Behavioral and emotional disorders in children during the COVID-19 epidemic
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Parent-completed questionnaires showed that children felt uncertain, fearful, and isolated during the pandemic.
“Based on the questionnaires completed by the parents, findings reveal that children felt uncertain, fearful and isolated during current times.”
From Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations (2020) · cites this paper as Jiao et al., 2020
The Early Investigation section (page not provided) says parents completed the questionnaire and reports fear among the children's behavioral and emotional problems. It also describes children experiencing uncertainty and physical and social isolation, but does not identify those as findings from the parent-completed questionnaires. (LLM, conf=0.85)
Experimental — accuracy not yet measuredSeparation from primary caregivers can make a child more vulnerable and threaten a child's mental health.
“It is found that separation from the primary caregivers can make a child more vulnerable and can pose a threat to a child's mental health (Cooper, 2020; Jiao et al., 2020; Liu et al., 2020).”
From Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations (2020) · cites this paper as Jiao et al., 2020
The Early Investigation section lists “separation problems” among the psychological conditions investigated, and the resilience section says family support can help children recover from distress. Neither section says that separation from primary caregivers makes children more vulnerable or threatens their mental health; that specific link is not established in our copy. (LLM, conf=0.82)
Experimental — accuracy not yet measuredChildren experienced disturbed sleep, nightmares, poor appetite, agitation, inattention, and separation-related anxiety.
“It was also shown that children experienced disturbed sleep, nightmares, poor appetite, agitation, inattention and separation related anxiety (Jiao et al., 2020).”
From Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations (2020) · cites this paper as Jiao et al., 2020
The Early Investigation section reports inattention, irritability and clinginess among children in the preliminary Shaanxi study. It lists poor sleep and nightmares, poor appetite, agitation and separation problems as conditions the questionnaire investigated, but does not report that children experienced every condition on that list. The Conclusions also advise parents to watch for sleep difficulties and nightmares. (LLM, conf=0.86)
Experimental — accuracy not yet measuredDisplacement-related frustration and family conflict may manifest as violence toward children, making the child more vulnerable to depression, anxiety, and suicide.
“By the reason of displacement, the frustration and family conflict may manifest itself in the form of violence towards children. This can make the child more vulnerable to depression, anxiety and suicide (Jiao et al., 2020; Petito et al., 2020; Solantaus et al., 2020)”
From Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations (2020) · cites this paper as Jiao et al., 2020
The section “Psychological distress in Children Exposed to Adverse Events” reports anxiety and depression as common manifestations of psychological stress in children. It does not link displacement or family conflict to violence toward children, or discuss suicide; searches for those terms found no supporting passage. Page numbers were unavailable in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredHome confinement of children and adolescents is associated with uncertainty and anxiety attributable to disruption in education, physical activities, and socialization opportunities.
“The home confinement of children and adolescents is associated with uncertainty and anxiety which is attributable to disruption in their education, physical activities and opportunities for socialization (Jiao et al., 2020).”
From Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations (2020) · cites this paper as Jiao et al., 2020
The ‘Early Investigation’ section describes children experiencing uncertainty, isolation and prolonged absence from school during the epidemic. ‘Psychological distress in Children Exposed to Adverse Events’ says enforced isolation and school closure limit contact with classmates and physical activity, and identifies anxiety as a response to adverse events. Neither passage establishes that disruptions to education, activity and socialization specifically caused the uncertainty and anxiety claimed. (LLM, conf=0.82)
Experimental — accuracy not yet measured
Most studies in the review relied on online self-reports.
“The majority of the studies included in the review were based on online self-reports(Bhat et al., 2020; Jiao et al., 2020; Oosterhoff et al., 2020b).”
From Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations (2020) · cites this paper as Jiao et al., 2020
In “Early Investigation of Chinese Children's Behavioral and Emotional Reactions to COVID-19,” Jiao et al. describe an online questionnaire, supporting the online-reporting part. They say parents completed it, however, and do not establish that most studies in the citing review used online self-reports. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn a study by Jiao et al. (2020) in China, anxiety, depression, distraction, irritability, and fear that family members would contract the disease were the most common problems identified among children and adolescents screened for behavioral and emotional distress due to COVID-19.
“A recent study that Jiao et al. (2020) conducted in China screened children and adolescents for behavioral and emotional distress due to the COVID‑19 pandemic. Anxiety, depression, distraction, irritability, and the fear that family members would contract the deadly disease were the most common problems that they identified [7].”
From Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review (2021) · cites this paper as [7]
The “Early Investigation” section reports a screening study of children and adolescents in China and identifies distraction and irritability among its most common problems. The “Psychological distress” section reports fear that family members could contract the infection, particularly among younger children. But the study’s list of most common problems does not include anxiety or depression; the paper says the questionnaire was not intended to diagnose depression. (LLM, conf=0.90)
Experimental — accuracy not yet measuredPsychosocial support programs work for adolescents during the COVID-19 pandemic.
“These findings demonstrate that psychosocial support programs work for adolescents during the COVID-19 pandemic and the psychoeducation programs are important to support the mental health and wellbeing of adolescents (Jiao et al., 2020; Wang et al., 2020).”
From Reducing Test Anxiety During the COVID-19 Pandemic: A Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy (2024) · cites this paper as Jiao et al., 2020
The section “The Importance of Nurturing Resilience in Children Exposed to Epidemics” says that support from healthcare professionals, families, and schools can help children and adolescents overcome distress. The Conclusions describe measures suggested by pediatricians, but the paper does not evaluate a psychosocial support program or demonstrate that such programs work for adolescents during COVID-19. (LLM, conf=0.85)
Experimental — accuracy not yet measuredPrevious studies showed a prevalence of anxiety symptoms as well as depressive symptoms and posttraumatic stress disorder among children who have been quarantined during pandemic disease.
“Previous studies showed a prevalence of anxiety symptoms as well as depressive symptoms and posttraumatic stress disorder among children who have been quarantined during pandemic disease [26,27].”
From COVID-19-Related Anxiety Symptoms among Quarantined Adolescents and Its Impact on Sleep Pattern Changes and Somatic Symptoms (2022) · cites this paper as [26]
The “Psychological distress in Children Exposed to Adverse Events” section says anxiety and depression are commonly reported responses to adverse events and notes that children may face enforced isolation during epidemics. It does not report the prevalence of these symptoms specifically among quarantined children or identify posttraumatic stress disorder in that group. No page number is available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredConfined during a period of quarantine, children and adolescents may experience higher probability of behavioral and emotional disorders, including anxiety.
“Confined during a period of quarantine, this population may experience higher probability of behavioral and emotional disorders, including anxiety [26].”
From COVID-19-Related Anxiety Symptoms among Quarantined Adolescents and Its Impact on Sleep Pattern Changes and Somatic Symptoms (2022) · cites this paper as [26]
The Early Investigation section reports behavioral and emotional problems among children and adolescents during COVID-19 restrictions, including some confined at home. The Psychological Distress section discusses anxiety and reports higher rates of fear and anxiety in highly affected areas, but says those differences were not statistically significant. The paper does not establish that quarantine itself increases the probability of these problems compared with not being confined. (LLM, conf=0.82)
Experimental — accuracy not yet measuredPrevious studies on the general population in China reported changes in sleep quality, sleep disturbance, and insomnia among participants suffering from anxiety symptoms.
“Previous studies on the general population in China reported changes in sleep quality, sleep disturbance, and insomnia among participants suffering from anxiety symptoms [26,30].”
From COVID-19-Related Anxiety Symptoms among Quarantined Adolescents and Its Impact on Sleep Pattern Changes and Somatic Symptoms (2022) · cites this paper as [26]
The Early Investigation section describes a questionnaire for children in Shaanxi, China that investigated both anxiety-related concerns and poor sleep, including nightmares. It does not report sleep changes or insomnia among participants with anxiety symptoms, and its sample was children rather than the general population. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPreliminary unpublished data from China during the COVID-19 pandemic indicate that children and adolescents aged 3 to 18 years are commonly displaying behavioral manifestations of anxiety, including clinginess, distraction, fear of asking questions about the pandemic, and irritability.
“These results are consistent with preliminary unpublished data emerging from China during the COVID-19 pandemic, where children and adolescents aged 3 to 18 years are commonly displaying behavioral manifestations of anxiety, including clinginess, distraction, fear of asking questions about the pandemic, and irritability.83”
From Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19 (2020) · cites this paper as [83]
The COVID-19 pandemic had negative effects on adolescents and created a need for psychosocial support.
“The negative effects of the COVID-19 pandemic on adolescents and the need for psychosocial support were well-documented in previous studies (Gabor et al., 2020; Jiao et al., 2020; Munasinghe et al., 2020; Wang et al., 2020).”
From Reducing Test Anxiety During the COVID-19 Pandemic: A Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy (2024) · cites this paper as Jiao et al., 2020
Earlier child clinical work suggests that social-emotional learning programs might boost well-being, lower distress, and support persistence and school success.
“Results from previous child clinical research indicate that interventions based on social-emotional learning could potentially increase children’s well-being and reduce psychological distress, while encouraging perseverance and academic achievement in school [17].”
From Online art therapy in elementary schools during COVID-19: results from a randomized cluster pilot and feasibility study and impact on mental health (2021) · cites this paper as [17]
Reports describe emotional and behavioral difficulties among children kept at home.
“Specifically, emotional and behavioral problems arising in children who have been or are still confined to their homes have been reported [14, 17, 21, 24, 29].”
From Online art therapy in elementary schools during COVID-19: results from a randomized cluster pilot and feasibility study and impact on mental health (2021) · cites this paper as [17]
Four studies provided no or inadequate information on their sampling strategy.
“four studies provided no or inadequate information on their sampling strategy [41,42,43,44].”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [41]
One study does not provide information on how the questionnaire was developed.
“one study does not provide information on how the questionnaire was developed [41]”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [41]
Younger children (3-6 years old) were more likely to present with clinginess and fear that family members could contract COVID-19.
“One study [41] found that younger children (3–6 years old) were more likely to present with clinginess and fear that family members could contract COVID-19”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [41]
Somatic symptoms incidence in children across two studies ranged from 2.39% to approximately 22%.
“Somatic symptoms were also assessed by two studies [35,41] with their incidence ranging from 2.39% to approximately 22%.”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [41]
Approximately 22% of participants in one study reported fear for the health of relatives.
“[41] found that approximately 22% of their participants reported fear for the health of relatives”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [41]
Older children (6-18 years old) were more likely to show inattention (although marginally) and persistent inquiry.
“while older children (6–18 years old) were more likely to show inattention (although marginally) and persistent inquiry.”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [41]
The discrepancy in reported somatic symptom rates may be because one included study used a self-report established measure, while the other used a study-specific measure with parents as informants.
“This discrepancy in reported rates may be because one of the included studies used a self-report established measure [35], while the other study [41] used a study-specific measure with parents as informants.”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [41]
Younger children (3-6 years) experience different mental health symptoms than their older counterparts (6-18 years).
“One study indicated that younger children (3–6 years) experience different mental health symptoms than their older counterparts (6–18 years) [41].”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [41]
Quarantine influences people's daily behavior, causing anxiety, fear, depression, and panic.
“Studies show that this situation influences people's daily behavior, causing anxiety, fear, depression, and panic. 4 , 5”
From Social isolation and its impact on child and adolescent development: a systematic review (2022) · cites this paper as [5]
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“These fi ndings demonstrate that psychosocial support programs work for adolescents during the COVID-19 pandemic and the psychoeducation programs are important to support the mental health and wellbeing of adolescents (Jiao et al., 2020; Wang et al., 2020).”
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“Confined during a period of quarantine, this population may experience higher probability of behavioral and emotional disorders, including anxiety [26].”
Background
- Authors
- Jiao, W. Y., Wang, L. N., Liu, J., Fang, S. F., Jiao, F. Y., Pettoello-Mantovani, M., & Somekh, E.
- Affiliations
- Shaanxi Provincial People's Hospital (CN)
- Xi'an Medical University (CN)
- Tel Aviv University (IL)
- Corresponding author
- Somekh, Eli
- ORCID
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2020-06
- Volume
- 221
- Pages
- 264-266.e1
- ISSN
- 0022-3476 (ISSN-L)
- PMC
- PMC7127630
- OpenAlex
- W3014138269
- Cited by
- 1,468
- References
- 19
- Citations by year
- 2026: 20 · 2025: 48 · 2024: 140 · 2023: 253 · 2022: 385 · 2021: 458 · 2020: 161 · 2018: 2
- FWCI
- 125.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- COVID-19 pandemic, SARS-CoV-2, behavioral disorders, emotional disorders, children, child mental health, pandemic impact on children
- MeSH terms
- Problem Behavior, Betacoronavirus, Psychological Distress, COVID-19, SARS-CoV-2, Child, China, Humans, Pediatrics, Pneumonia, Viral, Coronavirus Infections, Mood Disorders, Resilience, Psychological, Pandemics
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