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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 the citing paper
“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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“Accordingly, researchers have begun to explore factors that may have exacerbated depressive symptoms in adolescents ’ samples during the COVID-19 pandemic (Panda et al., 2021; Tang et al., 2021).”
InfluentialParks, R., Bedard, C., Yessis, J. L., Meyer, S. B., & Ferro, M. A. (2025) · Psychiatry International · doi:10.3390/psychiatryint6020066
Gallego-Ausín, N., Llamazares, M. D. C. E., Corral-Puente, S., Alonso, M. Y. G., Serrano‐Gómez, D., González, A. L. O., Pintado, I. S., & Martín, M. Á. M. (2025) · Health Care Analysis · doi:10.1007/s10728-025-00528-z
“To do so, the instrument was administered at two different points in time, with an interval of one and two weeks [114], to a sample of 16 randomly selected participants, among health care professionals from the Burgos Health Area (Castilla y León, Spain).”
Méndez, J. H. M., Sánchez, M. M. R., Maldonado-Avendaño, N., Suárez, A. M. S., Belmonte, J. V., Hernández, J. A. F., Minutti, S. T., & Hernández, R. C. L. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22060932
Lu, R., Zhao, S., JIANG, Y., Zhou, J., Juan, W. E. N., & Lingmin, H. U. (2025) · PSYCHOLOGIA · doi:10.2117/psysoc.2023-a223
Chien, W., Chang, H.-F., Shia, B.-C., Wang, K.-H., Shih, Y.-N., Tai, Y.-H., & Chen, M.-C. (2024) · ASEAN Journal of Psychiatry · doi:10.54615/2231-7805.24.12.422
Child and adolescent psychiatry consultations during the COVID-19 pandemic
Pınar, Z. V., Çimen, İ. D., Küçük, E., Köle, M. T., & Kandemir, İ. (2025) · Scientific Reports · doi:10.1038/s41598-025-08566-2 · Cited by 2
“Prior studies likewise show that pandemic restrictions and the suspension of in-person schooling disrupt children’s daily routines and mental health 40 .”
Lok, E. Y. C. (2025) · East Asian Archives of Psychiatry · doi:10.12809/eaap2538
Mental health of adolescents during the pandemic - review
Główczyński, P., Dębski, P. G., & Badura-Brzoza, K. (2023) · Zeszyty Naukowe Wyższej Szkoły Humanitas w Sosnowcu Pedagogika · doi:10.5604/01.3001.0053.7616
Miyake, Y., Takagaki, K., Yoshino, A., & Okamoto, Y. (2025) · BioPsychoSocial Medicine · doi:10.1186/s13030-025-00329-9
“The cancelation of in-person classes and activities possibly provided students with more leisure time to engage in relaxing or creative endeavors, along with a reduced workload and less pressure to perform well academically [42].”
Tamai, N., Kimura, Y., Yoshizawa, R., & Kamizato, M. (2025) · Nursing Reports · doi:10.3390/nursrep15080279
“Life satisfaction during the COVID-19 pandemic was assessed using a 10-point scale developed by Tang et al. [28] ranging from “0: very dissatisfied” to “10: very satisfied”.”
Mental Health Outcomes and their Associated Factors among Children and Adolescents
Krishnaswamy, G., Shamsudeen, M. A., Yashriah, B., Hameed, Z. M., & Zulkiple, M. Z. H. (2025) · doi:10.38124//ijisrt/25jul286
Santos, M. F., Gómez‐Baya, D., Simões, C., Grazzani, I., & Lebre, P. (2025) · Child Indicators Research · doi:10.1007/s12187-025-10277-z
“…relationships were significantly affected as their daily environments changed drastically, leading to a reduction in social interactions outside the home (Orban et al., 2024; Tang et al., 2021) and potentially diminishing the quality of these interactions, thus affecting subjective happiness.”
6. Mental Health, Burnout and Stress-Related Symptoms Among Youth: Prevalence and Pandemic Effects
Jagodić, G. K., Seršić, D. M., & Antulić, S. (2025) · doi:10.18690/um.ff.7.2025.6
AlShammari, M. A., Alnasser, A. H., Alsalman, A., Alkhalifah, A., Alawadh, Y. W., Aljabri, A., Alwail, A. T., Aljaili, Z. K., Alsaihati, M. I., Alkufair, A. H., et al. (2025) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_282_25
“[10] However, research on how COVID‑19 affects communication skills, including auditory and speech‑related challenges, remains limited, particularly in regions such as the Eastern Province of Saudi Arabia.”
Harmancı, Ş. N., Hesapçıoğlu, S. T., Ayva, D. A., Kaygisiz, E., Kafalı, S., & Ceylan, M. F. (2025) · Türk tıp dergisi. · doi:10.70852/tmj.1762947
Lisboa, M. E. S. R., Cademartori, M. G., da Costa, V. P. P., Goettems, M. L., & Azevedo, M. S. (2025) · Pesquisa Brasileira em Odontopediatria e Clínica Integrada · doi:10.1590/pboci.2026.023
Guo, H., Wang, X., & Jin, Z. (2025) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2025.101004 · Cited by 1
Mao, P., Xia, J., Yang, J., Hou, X., Zou, Y., Liu, J., Cai, L., Tong, X., & He, W. (2025) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2025.107842
Vincent, J., Santhakumari, R. M., Nalinakumari Kesavan Nair, A., Sharahudeen, A., Asvini, K. P., Suresh, M. M., Valamparampil, M. J., Gayathri, A. V., Sujatha, C., & Thekkumkara Surendran, A. (2024) · Figshare · doi:10.6084/m9.figshare.26671836
Duong, C. B., Van Tran, N., Nguyen, A. H., Le, T. N., Ha, B. H., Do, C. N. P., Huynh, K., Le, T. M., Nguyen, T. P., & Nguyen, H. T. T. (2023) · Figshare · doi:10.6084/m9.figshare.22619459
Tinsae, T., Shumet, S., Takelle, G. M., Rtbey, G., Melkam, M., Andualem, F., Nakie, G., Segon, T., Koye, S., Fentahun, S., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26333331
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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