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

Abstract

Purpose: The pandemic and associated infection control measures are accompanied by severe restrictions in the lives of adolescents. The population-based longitudinal German COPSY study monitors changes in the 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 05-06/2020 (Wave 1), 12/2020-01/2021 (Wave 2) and 09-10/2021 (Wave 3). In total, n = 2,097 children and adolescents aged 7 to 17 years and their parents 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 significantly increased in the first two waves and improved only slightly in Wave 3, but was still high (pre-pandemic, Wave 1, 2, 3: 15%, 40%, 48%, 35%, all differences significant). Similarly, the occurrence of overall mental health problems (15%, 20%, 31%, 29%, difference Wave 3 vs 2 significant), anxiety (15%, 24%, 30%, 27%, difference Wave 2 vs 1 significant) and depressive symptoms (10%, 11%, 15%, 11%, chronological differences between waves significant) increased during the first two waves, followed by a slight improvement in Wave 3. A group with low parental education, restricted living conditions, migration background and parental mental problems was at significantly increased risk of HRQoL and mental health impairments.

Conclusions: 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.

Note:
Funding: The COPSY study was funded by the Kroschke Child Foundation and the Fritz and Hildegard Berg Foundation.

Declaration of Interests: There is no conflict of interest, real and perceived, for all named authors.

Ethics Approval Statement: The COPSY study was approved by the Local Psychological Ethics Committee (LPEK-0151) and the Commissioner for Data Protection of the University of Hamburg.

Keywords: SARS-COV-2, longitudinal study, mental health, health-related quality of life, adolescents, depression, anxiety