Mental health of Canadian youth: A systematic review and meta-analysis of studies examining changes in depression, anxiety, and suicide-related outcomes during the COVID-19 pandemic.

OBJECTIVES: This systematic review and meta-analysis aims to describe Canadian youth mental health during the COVID-19 pandemic, focusing on changes in anxiety and depressive symptoms and suicidality. METHODS: We searched four databases up to February 2023 for longitudinal or repeated cross-sectional studies reporting on changes in depressive and anxiety symptoms, suicidality, or related services utilization among young people under 25 years old residing in Canada during the COVID-19 pandemic. Random-effects meta-analyses were performed for studies comparing depressive and anxiety symptoms from before to during the first, second, and third COVID-19 waves (up to June 2021), and between COVID-19 waves. Other studies were described narratively. Risk of bias was assessed using an adapted Joanna Briggs Institute Checklist. SYNTHESIS: Of the 7916 records screened, 35 articles met inclusion criteria for this review. Included studies were highly heterogeneous in design, population, and type of change investigated, and many had a high risk of bias. The meta-analyses found that depressive symptoms worsened minimally from pre-pandemic to wave 1 but returned to pre-pandemic levels by wave 2. Anxiety symptoms were broadly comparable from pre-pandemic to waves 1 and 2 but worsened from waves 1 to 3 and from pre-pandemic to wave 1 for girls. The narrative review included several studies that provided inconclusive evidence of increases in services utilization. CONCLUSION: The current evidence is limited and highly heterogeneous, making it insufficient to draw definitive conclusions regarding the short- to medium-term impact of the pandemic on youth mental health in Canada. Obtaining better mental health surveillance among Canadian youth is imperative.

RéSUMé: OBJECTIFS: Cette revue systématique et méta-analyse vise à décrire la santé mentale des jeunes Canadiens pendant la pandémie de COVID-19 en ce qui concerne les changements dans les symptômes d'anxiété et de dépression et la suicidalité. MéTHODES: Nous avons cherché dans quatre bases de données, jusqu'en février 2023, des études longitudinales ou transversales répétées portant sur l'évolution des symptômes dépressifs et anxieux, de la suicidalité ou de l'utilisation des services en santé mentale chez les jeunes de moins de 25 ans résidant au Canada pendant la pandémie de COVID-19. Des méta-analyses à effets aléatoires ont été réalisées pour les études comparant les symptômes dépressifs et anxieux avant et pendant les première, deuxième et troisième vagues du COVID-19 (jusqu'en juin 2021), ainsi qu'entre les vagues de COVID-19. Les autres études ont été décrites de manière narrative. Le risque de biais a été évalué à l'aide d'une liste de contrôle adaptée du Joanna Briggs Institute. SYNTHèSE: Sur les 7 916 dossiers examinés, 35 articles répondaient aux critères d'inclusion de la présente étude. Les études retenues sont très hétérogènes en termes de conception, de population et de type de changement étudié, et un grand nombre d'entre elles présentent un risque élevé de biais. Les méta-analyses révèlent que les symptômes dépressifs se sont légèrement aggravés entre la période prépandémique et la première vague, mais qu'ils sont revenus aux niveaux prépandémiques lors de la deuxième vague. Les symptômes d'anxiété sont globalement comparables entre la période prépandémique et les vagues 1 et 2, mais se sont aggravés entre les vagues 1 et 3 et entre la période prépandémique et la vague 1 pour les filles. La revue narrative porte sur plusieurs études qui ont fourni des preuves non concluantes de l'augmentation de l'utilisation des services en santé mentale. CONCLUSION: Les données actuelles sont limitées et très hétérogènes, ce qui ne permet pas de tirer des conclusions définitives quant à l'impact à court et moyen terme de la pandémie sur la santé mentale des jeunes au Canada. Il est impératif d'améliorer la surveillance de la santé mentale des jeunes Canadiens.

Protocol for the Open Sky School: a two-arm clustered randomized controlled trial to test the effectiveness of a nature-based intervention on mental health of elementary school children.

BACKGROUND: This article outlines the protocol for a trial to test the effectiveness of a nature-based intervention called Open Sky School to reduce mental health problems among elementary school children. Experimental studies show that contact with nature (e.g. walks in parks) improve mental health. A growing number of teachers have been applying outdoor education within the regular school curriculum and evidence suggests that such teaching methods could improve students' mental health but a randomized controlled trial has never been conducted. METHODS: A two-arm clustered randomized controlled trial will be conducted in elementary schools across Québec, Canada. Following informed consent by teachers, parents and students, schools will be randomly assigned 1:1 to the intervention or the control group with a total of 2500 5-6th grade students and 100 teachers expected to participate. The intervention will take place outdoors in a green-space (2 h per week for 12 weeks) and include a toolkit of 30 activities to foster well-being (e.g. mindfulness) and academic competencies (e.g. mathematics). Questionnaires will be administered to teachers and students before, immediately after and 3 months after the intervention. The primary outcome will be reductions of mental health problems in children from pre-to-post test (Social Behavior Questionnaire: self and teacher reports). Secondary outcomes include depression, positive and negative affect, nature connectedness, and pro-environmental behaviors among children. We will explore, immediate benefits on teacher's well-being and positive and negative affect and sustained benefits among students at 3 months follow-up. For the primary outcome, we will explore moderators including child's sex, child's disability status, the green-space of neighbourhoods, the school's socio-economic position and teacher's experience. DISCUSSION: In conducting the first randomized controlled trial of the Open Sky School, our results could provide empirical evidence on the effectiveness of nature-based interventions in reducing mental health problems among elementary school children. TRIAL REGISTRATION: This study was registered with clinicaltrials.gov: NCT05662436 on December 22, 2022.

Parental loneliness, parental stress and child mental health during the COVID-19 pandemic: Variations by cumulative socioeconomic risk.

Background: The COVID-19 pandemic has raised concerns about parent and child mental health, especially within disadvantaged families. However, little is known about how parental stress and loneliness during the pandemic influenced their children and no studies have investigated if these associations could vary by socioeconomic status. Methods: In July to September 2021, a large representative sample of parents (N = 4,524) in Québec (Canada) reported on aspects of their own mental health and that of their 9-10 year old child. Outcome variables were child externalizing and internalizing symptoms. Exposure variables were changes in parental loneliness and parental stress since the onset of the pandemic. The moderator variable was cumulative socioeconomic risk. Multiple linear regression analyses were executed and adjusted for confounding factors. Results: Child internalizing symptoms were associated with higher levels of parental stress (ß = 0.14, p<.001) and loneliness (ß = 0.23, p<.001). Child externalizing symptoms were also associated with parental stress (ß = 0.13, p<.001) and loneliness (ß = 0.18, p<.001). Most of these associations were stronger within the most disadvantaged households. Limitations: The cross-sectional design does not allow interpretations about causality. Conclusions: Increases in parental stress and loneliness since the onset of the COVID-19 pandemic would be detrimental to parent and child mental health. As these issues were amplified within families experiencing more socioeconomic adversities, our results can inform public policy to support families in times of crisis and direct resources to those most in need.

Pathways of association between disordered eating in adolescence and mental health outcomes in young adulthood during the COVID-19 pandemic.

OBJECTIVES: The COVID-19 pandemic has been associated with increased mental health problems. We investigated (1) associations between disordered eating in adolescence and mental health problems after one year of the pandemic and (2) the mechanisms explaining associations. METHOD: We analyzed data from a population-based birth cohort in Quebec, Canada (557 males and 759 females). High and low levels of disordered eating symptom trajectories were previously estimated (age 12, 15, 17, and 20 years). Anxiety, depression, non-suicidal self-injury, and suicidal ideation were assessed at 23 years (March-June 2021). Putative mediators included loneliness and social media use (age 22 years, July-August 2020). Analyses controlled for mental health and socio-economic status at age 10-12 years and were conducted for males and females separately. RESULTS: Females in the high-level disordered eating symptom trajectory were at increased risk for non-suicidal self-injury (OR 1.60; 95% CI 1.02-2.52) and suicidal ideation (2.16; 1.31-3.57), whereas males were at increased risk for severe anxiety (2.49; CI 1.11-5.58). Males and females in the high-level trajectory were more likely to report severe depression (2.26; 1.14-5.92 and 2.15, 1.36-3.38 respectively). Among females, associations were partially explained (17-35%) by loneliness during the first 4 months of the pandemic. CONCLUSION: Young adults who experienced disordered eating as adolescents were at increased risk of mental health problems during the pandemic. Loneliness partially mediated the effect, suggesting that pandemic mitigation resulting in increased social isolation may have exacerbated mental health problems among women with a history of disordered eating.

RéSUMé: OBJECTIFS: La pandémie de COVID-19 a été associée à une augmentation des problèmes de santé mentale. Nous avons investigué 1) les associations entre les problèmes de comportement alimentaire à l'adolescence et les problèmes de santé mentale après un an de pandémie et 2) les mécanismes expliquant les associations. MéTHODE: Nous avons analysé les données d'une cohorte de naissance basée sur la population au Québec, Canada (557 hommes et 759 femmes). Nous avons utilisé des trajectoires précédemment estimées indicatives d'un haut et bas niveau de problèmes alimentaires (à l'âge de 12, 15, 17 et 20 ans). L'anxiété, la dépression, l'automutilation et les idées suicidaires ont été évaluées à 23 ans (mars à juin 2021). Les médiateurs putatifs incluaient la solitude et l'utilisation des réseaux sociaux (à l'âge de 22 ans, juillet à août 2020). Les analyses contrôlaient la santé mentale et le statut socio-économique à l'âge de 10 à 12 ans et ont été menées séparément pour les hommes et les femmes. RéSULTATS: Les femmes dans la trajectoire des problèmes alimentaires élevés présentaient un risque accru d'automutilation non-suicidaire (OR 1,60; IC à 95 % 1,02-2,52) et d'idées suicidaires (2,16; 1,31-3,57), tandis que les hommes présentaient un risque accru d'anxiété sévère (2,49; IC 1,11-5,58). Les hommes et les femmes de la trajectoire élevée étaient plus susceptibles de déclarer une dépression grave (2,26; 1,14-5,92 et 2,15; 1,36-3,38, respectivement). Chez les femmes, les associations s'expliquaient en partie (17-35 %) par la solitude durant les 4 premiers mois de la pandémie. CONCLUSION: Les jeunes adultes ayant connu des problèmes de comportement alimentaire à l'adolescence couraient un risque accru de problèmes de santé mentale pendant la pandémie. La solitude a partiellement atténué l'effet, suggérant que l'isolation accrue entrainée par la pandémie peut avoir exacerbé les problèmes de santé mentale chez les femmes ayant des antécédents de problèmes de comportement alimentaire.

Disrupting times in the wake of the pandemic: Dispositional time attitudes, time perception and temporal focus.

Introduction: The COVID-19 pandemic has majorly disrupted many aspects of people's lives, provoking psychosocial distress among students. People's positive and negative attitudes towards the past, present and future were a dispositional pre-COVID-19 reality. Faced with a pandemic, people have reported disruptions in the speed of passing time. People can shift their attention more towards the past, present or future when major changes in society occur. These aspects of psychological time would be key to understanding the quality of psychosocial adjustment to the pandemic. We hypothesized that dispositional time attitudes impact psychosocial distress because they would trigger situational changes in our time perception and temporal focus. Methods: One hundred and forty-four university students in Uruguay responded to self-report questionnaires online while in-person classes were cancelled. Students reported on shifts in temporal focus, changes in time awareness and dispositional time attitudes. Reactive psychological, social and learning environment distress were reported. Results: Students reported substantial changes in time perception and temporal focus. A correlation matrix showed significant relationships between time attitudes, focus and awareness. For example, psychological distress was correlated with negative time attitudes, slower passage of time, boredom, blurred sense of time and shifting focus to the past. Mediation models were derived. The indirect effect of time attitudes on psychological distress was significant through past focus. Discussion: Dispositional time attitudes would impact students' capacity to cope with the pandemic. Situational shifts in temporal focus and perception were prevalent and can be viewed as temporal coping mechanisms in the wake of powerful societal change. Our mediation models showed that those with negative time attitudes experienced more psychological distress because they shifted their attention to the past. Future directions for research and practical implications are discussed.

School readiness losses during the COVID-19 outbreak. A comparison of two cohorts of young children.

The COVID-19 context has created the most severe disruption to education systems in recent history. Its impact on child development was estimated comparing two cohorts of 4- to 6-year-old Uruguayan children: control (n = 34,355, 48.87% girls) and COVID cohort (n = 30,158, 48.95% girls) assessed between 2018 and 2020 in three waves, by a routinely administered school readiness instrument in public preschools. Ethnicity information is not available. For the COVID cohort, losses were observed in Motor and Cognitive development, Attitudes towards learning, and Internalizing behavior (range 0.13 - 0.27 SD). Losses were less pronounced among children from higher socioeconomic schools. These results extend the literature on the consequences of the pandemic on learning and early child development.

Role of parenting practices, mother's personality and depressive symptoms in early child development.

In this study we explore the possibility that maternal depressive symptomatology and personality would influence parenting practices which would in turn influence their offspring's socio-emotional and cognitive-motor development. We used a large representative sample of Uruguayan children and their mothers. The Big Five Inventory (BFI), subscales of the Home Observation for Measurement of Environment (HOME), Ages & Stages Questionnaires - third edition (n = 3596), Child Behavior Checklist (n = 3750), and a sociodemographic (SES) questionnaire were administered. We found that favorable scores in child development measures were correlated with maternal openness, extraversion, conscientiousness, agreeableness, low neuroticism, depressive symptomatology, positive parenting practices and high income households. We then elaborated pathway models that allowed us to account for covariance between relevant variables. We found that openness was indirectly associated with aspects of both socioemotional and cognitive motor development via parenting practices and maternal depressive symptomatology. The association between SES and both child development outcomes was fully explained by intermediary variables. Collectively, our results provide support for Belsky's model of child development and can be used by professionals to better target interventions geared at infants and young children and their mothers.

Drinking motives and alcohol consumption behaviors among young French people.

INTRODUCTION: Numerous studies suggest that social, enhancement, conformity and coping drinking motives each lead to unique behavioral patterns related to alcohol consumption. Recently it has been suggested to study specific coping motives that distinguish feelings of anxiety and depression. This study aims primarily to 1) psychometrically validate the recent five factor questionnaire of drinking motives among young French people, 2) explore differences in mean endorsements of motives across age and sex and 3) explore the concurrent validity of drinking motives by studying their associations with alcohol consumption behaviors. METHODS: The French Modified Drinking Motives Questionnaire Revised and the Alcohol Use Disorders Identification Test were administered to 314 university students and 193 high school students. RESULTS: The 5-factor model of drinking motives provided a good fit to the data and a better fit than the 4-factor model. Conformity motives were more strongly endorsed among high school students than among university students (d=0.26). Social motives were more endorsed by men than by women (d=0.47), as were enhancement motives (d=0.48). Our study suggests that each of the studied motives transcribes a specific set of drinking behaviors. CONCLUSIONS: Researchers and practitioners could effectively use this conception of drinking motives in order to better understand and prevent problematic alcohol use among young people.

Anomalous Experiences, Trauma, and Symbolization Processes at the Frontiers between Psychoanalysis and Cognitive Neurosciences.

Anomalous or exceptional experiences are uncommon experiences which are usually interpreted as being paranormal by those who report them. These experiences have long remained difficult to explain, but current progress in cognitive neuroscience and psychoanalysis sheds light on the contexts in which they emerge, as well as on their underlying processes. Following a brief description of the different types of anomalous experiences, we underline how they can be better understood at the frontiers between psychoanalysis and cognitive neurosciences. In this regard, three main lines of research are discussed and illustrated, alongside clinical cases which come from a clinical service specializing in anomalous experiences. First, we study the links between anomalous experiences and hallucinatory processes, by showing that anomalous experiences frequently occur as a specific reaction to negative life events, in which case they mainly take the form of non-pathological hallucinations. Next, we propose to analyze these experiences from the perspective of their traumatic aspects and the altered states of consciousness they often imply. Finally, these experiences are considered to be the consequence of a hypersensitivity that can be linked to an increase in psychic permeability. In conclusion, these different processes lead us to consider anomalous experiences as primary forms of symbolization and transformation of the subjective experience, especially during, or after traumatic situations.