Outbreaks of serious infectious diseases could have similar effects on children’s mental health as other traumatic experiences, according to a new brief research letter published in JAMA Pediatrics.

The coronavirus disease 2019 (COVID-19) left more than 180 million Chinese children restricted to their homes due to school closures. Students in Wuhan have been restricted to their homes from January 23, 2020 until April 8, 2020, whereas those in Huangshi were restricted from January 24, 2020 to March 23, 2020. Xinyan Xie, BA, of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China, and colleagues investigated depression and anxiety in children during the pandemic lockdown.

In total, 1784 participants (56.7% boys) took part in a survey to measure symptoms of depression and anxiety among 2 primary schools in Wuhan and Huangshi. Information included school grade, sex, optimism about the pandemic, whether they worried about being infected with COVID-19, and depressive and anxiety symptoms, measured by the Children’s Depression Inventory–Short Form (CDI-S) and the Screen for Child Anxiety Related Emotional Disorders, respectively.

On average, students were restricted to their homes for a mean of 33.7 days when they took the survey. Approximately 22.6% and 18.9% of students reported depressive and anxiety symptoms, respectively. Students in Wuhan had significantly higher CDI-S scores than those in Huangshi (β, 0.092; 95% CI, 0.014-0.170), with a greater risk of depressive symptoms (odds ratio, 1.426; 95% CI, 1.138-1.786).


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Across the 2 cities, approximately 62% of students were at least moderately worried about being infected with COVID-19, and approximately 12% were not at all optimistic about the pandemic. Students who were slightly or not worried about being affected by COVID-19 had lower CDI-S scores compared to those who were quite worried (β, −0.184; 95%CI, −0.273 to−0.095), with a reduced risk of depressives symptoms (odds ratio 0.521; 95%CI, 0.400-0.679). In comparison, those who were not optimistic about the pandemic had significantly higher CDI-S scores (β, 0.367; 95% CI, 0.250-0.485), with an increased risk of depressive symptoms (odds ratio 2.262; 95% CI, 1.642-3.117) compared with those who were quite optimistic.

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The study was limited by the short duration of the study period, and the researchers could not determine how long symptoms may affect children after the lockdown. The investigators concluded that continuing to monitor participants could help improve interventions for children in other countries affected by COVID-19.

“During the outbreak of COVID-19, the reduction of outdoor activities and social interaction may have been associated with an increase in children’s depressive symptoms,” the investigators noted.

Reference

Xie X, Xue Q, Zhou Y, et al. Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China (published online April 24, 2020). JAMA Pediatr. doi:10.1001/jamapediatrics.2020.1619