0.05). Conclusions. Approximately one third of JDM, JSLE and JIA patients presented abnormal total difficulties and emotional scores of SDQ. Female sex and poor sleep quality were the main factor associated with emotional impact in these ARD adolescents.
ABSTRACT
At the onset of the COVID-19 pandemic in early 2020 in South Africa, many safety measures were implemented to protect the lives of the population. Ironically, these same safety measures have negatively impacted on the lives of children and their caregivers resulting in increased mental health problems. This study forms part of the multicountry Co-SPACE (COVID-19: Supporting Parents, Adolescents and Children during Epidemics) study that explores how families are coping during the COVID-19 pandemic, and what caregivers can do to help support their children's mental health. This paper aims to gain a better understanding of the mental health status of families specifically in South Africa in the early onset of the pandemic during restrictive lockdown measures, and identify certain risk factors that might contribute towards deteriorating mental health. Two hundred and fifty-four South African parents and carers of children and adolescents completed an online survey about their child's mental health as well as their own mental health during and post- hard lockdown in South Africa. Data collection took place over the period of the first and second waves of the COVID-19 pandemic in South Africa. Results showed that children experienced significantly higher mental health problems than adolescents (p = 0.016). Younger children were particularly negatively affected by lockdown and had more mental health problems than adolescents (p = 0.023); including emotional problems (p = 0.017), misconduct (p = 0.030), and hyperactivity (p = 0.001). Additionally, the presence of special educational needs/neurodevelopmental disorders (SEN/ND) was associated with more mental health problems (p = 0.001). Surprisingly, single parent households, which is another well-known risk factor showed no differences in mental health problems compared to nuclear families. There was also a reciprocal relationship between parental/carer mental health and child/adolescent mental health, with higher level of endorsement of mental health problems in children by parents/caregivers who themselves associated with higher levels of depression, anxiety and stress (all p's < 0.001). These results highlight the dramatic impact that COVID-19 had on children, adolescents and parents in South Africa early in the pandemic, and emphasises the need for specific support structures to be implemented within the SEN/ND community, as well as for younger children and single parent households.
ABSTRACT
Background: Mental health problems are increasingly prevalent among children and adolescents. Children from low income families are likely to have worse mental health than their wealthier peers. Understanding the association between economic deprivation and poor child mental health, how it varies across ages from early childhood to teen years, and the mechanisms underlying the association is of paramount importance to tackle this increasing public health problem which has been further exacerbated by the COVID-19 pandemic. Aim: This study aims to investigate the relationship between family income and child mental health problems from childhood to adolescence in the UK, its potential variation with age, and the potential mechanisms that may explain the relationship. Methods: Using data from the UK Millennium Cohort Study, child mental health was measured by the Total Difficulties Score (TDS), Internalising and Externalising subscales, all derived from the Strengths and Difficulties Questionnaire (SDQ) at ages 3, 5, 7, 11 and 14 years. Family income was operationalised as permanent income, with lagged transitory income used as robustness check. A secondary exposure was frequency of poverty. Cross-sectional analysis using multivariable logistic regression was conducted at each survey age, based on the Grossman health production function. Results: Results were available for 8,096 children, the prevalence of mental health problems (TDS) ranged from 4.6% to 11.1% across all ages. Unadjusted results indicated significant protective effects of higher family income on the likelihood of the child having poorer mental health in all age groups. The relationship weakened after adjustment for confounding and potential mediating factors, and marginal effects of income on TDS were -0.024(SE=0.009), -0.014(SE=0.004), -0.009(SE=0.006), -0.048(SE=0.010) and -0.041(SE=0.011) at age 3, 5, 7, 11, and 14 years, respectively (p<0.001 in all age groups except age 7 where p=0.163). Adjust- ment for poor maternal mental health and low mother-to-infant attachment reduced the strength of the association between income and child mental health. Fully adjusted model suggested an increased independent effect of poor maternal mental health on children's mental health as children grew older. Discussion: While family income is strongly associated with a child's mental health, much of this effect is explained by other risk factors such as maternal depression, and therefore the direct effects are relatively small. This may suggest that policies targeting income redistribution may reduce child mental health inequalities, and also be beneficial to the wider family, reducing the prevalence of other associated risk factors. This is even more important as the ongoing COVID-19 pandemic pushes more families into poverty.
ABSTRACT
Background The COVID-19 pandemic profoundly affected the life of children and ado-lescents, with potential negative repercussions on their well-being. How-ever, this impact may have differed depending on context, household or individual level characteristics. We aimed to 1) identify risk factors for having been heavily impacted by the COVID-19 pandemic 2) evaluate the association between experiencing a heavy pandemic impact and the health-related quality of life (HRQoL) and mental health status of children and adolescents. Methods We invited children of adult participants in a Geneva population-based cohort (Specchio-COVID19), and from a random sample drawn from state registries to participate in the SEROCoV-KIDS cohort study. Children and adolescents aged 2-17 years old were included between December 2021 and February 2022. Parents were asked about the impact of the pandemic on their child(ren) with the Coronavirus impact scale, which covers health, financial and social aspects at the child and household level;a score higher than one standard deviation above the mean was deemed as a heavy im-pact. They also reported about their child(ren)'s HRQoL with the Ped-sQLTM, mental health with the Strengths and Difficulties Questionnaire, and on socio-demographic characteristics. Risk factors for having been heavily impacted by the COVID-19 were estimated with generalized esti-mating equations, as was the association between having experienced a heavy pandemic impact and having a poor HRQoL or mental health. Results Out of 1051 participants, 133 (12.7%) had experienced a heavy COVID-19 impact, 164 (15.6%) had a poor HRQoL, and 112 (12.7%) a poor mental health. Older age (aOR = 1.06;95%CI = 1.01-1.11), average to poor parent-child relationship (aOR = 5.34;95%CI = 2.39-11.94), average to poor par-ent's mood (aOR = 2.77;95%CI = 1.63-4.71) and average to poor house-hold financial situation (aOR = 2.68;95%CI = 1.51-4.76) were associated with having been heavily impacted by the pandemic, after adjustment for age and sex. Participants who had experienced a heavy COVID-19 impact were more likely to present a poor HRQoL (aOR = 2.60;95%CI = 1.64-4.13) and a poor mental health (aOR = 3.75;95%CI = 2.15-6.55) compared to those with an average impact. Discussion Older children and adolescents, living in unfavourable family and financial conditions seemed at higher risk for being heavily impacted by the pan-demic, which in turn was strongly associated with a decreased HRQoL and mental health.
ABSTRACT
The study aimed to evaluate children's emotional behaviors during COVID-19 pandemic in Mosul city and to find out the relationship between children behavior and their socio-demographic characteristics. A quantitative research (descriptive study design) was carried out from the 11th of May until the 2nd of November 2021. A non-probability (Purposive) sample technique is chosen for the current study. The sample involved of (620) children selected from the pediatric consultation clinics in the three of Mosul Hospitals. Scale was used called strengths and difficulties questionnaire (SDQ) for children behavioral screening. The data analyzed by the use of both descriptive and inferential statistical analysis procedures by SPSS version 26. The results of the study reflects abnormal emotional behavior represent by highest percentage (79.4%), and then this percentage was followed by (19.5%) with normal behaviors, while represent (1.1%) by borderline,. children emotional behavior shows that is more affected by preventive measures (lockdown and social separation) during the COVID-19 pandemic outbreak. The result of the present study revealed that is only a high significant association between children emotional behaviors with their gender of child's (0.015) and residence (0.000) at P. value ≤ 0.05 levels. The study concluded that there is a clear impact upon children's behavior due to the preventive measures (lockdown and social separation) that were imposed due to the COVID-19 pandemic. Emotional behavior is more affected than other types of behaviors. Child's gender and residence of living shows high significant effects with total difficult score of behaviors. The study recommendation the following: detecting on children who have abnormal behavior and refer the suspected cases of having behavioral problems to psychological counseling clinics, that's because a long-term of disorderly behavior leads to mental disorders and may accompany children at puberty. Work on developing plans and programs for entertainment and dealing with children during the home confinement in the future when other pandemics occur or recurrent. Establishing psychiatric medical and Nursing consultations for children by communication with parents, or allocating a phone number for this purpose in the event of a lockdown when parents notice any changes in children behavior.