부산대학교 도서관

Background: Little is known about the long-term mental health consequences of the pandemic in children and young people (CYP), despite extremely high levels of exposure to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus and the disruption to schooling and leisure activities due to the resultant restrictions. There are mixed findings from systematic reviews of how the pandemic affected CYP's mental health, which may be due to heterogeneous methods and poor quality studies. Most, but not all, suggest deterioration in mental health but population level studies may obscure the differing experiences of subgroups. The study questions are: (i) are there subgroups of CYP with distinct mental health profiles over the course of the second year of the Coronavirus Disease 2019 (COVID-19) pandemic (between April 2021 and May 2022); and (ii) do vulnerability factors influence CYP's mental health trajectories. Methods and findings: A matched longitudinal cohort study of non-hospitalised test-positive and test-negative 11- to 17-year-old CYP in England were recruited from the UK Health Security Agency having undergone PCR testing for COVID-19. They completed the Strengths and Difficulties Questionnaire (SDQ) at least twice over a 12-month follow-up period. Overall, 8,518 of 17,918 (47.5%) CYP who returned their first SDQ at 3 or 6 months post-testing were included in the analytical sample. Associations between age, sex, ethnicity, socioeconomic status (SES), and an educational health and care plan (EHCP, indicating special educational needs) on SDQ score trajectories were examined separately, after adjusting for PCR test result. Findings from multilevel mixed-effects linear regression model showed that on average mental health symptoms as measured by the total SDQ score increased over time (B = 0.11 (per month), 95% CI = 0.09 to 0.12, p < 0.001) although this increase was small and not clinically significant. However, associations with time varied by age, such that older participants reported greater deterioration in mental health over time (B = 0.12 (per month), 95% CI = 0.10 to 0.14 for 15 to 17y; 0.08 (95% CI = 0.06 to 0.10) for 11 to 14y; pinteraction = 0.002) and by sex, with greater deterioration in girls. Children with an EHCP experienced less deterioration in their mental health compared to those without an EHCP. There was no evidence of differences in rate of change in total SDQ by ethnicity, SES, or physical health. Those with worse prior mental health did not appear to be disproportionately negatively affected over time. There are several limitations of the methodology including relatively low response rates in CLoCk and potential for recall bias. Conclusions: Overall, there was a statistically but not clinically significant decline in mental health during the pandemic. Sex, age, and EHCP status were important vulnerability factors that were associated with the rate of mental health decline, whereas ethnicity, SES, and prior poor physical health were not. The research highlights individual factors that could identify groups of CYP vulnerable to worsening mental health. Laura Panagi and co-workers study mental health among children and young people in England during the COVID-19 pandemic. Author summary: Why was this study done?: Almost all children and young people (CYP) have been exposed to Coronavirus Disease 2019 (COVID-19) and lived through a pandemic. The pandemic appears to have had negative implications for CYP's mental health across the world although the quality of research is often poor. The large-scale CYP with Long COVID (CLoCk) study conducted in England allows researchers to describe the natural course of mental health symptoms at 3, 6, and 12 months after testing using a robust measure of emotional and behavioural difficulties (the Strengths and Difficulties Questionnaire (SDQ)). The CloCk study allows exploration of what factors are associated with developing or worsening of mental health problems. We wanted to know whether there are subgroups of CYP with distinct mental health characteristics and to understand how specific vulnerability factors are associated with CYP's mental health over the pandemic. What did the researchers do and find?: We asked CYP who had tested positive or negative for COVID-19 in England between September 2020 and March 2021 to complete a questionnaire about their mental health 3, 6, and/or 12 months after testing. The study uses information from 8,518 CYP who agreed to take part and filled in at least 2 questionnaires. We did not find subgroups of CYP with distinct mental health profiles over the course of the second year of the COVID-19 pandemic, but found that although there was a statistical deterioration in mental health over time, overall, the mean deterioration was relatively small and not clinically meaningful. We found that age, sex, and whether a CYP had an educational health and care plan (EHCP, which is typically given when there are learning difficulties) were all associated with the rate of change in mental health over time. Older teenagers and girls had on average a greater decline in their mental health than younger CYP and boys. In contrast, CYP with an EHCP experienced a smaller decline in their mental health during the pandemic, although overall experienced much higher levels of difficulties compared to their non-EHCP counterparts. What do these findings mean?: Changes in the mental health of CYP during the pandemic is somewhat unclear but our findings indicate that there were differences in behavioural, emotional, and attentional difficulties in children with special educational needs compared to the rest of the sample. Our findings suggest that CYP in their mid to late teens are particularly vulnerable and continue to struggle with their mental health. However, it is important to consider that within the findings there were a lot of differences between individuals. Our findings suggest that on average rates of change in mental health during the pandemic differed by age, sex, and whether the CYP had an EHCP. We need long-term follow-up of such cohorts to further understand the mental health trajectories of young people as we emerge from the pandemic. [ABSTRACT FROM AUTHOR]