Die COVID-19-Pandemie – Wie hat sie die Kinderpsyche beeinflusst? The COVID-19 pandemic—How did it affect the mental health of children?

Hintergrund Lockdowns, Kontaktbeschränkungen, Schließung von Kinderbetreuungs‑, Schul- und Freizeiteinrichtungen während der COVID-19-Pandemie haben den Alltag von Kindern und Jugendlichen deutlich beeinträchtigt. Ziel der Arbeit (Fragestellung) Der Beitrag untersucht die Auswirkungen der Pandemie auf die psychische Gesundheit von Kindern und Jugendlichen in Deutschland. Material und Methoden Die bevölkerungsbezogene COPSY-Längsschnittstudie (Corona und Psyche) umfasst bisher 5 Befragungszeitpunkte (t1: Mai bis Juni 2020 bis t5: Sept. bis Okt. 2022). Es wurden etwa 1600 Eltern von 7‑ bis 17-Jährigen sowie 1000 Kinder und Jugendliche zwischen 11 und 17 Jahren mithilfe etablierter Instrumente zur psychischen Gesundheit befragt. Präpandemische Vergleichsdaten lieferte die repräsentative BELLA-Studie (Befragung zum seelischen Wohlbefinden und Verhalten). Ergebnisse Während der Pandemie stieg der Anteil von Kindern und Jugendlichen, die über eine geminderte gesundheitsbezogene Lebensqualität berichteten, von 15 % (präpandemisch) auf 48 % im ersten Jahr an und reduzierte sich 2022 auf 27 %. Damit war der Wert noch deutlich über dem vor Beginn der Pandemie. Ein ähnlicher Verlauf zeigte sich für psychische Auffälligkeiten: Deren Prävalenz stieg von 18 % (präpandemisch) auf 31 % an und reduzierte sich 2022 auf 23 %. Symptome für Ängstlichkeit und Depressivität folgten dem Trend. Lediglich Symptome der Depressivität sanken auf das präpandemische Niveau zurück. Hinsichtlich ihres Gesundheitsverhaltens bewegt sich ein Drittel der Kinder und Jugendlichen noch immer zu wenig. Diskussion Die psychische Gesundheit von Kindern und Jugendlichen wurde während der Pandemie lange ignoriert. Dringend müssen Unterstützung und finanzielle Mittel gewährt werden, um negative psychische Gesundheitseffekte zu reduzieren und Beeinträchtigungen durch erneute Krisen vorzubeugen.

[Epidemiology of mental well-being in childhood and adolescence. Results from three epidemiological studies before and during the COVID-19 pandemic]. / Epidemiologie seelischen Wohlbefindens von Kindern und Jugendlichen in Deutschland. Ergebnisse aus 3 Studien vor und während der COVID-19-Pandemie.

BACKGROUND: Continuous nationwide health monitoring is important to track the well-being of children and adolescents and to map developmental trajectories. Based on the results of three selected epidemiological studies, developments in child well-being over the past 20 years are presented. METHODS: Data are based on (1) the mental health module of the German National Health Interview and Examination Survey among Children and Adolescents (BELLA study, 2003-2017, N = 1500 to 3000), which is a module of the KiGGS study; (2) the COvid-19 and PSYchological Health Study (COPSY, 2020-2022, N = 1600-1700), which is based on the BELLA Study; and (3) the International Health-Behaviour in School-aged Children Study (HBSC, 2002-2018, N = 4300-7300). Well-being was assessed in 7­ to 17-year-olds using indicators of health-related quality of life (KIDSCREEN-10), life satisfaction (Cantril Ladder), and mental health problems (Strenghts and Difficulties Questionnaire (SDQ), Screen for Child Anxiety Related Emotional Disorders (SCARED), and Center for Epidemiological Studies Depression Scale for Children (CES-DC)). RESULTS: Overall, children and adolescents show consistently high health-related quality of life and high overall life satisfaction pre-pandemic (2002-2018), which initially worsened with the onset of the 2020 COVID-19-pandemic. Two years later, improvements are evident but have not yet reached baseline levels. Psychological problems, as well as symptoms of anxiety and depression, increased by up to 12 percentage points at the beginning of the pandemic and are still higher two years after the onset of the pandemic compared to pre-pandemic studies. CONCLUSION: The epidemiology of child well-being provides a necessary data basis to assess the support needs of children and adolescents and to use this as a basis for developing measures of health promotion, prevention, and intervention.

[The COVID-19 pandemic-How did it affect the mental health of children?] / Die COVID-19-Pandemie ­ Wie hat sie die Kinderpsyche beeinflusst?

Background: The COVID-19 pandemic has had a substantial impact on the daily life of children and adolescents due to lockdowns, contact restrictions, closings of childcare, schools and leisure facilities. Objective: This article examines the impact of the pandemic on the mental health of children and adolescents in Germany. Material and methods: In the population-based longitudinal COPSY study (COVID-19 and Psychological Health) 1600 parents of children aged 7-17 years old and 1000 children and adolescents aged 11-17 years old completed established questionnaires at 5 online survey points (t1: May and June 2020 to t5: September and October 2022). For comparison, pre-pandemic data were obtained from the representative BELLA study. Results: During the pandemic the portion of children and adolescents, who reported a low health-related quality of life, increased from pre-pandemic 15% to 48% in the first year of the pandemic and improved in year 3 to 27%. This is still substantially above pre-pandemic levels. Similar trajectories were found for mental health problems which rose from 18% (pre-pandemic) to 31% and improved in year 3 to 23%. For anxiety and depression, the changes were similar except that depressive symptoms returned to pre-pandemic levels in year 3. The physical activity of almost one third of the youth was still very low in year 3. Conclusion: The mental health of children and adolescents was ignored during the pandemic for a long time. Now support and allocation of funding is urgently needed to mitigate the negative mental health effects and prevent further impairment by new crises.

[Prevention perspective: mental health of schoolchildren in Germany]. / Perspektive Prävention: Psychische Gesundheit von Schülerinnen und Schülern in Deutschland.

BACKGROUND: The COVID-19 pandemic has impacted the learning and health of children and adolescents. The aim of this paper is to examine school students' mental health problems, family burden, and support needs during the pandemic depending on the type of school. Approaches to school-based prevention and health promotion are discussed. METHODS: Findings are based on data from the population-based COPSY study (T1: 05/2020 - T4: 02/2022) and the BELLA study (T0, pre-pandemic comparison). Approximately 1600 families with children aged 7 to 19 years were surveyed at each measurement point (T). Mental health problems were assessed using the SDQ, while family burden and support needs were captured with individual items in the parent report. RESULTS: Mental health problems increased among students in all school types at the beginning of the pandemic and have stabilized at a high level. Elementary school students are particularly affected (increase from 16.9% pre-pandemic to 40.0% at T2), especially in behavioral problems (11.7% to 24.6%) and hyperactivity (13.9% to 34.0%). Secondary school students also show higher levels of mental health problems (21.4% to 30.4%). Pandemic-related burden is consistently high, as is the need for family support received from schools/teachers and experts. DISCUSSION: There is a high need for mental health promotion and prevention measures in the school setting. These should start at primary school age in the sense of a "whole school approach" at different levels and include external stakeholders. In addition, binding legal requirements are needed in all federal states to create framework conditions and structures for school-based health promotion and prevention, including access to necessary resources.

Child and Adolescent Mental Health During the COVID-19 Pandemic: Results of the Three-Wave Longitudinal COPSY Study.

PURPOSE: The German population-based longitudinal COVID-19 andPsychological Health study monitors changes in health-related quality of life (HRQoL) and mental health of children and adolescents during the COVID-19 pandemic and identifies vulnerable groups. METHODS: A nationwide, population-based survey was conducted in May 2020 to June 2020 (Wave 1), December 2020 to January 2021 (Wave 2), and September 2021 to October 2021 (Wave 3). In total, n = 2,097 children and adolescents aged 7-17 years were investigated using measures to assess HRQoL (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), depressive symptoms(PHQ-2), and psychosomatic complaints(HBSC-SCL). RESULTS: The prevalence of low HRQoL increased from 15% prepandemic to 40% and 48% in Waves 1 and 2 and improved slightly to 35% in Wave 3 (all differences significant). Similarly, overall mental health problems increased from 18% prepandemic to 29% in Wave 1 and 31% in Wave 2 to 28% in Wave 3 (all differences significant, except Wave 3 vs. 2), anxiety increased from 15% prepandemic to 24% and 30% in Waves 1 and 2 and was still 27% in Wave 3. Depressive symptoms increased from 10% prepandemic to 11% and 15% in Waves 1 and 2 and were 11% in Wave 3. A group with low parental education, restricted living conditions, migration background, and parental mental health problems was at significantly increased risk of HRQoL and mental health impairments. DISCUSSION: The prevalence of low HRQoL, mental health problems, and anxiety has been elevated throughout the pandemic. Thus, mental health promotion, prevention, and intervention strategies need to be implemented to support adolescents-particularly those at risk.