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Effects of COVID-19 pandemic on mental health of children and adolescents: A systematic review of survey studies
Open accessAbstract
Objective: Mental health problems among children and adolescents are increasingly observed during the outbreak of COVID-19, leading to significant healthcare concerns. Survey studies provide unique opportunities for research during this pandemic, while there are no existing systematic reviews in this setting. The objective was to summarize existing survey studies addressing the effects of the current COVID-19 pandemic on the mental health of children and adolescents. Methods: For this systematic review, we performed an electronic search in multiple databases from December 2019 to December 2020. The quality appraisal of the included studies was performed with the Critical Appraisal Skills Programme Qualitative Checklist. Because of the high methodological heterogeneity between studies, a narrative synthesis of the qualitative data was used. Results: In total, 35 survey studies with 65,508 participants, ranging from 4 to 19 years of age, are included in this review. Anxiety (28%), depression (23%), loneliness (5%), stress (5%), fear (5%), tension (3%), anger (3%), fatigue (3%), confusion (3%), and worry (3%) were the most common mental health issues reported. Children and adolescents with psychiatric and/or developmental disorders, such as severe obesity, chronic lung disease, attention deficit hyperactivity disorder, cystic fibrosis, and obsessive-compulsive disorders, were especially vulnerable to the mental health effects of the COVID-19 pandemic. Age, gender, psychological quality, and negative coping strategies were identified as risk factors for the development of mental health problems. Social and family support, along with a positive coping style, was associated with better outcomes. Conclusion: The impact of the COVID-19 pandemic on mental health of children and adolescents is multifaceted and substantial. Survey studies regarding child and adolescent mental health amid COVID-19 indicated that anxiety, depression, loneliness, stress, and tension are the most observed symptoms. Positive coping strategies with family and social support may be important to achieving better outcomes. Due to limited available evidence, more well-designed studies in this area are urgently needed.
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“Systematic reviews have estimated the global prevalence of childhood and teenage depression at 23% and anxiety at 28% [2]”
From Psychological Interventions and Those With Elements of Positive Psychology for Child and Youth Mental Health During the COVID-19 Pandemic: Literature Review, Lessons Learned, and Areas for Future Knowledge Dissemination (2024) · cites this paper as [2]
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“Furthermore, the COVID-19 pandemic has exerted a substantial influence on the mental well-being of children and adolescents, with specific subgroups being especially susceptible to the psychological consequences of the pandemic [55].”
From Clinical Efficacy of Psychotherapeutic Interventions for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Analysis. (2024) · cites this paper as [55]
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“Several systematic reviews also found that certain child and adolescent populations were at risk for experiencing poorer well-being outcomes, including older adolescents, girls, neurodivergent populations, and/or chronic physical conditions [23], and populations with psychiatric or developmental disorders (e.g., obesity, lung disease, attention deficit hyperactivity disorder (ADHD), obsessive comp”
From Loneliness and Well-Being in Children and Adolescents during the COVID-19 Pandemic: A Systematic Review (2023) · cites this paper as [25]
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“Methods of increasing children’s and adolescents’ feelings of belonging to a social group and experiencing positive social rewards can include access to physical exercise, social hobbies, and entertainment [25,71].”
From Loneliness and Well-Being in Children and Adolescents during the COVID-19 Pandemic: A Systematic Review (2023) · cites this paper as [25]
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Trends in Adolescent Health: Successes and Challenges From 2010 to the Present
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Kurbatfinski, S., Letourneau, N. L., Dewey, D., Hayes, A. F., Hayden, A., Anis, L., & Dosani, A. (2023) · Clinical Medicine Insights Psychiatry · doi:10.1177/11795573231212175 · Cited by 6
Pace, C. S., Muzi, S., Frigerio, A., Morganti, W., Bianchi, V., & Rogier, G. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1161917 · Cited by 11
Testing a model of benefit-finding and growth in youths with chronic health conditions
von Rezori, R. E., Baumeister, H., Holl, R. W., Minden, K., Mueller‐Stierlin, A. S., Reinauer, C., Temming, S., & Warschburger, P. (2024) · BMC Pediatrics · doi:10.1186/s12887-023-04467-3 · Cited by 7
“Specific CCs (e.g., diabetes) were identified and communicated as a risk factor for severe complications from COVID-19 at an early stage during the pandemic, and children and adolescents with CCs were especially vulnerable to the mental health effects of the COVID-19 pandemic [39].”
BackgroundKim‐Ju, G. M., Knifsend, C. A., & Gonzales, A. (2024) · Social and Emotional Learning Research Practice and Policy · doi:10.1016/j.sel.2024.100033 · Cited by 11
García-Cerde, R., Wagner, G. A., Valente, J. Y., & Sanchez, Z. M. (2024) · Jornal de Pediatria · doi:10.1016/j.jped.2024.01.005 · Cited by 9
“26,29 The present study is the fi rst to investigate the Latin American adolescent population to analyze the consequences of drug use and its relationship with mental health.”
BackgroundResultBadger, J. R., Holst, C. G., Thompson, P. A., Bowes, L., Hayes, R. A., Clarkson, S., Hutchings, J., & Hastings, R. P. (2024) · British Educational Research Journal · doi:10.1002/berj.4022 · Cited by 6
Johnson, S. M., Penner, J., Issitt, R. W., Kmentt, L., Grant, K., Pandey, A., Champsas, D., Abdel‐Mannan, O., Maillard, S., McKenzie, K. A. G. C. A., et al. (2024) · The Pediatric Infectious Disease Journal · doi:10.1097/inf.0000000000004430 · Cited by 6
“32 A small study comparing patients with MIS-C with sibling controls demonstrated lower executive functioning scores.”
Berchialla, P., Canale, N., Kilibarda, B., Comoretto, R. I., Alexandrova‐Karamanova, A., Baška, T., ter Bogt, T., Vieno, A., & Charrier, L. (2024) · Addictive Behaviors · doi:10.1016/j.addbeh.2024.108238 · Cited by 6
Mondragón, N. I., Berasategi, N., Ozamiz-Etxebarria, N., & Santamaría, M. D. (2022) · Children s Geographies · doi:10.1080/14733285.2022.2118030 · Cited by 6
“…post-lockdown period (Cordovil et al. 2021; Idoiaga et al. 2022; Mourouvaye et al. 2021) and meta-analyses (Oliveira et al. 2022; Samji et al. 2022; Theberath et al. 2022) carried out on the effects of pandemics on children point to the fact that children’s mental health is being affected over…”
Marciano, L., Albanese, E., Viswanath, K., & Camerini, A.-L. (2023) · European Journal of Health Communication · doi:10.47368/ejhc.2023.101 · Cited by 6
Green, R., Linga-Easwaran, J., Goodman, C. V., Taylor, M., Fabiano, G. F., Miller, S., & Williams, T. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1328476 · Cited by 5
Children’s Coping in Disasters: Developments, Challenges, and Future Directions
Powell, T. M., Cohen, F., & Ramchal, M. (2025) · Current Psychiatry Reports · doi:10.1007/s11920-025-01654-0 · Cited by 6
“In response, researchers have examined children’s cop - ing during the pandemic, revealing that negative strategies such as behavioral avoidance, denial, self-blame, substance use, venting, were consistently associated with heightened distress [ 38, 39 ].”
Gender specific mental health among adolescents in Northern Italy: a cross-sectional study
Barbieri, V., Piccoliori, G., Engl, A., & Wiedermann, C. J. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1705580 · Cited by 5
Tabullo, Á., Juric, L. C., & Abusamra, V. (2023) · Cognitive Development · doi:10.1016/j.cogdev.2023.101378 · Cited by 9
Guo, Z., Zhang, Y., Pi, P., Zhu, X., Cui, Y., Miao, D., & Lü, H. (2024) · Current Psychology · doi:10.1007/s12144-024-05912-x · Cited by 5
“With regard to PCS and fatigue, many lines of evidence have corroborated the negative relationship between them (Du et al., 2013; Li et al., 2022, c; Theberath et al., 2022), which is in line with our findings.”
Marcotullio, C., Attanasi, M., Porreca, A., Filippo, P. D., Matricardi, S., Venanzi, A., Schiavo, M., Paone, A., Rossi, N., Chiarelli, F., et al. (2024) · Children · doi:10.3390/children11050532 · Cited by 6
“The analysis reported significant rates of headaches [15.88% (95% CI 6.85 The mechanisms underlying the development of short-and long-term pain manifestations post-COVID-19 remain incompletely understood.”
BackgroundInfluentialAn Adaptive Decision-Making System for Behavior Analysis Among Young Adults
Pragathi, S., Narayanamoorthy, S., Pamucar, D. S., & Kang, D. (2024) · Cognitive Computation · doi:10.1007/s12559-024-10372-3 · Cited by 5
“Since the pandemic’s breakout, a growing number of reports of psychotic issues in kids and teens have surfaced, resulting in major health concerns [23].”
Stresserleben und Stresssymptomatik von Kindern und Jugendlichen in Zeiten der COVID-19-Pandemie
Rueth, J., Döring, L., Baier, A., Essing, K., Wagner, S., & Lohaus, U. A. (2023) · Kindheit und Entwicklung: Zeitschrift für Klinische Kinderpsychologie · doi:10.1026/0942-5403/a000430 · Cited by 3
Phan, M. L., & Renshaw, T. L. (2024) · Journal of Educational and Psychological Consultation · doi:10.1080/10474412.2024.2373462 · Cited by 6
“Post-pandemic, anxiety, depression, loneliness, stress, and tension are the now the most commonly reported symptoms affecting children and adolescents (Theberath et al., 2022).”
Global Challenges After a Global Challenge: Lessons Learned from the COVID-19 Pandemic
Yazdanpanah, N., Sedikides, C., Ochs, H. D., Camargo, C. A., Darmstadt, G. L., Cerdà, A., Cauda, V., Peters, G. J., Sellke, F. W., Wong, N. D., et al. (2024) · Advances in experimental medicine and biology · doi:10.1007/978-3-031-61939-7_1 · Cited by 5
“Anxiety, depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and sleep disturbances were commonly reported during the pandemic (Zeng et al. 2023; Peng et al. 2023; Ghahramani et al. 2022; Theberath et al. 2022).”
BackgroundRaffagnato, A., Miscioscia, M., Bruni, G., Col, L. D., Traverso, A., Ferrarese, M., Ancora, C., Zanato, S., & Gatta, M. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1152876 · Cited by 6
Aragón-Daud, A., Abadi, A. F., López, P. L., Torrente, F. M., & Musich, F. M. (2022) · Early Child Development and Care · doi:10.1080/03004430.2022.2090931 · Cited by 5
“In addition, social policies could offer basic and concrete explanations about the Covid-19 pandemic, adapted to preschoolers’ cognitive level, as having accurate knowledge acts as a protective factor for mental health (Theberath et al., 2022).”
BackgroundInfluentialHu, L., & Stamoulis, C. (2024) · Cerebral Cortex · doi:10.1093/cercor/bhae164 · Cited by 6
Equine-assisted learning reduces anxiety and increases calmness and social skills in young people
Sullivan, K., & Hemingway, A. (2024) · Academia Mental Health and Well-Being · doi:10.20935/mhealthwellb7424 · Cited by 5
Ringing the bell for quality P.E.: What are the realities of remote physical education?
Kovacs, V. A., Csányi, T., Blagus, R., Brandes, M., Starc, G., Rocha, P. M., Scheuer, C., & Okely, A. D. (2022) · European Journal of Public Health · doi:10.1093/eurpub/ckac082 · Cited by 5
Fehkührer, S., Humer, E. C., Kaltschik, S., Pieh, C., Probst, T., Diestler, G., & Jesser, A. (2023) · Healthcare · doi:10.3390/healthcare11162242 · Cited by 4
The impact of the COVID-19 pandemic on children’s occupations
Blanta, M., Karathanasi, A., & Tzonichaki, I. (2023) · Hong Kong Journal of Occupational Therapy · doi:10.1177/15691861231204905 · Cited by 4
“A systematic review by Theberath et al. (2022), as well as in this study (Eirich et al., 2022; Gadermann et al., 2022; Li et al., 2021; Nithya et al., 2021; Palomo-Carrion et al., 2022; Sama et al., 2021; Smirni et al., 2021; Werling et al., 2021), the COVID-19 pandemic has been linked with an…”
BackgroundBassi, G., Mancinelli, E., Boldrini, B., Mondini, G., Ferruzza, E., Riso, D. D., & Salcuni, S. (2022) · Children · doi:10.3390/children9060806 · Cited by 4
Conradi, L., Hazen, A. L., & Covert, J. (2022) · Global Implementation Research and Applications · doi:10.1007/s43477-022-00065-0 · Cited by 4
“Effects such as the loss of family members, fears of contracting the disease, economic insecurity, increased caregiving burden, social isolation, and reduced access to supportive services have been associated with heightened levels of stress, increases in mental health and substance use concerns among both adults and…”
BackgroundMüderrisoğlu, S., Akkan, B., Semerci, P. U., & Erdoğan, E. (2023) · International Journal on Child Maltreatment Research Policy and Practice · doi:10.1007/s42448-023-00152-1 · Cited by 4
Olsen, E. B., Tsuda, E., Wyant, J. D., Burrell, R., Mukherjee, J., McKay, A., Herrera, J., & Labrador, D. (2023) · Journal of Teaching in Physical Education · doi:10.1123/jtpe.2022-0196 · Cited by 4
Erazo, C. V., Carcelén, A. C. C., Navas, A. M., Suárez, F. C., Caicedo-Gallardo, J. D., Miño, M. A. A., & Moncayo, A. L. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-068761 · Cited by 4
Family Support And Social Support In Pre-Operative Anxiety Status
Mustamu, A. C., Bistara, D. N., & Susanti, S. (2023) · Journal of Health Sciences · doi:10.33086/jhs.v16i02.3802 · Cited by 4
“The family can be the closest part of the client, so maximum support must be given (Gao et al., 2022; Schwab et al., 2022; Shi et al., 2022; Theberath et al., 2022).”
BackgroundMaternal Beliefs about the Costs and Benefits of Solitude in Childhood and Adolescence
Coplan, R. J., Weingarten, J. P., Bowker, J. C., Ooi, L. L., & Archbell, K. A. (2023) · Journal of Child and Family Studies · doi:10.1007/s10826-023-02713-x · Cited by 5
“Global experiences of lockdowns and social distancing during the COVID-19 pandemic have further highlighted the importance of considering both positive and negative impacts of solitude on youth well-being and mental health (Theberath et al., 2022).”
Long-COVID in children: An exploratory case-control study from a bio-psycho-social perspective
Freda, M. F., Scandurra, C., Auriemma, E., Guarino, A., Lemmo, D., Martino, M. L., Nunziata, F., Maldonato, M. N., & Continisio, G. I. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111564 · Cited by 5
Koslouski, J. B., Iovino, E. A., & Chafouleas, S. M. (2024) · Social and Emotional Learning Research Practice and Policy · doi:10.1016/j.sel.2024.100037 · Cited by 4
Cattan, S., Farquharson, C., Krutikova, S., McKendrick, A., & Sevilla, A. (2023) · doi:10.1920/re.ifs.2023.0267 · Cited by 4
Rejuvenating School Leadership Preparation and Development: Lessons from the COVID-19 Pandemic
Okilwa, N. S. A., Barnett, B., & Cleveland, S. (2025) · Studies in educational leadership · doi:10.1007/978-3-031-92064-6_16 · Cited by 3
Vatandoost, S., Baetens, I., Meersschaut, J. V. D., Heel, M. V., & Hove, L. V. (2023) · Clinical Medicine Insights Psychiatry · doi:10.1177/11795573231206378 · Cited by 3
“17 Future research needs to determine the potential cross-cultural differences in psychological impact of COVID-19 on adolescents, especially in understudied countries, such as Belgium and Iran.”
Background
Metadata
- Authors
- Theberath, M., Bauer, D., Chen, W., Salinas, M., Mohabbat, A. B., Yang, J., Chon, T. Y., Bauer, B. A., & Wahner-Roedler, D. L.
- Affiliations
- St. Olaf College (US)
- Century High School, Rochester, MN, USA
- Mayo Clinic (US)
- St. Olaf College, Northfield, MN, USA
- Venue
- SAGE Open Medicine
- Publisher
- SAGE Publications
- Published
- 2022-01
- Volume
- 10
- Pages
- 20503121221086712-20503121221086712
- ISSN
- 2050-3121 (ISSN-L)
- PMC
- PMC8972920
- OpenAlex
- W4225507166
- Cited by
- 244
- References
- 44
- Citations by year
- 2026: 21 · 2025: 35 · 2024: 77 · 2023: 89 · 2022: 21
- FWCI
- 9.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- SAGE Open Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- The HEAD Foundation, Singapore
- 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, child mental health, adolescent mental health, anxiety, depression, loneliness, stress, coping strategies, social support, family support, mental illness, developmental disorders, attention deficit hyperactivity disorder, cystic fibrosis, obsessive-compulsive disorder, morbid obesity, chronic lung disease, risk factors
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