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Mental health and its correlates among children and adolescents during COVID-19 school closure: The importance of parent-child discussion
Open accessAbstract
Background School closures due to the COVID-19 outbreak have affected 87% of the world's students physically, socially, and psychologically, yet rigorous investigation into their mental health during this period is still lacking. Methods A cross-sectional online survey of 4-342 primary and secondary school students from Shanghai, China was conducted during March 13-23, 2020. Besides demographic information, psychological distress (including depression, anxiety, and stress), life satisfaction, perceived impact of home quarantine, and parent-child discussions on COVID-19 were assessed. Results The three most prevalent symptoms were: anxiety (24.9%), depression (19.7%), and stress (15.2%). Participants were generally satisfied with life and 21.4% became more satisfied with life during school closures. Senior grades were positively correlated with psychopathological symptoms and negatively associated with life satisfaction, whereas the perceived benefit from home quarantine and parent-child discussions on COVID-19 were negatively correlated with psychopathological symptoms and positively correlated with life satisfaction. Among participants who perceived no benefit from home quarantine, those who had discussions with their parents about COVID-19 experienced less depression, anxiety, and stress. Limitations Limitations included the inability to infer the casual relationship, no parental report for mental health of children aged 6 to 9, and the inadequate measurement of parent-child discussion. Conclusions Mental health problems and resilience co-existed in children and adolescents during the COVID-19 outbreak. Given the important role of parent-child discussions, open communication between parents and children about the pandemic should be encouraged to help children and adolescents cope with mental health problems in public health crisis.
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“In an unfamiliar situation of home-quarantine, children do not always know how to communicate their fears and anxieties [31].”
From COVID-19-Related Anxiety Symptoms among Quarantined Adolescents and Its Impact on Sleep Pattern Changes and Somatic Symptoms (2022) · cites this paper as [31]
Experimental — accuracy not yet measuredIn the citing paper
“our findings of five studies on children and 16 studies on college students”
From Mental Health Impact of COVID-19 among Children and College Students: A Systematic Review (2023) · cites this paper as [17]
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“Five studies remained, which were all cross-sectional studies, conducted in China, and the variables most commonly measured were depression and anxiety [14–18].”
From Mental Health Impact of COVID-19 among Children and College Students: A Systematic Review (2023) · cites this paper as [17]
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“the variables most commonly measured were depression and anxiety [14–18]”
From Mental Health Impact of COVID-19 among Children and College Students: A Systematic Review (2023) · cites this paper as [17]
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“Up until now, the majority of current studies analyzing the impact of the COVID-19 pandemic conducted with children and adolescents refer to mental health constructs such as depression or anxiety, indicating that mental health has declined since the beginning of the pandemic (Bacikova-Sleskova et al., 2021; Chen et al…”
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Jost, G. M., Hang, S., Shaikh, U., & Hostinar, C. E. (2023) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2023.101646 · Cited by 44
The youth mental health crisis: Quasi-experimental evidence on the role of school closures
Felfe, C., Saurer, J., Schneider, P., Vornberger, J., Erhart, M., Kaman, A., & Ravens‐Sieberer, U. (2023) · Science Advances · doi:10.1126/sciadv.adh4030 · Cited by 45
Zhen, B., Yao, B., & Zhou, X. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.03.029 · Cited by 38
Chen, J., YANG, K. Y., Cao, Y., Du, Y., Wang, N., & Qu, M. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.870346 · Cited by 40
“The prolonged home confinement is associated with a range of negative outcomes for children and adolescents, such as decreased social interactions with peers, reduced physical activity, increased conflicts with parents, and academic pressures due to sudden changes in traditional learning methods (8, 9).”
Backgroundvan Loon, A. W. G., Creemers, H. E., Vogelaar, S., Saab, N., Miers, A. C., Westenberg, P. M., & Asscher, J. J. (2022) · Scientific Reports · doi:10.1038/s41598-022-20344-y · Cited by 39
Dvorsky, M. R., Breaux, R., Cusick, C. N., Fredrick, J. W., Green, C. D., Steinberg, A., Langberg, J. M., Sciberras, E., & Becker, S. P. (2021) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-021-00857-2 · Cited by 41
Prime, H., Wade, M., May, S. S., Jenkins, J. M., & Browne, D. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.669106 · Cited by 31
Peer Connectedness and Social Technology Use During COVID-19 Lockdown
James, K. M., Silk, J. S., Scott, L. N., Hutchinson, E., Wang, S., Sequeira, S. L., Lu, C., Oppenheimer, C. W., & Ladouceur, C. D. (2023) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-023-01040-5 · Cited by 42
“…to this rise in symptoms during the early stage of the pandemic, the most prominent concern reported by adolescents across sociodemographic groups was the dramatic reduction in live social interaction with peers (Cost et al., 2022; Magson et al., 2021; Silk et al., 2022; Tang et al., 2021).”
BackgroundInfluentialAnsiedade em adolescentes no contexto da pandemia por COVID-19
Rego, K. D. O., & Maia, J. L. F. (2021) · Research Society and Development · doi:10.33448/rsd-v10i6.15930 · Cited by 37
Cox, R. M., Lieber, C. M., Wolf, J. D., Karimi, A., Lieberman, N. A. P., Sticher, Z. M., Roychoudhury, P., Andrews, M. K., Krueger, R. E., Natchus, M. G., et al. (2023) · Nature Communications · doi:10.1038/s41467-023-40556-8 · Cited by 34
Miah, M., Singh, J. S. K., & Rahman, M. A. (2023) · Sustainability · doi:10.3390/su15043543 · Cited by 33
Liang, Z., Mazzeschi, C., & Delvecchio, E. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18158074 · Cited by 41
“At the same time, parents can strengthen the parent–child relationship through active parent–child interactions and coping strategies and give their children support and a sense of safety, such as active discussions about the epidemic [26] and sharing their emotions [50].”
BackgroundImpact of School Closures due to COVID-19 on Children with Neurodevelopmental Disorders in Japan
Kawaoka, N., Ohashi, K., Fukuhara, S., Miyachi, T., Asai, T. T., Imaeda, M., & Saitoh, S. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05119-0 · Cited by 32
Research on Students in COVID-19 Pandemic Outbreaks: A Bibliometric Network Analysis
Boonroungrut, C., Saroinsong, W. P., & Thamdee, N. (2021) · International Journal of Instruction · doi:10.29333/iji.2022.15126a · Cited by 38
“The low economic class was more affected, with higher stress, depression and anxiety among parents who have sons or daughters in any learning stages (Husky, Kovess-Masfety, & Swendsen, 2020; Patrick et al., 2020; Tang, Xiang, Cheung, & Xiang, 2020; Wu et al., 2020).”
Garrido‐Cumbrera, M., Foley, R., Correa-Fernández, J., González‐Marín, A., Braçe, O., & Hewlett, D. (2022) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2022.101864 · Cited by 36
Xue, Y., Xue, B., Zheng, X., Shi, L., Liang, P., Xiao, S., Dong, F., Zhang, J., Chen, Y., Liu, Y., et al. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1097331 · Cited by 31
Lou, F., Luo, S., Kang, N., Yan, L., Long, H., Yang, L., Wang, H., Liu, Y., Pu, J., Xie, P. P., et al. (2024) · Pharmacological Research · doi:10.1016/j.phrs.2024.107214 · Cited by 32
Ramaiya, A., Chandra‐Mouli, V., Both, R., Gottert, A., Guglielmi, S., Beckwith, S., Li, M., & Blum, R. W. (2023) · Sexual and Reproductive Health Matters · doi:10.1080/26410397.2023.2187170 · Cited by 30
Mendoza, N. B., King, R. B., & Haw, J. Y. (2023) · Educational Psychology · doi:10.1080/01443410.2023.2226846 · Cited by 37
COVID-19 and Resilience in Schools: Implications for Practice and Policy
Luthar, S. S., Pao, L. S., & Kumar, N. L. (2021) · Child Policy Nexus · doi:10.1002/sop2.16 · Cited by 29
Stevens, G. W. J. M., Büyükcan-Tetik, A., Maes, M., Weinberg, D., Vermeulen, S., Visser, K., & Finkenauer, C. (2022) · Stress and Health · doi:10.1002/smi.3179 · Cited by 29
“Similarly, Tang et al. (2021) asked primary and secondary school children to evaluate their home quarantine in March 2020.”
BackgroundMental health in Japanese children during school closures due to the COVID‐19
Saito, M., Kikuchi, Y., Lefor, A. K., & Hoshina, M. (2021) · Pediatrics International · doi:10.1111/ped.14718 · Cited by 27
Crisis response among essential workers and their children during the COVID-19 pandemic
Sugg, M. M., Runkle, J. D., Andersen, L. M., Weiser, J., & Michael, K. D. (2021) · Preventive Medicine · doi:10.1016/j.ypmed.2021.106852 · Cited by 30
Monnier, M., Moulin, F., Thierry, X., Vandentorren, S., Côté, S. M., Barbosa, S., Falissard, B., Plancoulaine, S., Charles, M.-A. A., Simeon, T., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-01676-7 · Cited by 30
Family economic hardship and adolescent mental health during the COVID-19 pandemic
Kim, B., Kim, D. H., Jang, S., Shin, J., Lee, S. G., & Kim, T. H. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.904985 · Cited by 27
Gao, C., Tadesse, E., & Khalid, S. (2022) · Child Indicators Research · doi:10.1007/s12187-022-09923-7 · Cited by 26
“Nevertheless, few studies examining the influence of COVID-19 on LBC considering their vulnerable position have been conducted (Tang et al., 2021), and few studies have employed qualitative research approaches to determine the experiences of LBC.”
BackgroundLi, S.-F., Xu, Q.-Y., Xie, J., Wang, L., Li, H.-N., Ma, L., & Xia, R.-X. (2022) · Social Science & Medicine (1967) · doi:10.1016/j.socscimed.2022.115301 · Cited by 23
“health, home confinement during the COVID-19 pandemic may have also offered a good opportunity to enhance the interaction between family members and their children (Tang et al., 2021).”
Impact of COVID‐19 inequalities on children: An intersectional analysis
Lemkow–Tovías, G., Lemkow, L., Cash‐Gibson, L., Teixidó‐Compañó, E., & Benach, J. (2022) · Sociology of Health & Illness · doi:10.1111/1467-9566.13557 · Cited by 29
Holzer, J., Korlat, S., Pelikan, E. R., Schober, B., Spiel, C., & Lüftenegger, M. (2023) · The Journal of Early Adolescence · doi:10.1177/02724316231162306 · Cited by 42
“In another survey with students from China, adolescents who reported discussing the pandemic with their parents reported higher levels of current life satisfaction and had a lower risk of meeting the threshold of depressive, anxiety, and stress symptoms (Tang et al., 2021).”
BackgroundMagis‐Weinberg, L., Vargas, M. A., Carrizales, A., Trinh, C. T., Lopez, D. E. M., Hussong, A. M., & Lansford, J. E. (2024) · Journal of Research on Adolescence · doi:10.1111/jora.12931 · Cited by 35
Jeelani, A., Dkhar, S., Quansar, R., & Khan, S. M. S. (2022) · Middle East Current Psychiatry · doi:10.1186/s43045-022-00185-1 · Cited by 22
Association of sleep with mental health in Chinese high school students: a cross‐sectional study
Xue, B., Xue, Y., Zheng, X., Shi, L., Liang, P., Dong, F., Xiao, S., Zhang, J., Qin, Z., Xu, Y., et al. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13697 · Cited by 25
“…was close to the findings of the Tang et al. study (32.2% for CI, confidence interval; (A)(U)OR, (adjusted) (unadjusted) odds ratio. aAdjusted for sex, age, residence, school grade, study-induced burden, and residence on campus. depression, 39.3% for anxiety, 25.1% for stress; Tang et al., 2021).”
ResultInfluentialPretorius, T. B., & Padmanabhanunni, A. (2022) · African Journal of Psychological Assessment · doi:10.4102/ajopa.v4i0.106 · Cited by 26
Zhang, Y., Xu, C., Dai, H., & Jia, X. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182312279 · Cited by 30
“Previous research found that high quality PCRs moderated the relationship between parents’ and children’s emotional health during COVID-19, and high PCR buffers cyberbullying perpetration [18,33].”
Metadata
- Authors
- Tang, S., Xiang, M., Cheung, T., & Xiang, Y.-T.
- Affiliations
- Shenzhen University (CN)
- Shanghai Jiao Tong University (CN)
- Hong Kong Polytechnic University (HK)
- University of Macau (MO)
- Corresponding author
- Tang, Suqin
- Xiang, Mi
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 279
- Pages
- 353-360
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC7550131
- OpenAlex
- W3092386566
- Cited by
- 628
- References
- 29
- Citations by year
- 2026: 17 · 2025: 56 · 2024: 84 · 2023: 144 · 2022: 208 · 2021: 115
- FWCI
- 46.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Shenzhen University
- National Natural Science Foundation of China
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
- Keywords
- COVID-19 pandemic, school closures, child and adolescent mental health, psychological distress, depression, anxiety, stress, life satisfaction, parent-child communication, home quarantine, resilience, pandemic coping
- MeSH terms
- COVID-19, SARS-CoV-2, Adolescent, Anxiety, Child, China, Cross-Sectional Studies, Depression, Female, Humans, Male, Mental Health, Parent-Child Relations, Parents, Quarantine, Surveys and Questionnaires, Schools, Students, Pandemics
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