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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]
In the citing paper
“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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Psychometric Validation of the Indonesian Version of Children’s Revised Impact of Event Scale 13
Laksmita, O. D., Chung, M., Shieh, Y., & Chang, P. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192417069 · Cited by 4
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Child Well‐Being and Family Quality of Life During the COVID‐19 Pandemic
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“…deteriorations or exacerbations during the pandemic (Cost et al. 2022; Hawke et al. 2020; Richard et al. 2023; T. Vaillancourt et al. 2021; Theberath et al. 2022), there is evidence that a child's mental health condition can negatively impact parental well-being (Azman et al. 2019;…”
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Parent–Adolescent communication during COVID-19 and adolescent Emotions: The role of parenting style
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“Consistent with coping and stress buffering theories [14,15], children’s coping strategies and their level of perceived family and peer support are speculated to be important moderators of the pandemic’s impact [8,9,13].”
BackgroundResultCocientes de neurodesarrollo en niños postconfinamiento por covid-19
Salazar, C. M. L., Pérez, M. L. R., Ortíz, A. B., & Rubio, A. D. R. M. (2023) · LATAM Revista Latinoamericana de Ciencias Sociales y Humanidades · doi:10.56712/latam.v4i1.371 · Cited by 1
Psychological Impact of COVID-19 on Children and Adolescents: A Narrative Review
Nafei, Z., Samadzadeh, G., Ordooei, M., & Vaghefi, M. (2023) · Journal of Pediatrics Review · doi:10.32598/jpr.11.1.1088.1 · Cited by 1
Ordóñez-Camblor, N., Landa, S. U., Castro, J. L. G., & Pizarro-Ruiz, J. P. (2023) · Current Psychology · doi:10.1007/s12144-023-04893-7 · Cited by 1
“…the cross-sectional studies conducted in this field, informants were parents rather than the children/adolescents themselves (Ezpeleta et al., 2020; Stassart et al., 2021), rendering the number of those that directly assessed young people smaller still (Jones et al., 2023; Theberath et al., 2022).”
ISLAM, M. A. (2023) · Journal of Community Positive Practices · doi:10.35782/jcpp.2023.2.05 · Cited by 3
Quality of life in adolescents. A longitudinal study of the impact of the COVID-19 pandemic
Morales-Ortiz, J., Muñoz-Martínez, S., Martínez-Sánchez, A., & García, J. J. L. (2023) · Anales de Psicología · doi:10.6018/analesps.554511 · Cited by 3
Sosialisasi Resiliensi Pada Remaja: You Are Strong Than You Think
Putri, R. D., Hidajat, H. G., Asfari, N. A. B., & Rahmi, Y. (2023) · GERVASI Jurnal Pengabdian kepada Masyarakat · doi:10.31571/gervasi.v7i2.5234 · Cited by 1
“Guna mengoptimalkan perkembangan remaja dalam mengatasi faktor risiko dari masalah kesehatan mental, beberapa studi menjelaskan bahwa remaja dapat melakukan positive coping strategies (Jones et al., 2021; Theberath et al., 2022).”
BackgroundCross-Cohort Changes in Parent-Rated Child Mental Health over Two Decades
Slobodskaya, H. R., Kornienko, O. S., Leto, I. V., Ryabichenko, T. I., Варшал, А. В., Petrenko, E. N., Козлова, Е. А., Grishkevich, M. E., & Loginova, S. V. (2024) · Psikhiatriya · doi:10.30629/2618-6667-2023-21-6-6-16 · Cited by 1
Covid-19 Pandemisi Sonrası Okullarda Yaşanan Öğrenci Sorunlarının İncelenmesi
Çelik, N., & Kılıçoğlu, D. Y. (2024) · Anadolu Üniversitesi Eğitim Fakültesi Dergisi · doi:10.34056/aujef.1338055 · Cited by 2
Gowans, L., Ritchie, T., Rogers, M., Jiang, Y., Climie, E. A., Mah, J. W. T., Corkum, P. V., Krause, A., & Parvanova, M. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01732-z · Cited by 2
Impact of healthy lifestyles on mental health indicators in adolescents after the COVID-19 pandemic
Carrizales, L. M., Vilca, L. W., Santiago-Vizcarra, C., Fernández, Y. S., & Caycho‐Rodríguez, T. (2024) · Mental Health & Prevention · doi:10.1016/j.mhp.2024.200371 · Cited by 4
Zupanič, S., Karakatič, S., & Radobuljac, M. D. (2024) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-024-00811-2 · Cited by 1
Sohn, S., Jeong, J., & Park, H. (2024) · Asian Social Work and Policy Review · doi:10.1111/aswp.70001 · Cited by 1
Muhajarine, N., & Ramamoorthy, S. (2024) · Current Psychology · doi:10.1007/s12144-024-07009-x · Cited by 1
“Adolescent life stage, developmentally and chrono - logically, has consistently been identified as a significant risk factor for adverse mental health outcomes during the COVID-19 pandemic (Theberath et al., 2022 ).”
Telepsychiatry Expansion of Inpatient Psychiatry Services During the COVID-19 Pandemic
Penwill, N. Y., Lalisan, A., Carubia, B. A., McNitt, C., Fritsch, S. L., Clark, B., Hyle, B., & Lockwood, J. M. (2025) · Hospital Pediatrics · doi:10.1542/hpeds.2024-007942 · Cited by 1
Network analysis of loneliness, mental, and physical health in Czech adolescents
Meier, Z., Helvich, J., Fürstová, J., Novák, L., Purova, D., Žídková, R., & Tavel, P. (2025) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-025-00884-7 · Cited by 1
“This isolation was closely tied to mental health challenges such as depression, anxiety, and stress [18, 168– 170].”
Durak, F., Tezol, Ö., Aksu, G. G., & Bozlu, G. (2025) · The Journal of Pediatric Academy · doi:10.4274/jpea.2025.398 · Cited by 1
“The COVID-19 pandemic has significantly impacted young child and adolescent mental health, with anxiety, depression, loneliness, and stress being the most commonly reported issues 13 .”
Schreyer, V., Bornschlegl, M. X., & Hemmje, M. (2025) · Information · doi:10.3390/info16050349 · Cited by 1
Penguatan Kapasitas Guru SMA Dalam Masa Pandemi Covid-19 Terkait Usaha Kesehatan Sekolah
Santi, B. T., Kristian, K., Hadiyanto, H., Fitriah, N., & Gunawan, D. (2023) · Jurnal Pengabdian Pada Masyarakat · doi:10.30653/jppm.v8i1.184 · Cited by 1
COVID-19 and children's behavioral health: An overview
Pajek, J. A., Mancini, K. J., & Murray, M. S. (2023) · Current problems in pediatric and adolescent health care · doi:10.1016/j.cppeds.2023.101491 · Cited by 3
Anaemia and its relation to physical and mental health of Indonesian adolescents
Asrullah, M. (2023) · doi:10.18174/586155 · Cited by 1
Mental Health Outcomes and Vulnerability to COVID-19: A Systematic ReviewPreprint
Dondashe, N., Anakpo, G., & Mishi, S. (2023) · Preprints.org · doi:10.20944/preprints202308.0469.v1
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“%) among other mental health concerns (Theberath et al., 2022).”
Raffagnato, A., Miscioscia, M., Bruni, G., Col, L. D., Traverso, A., Tascini, B., Rossaro, M. P., Zanato, S., & Gatta, M. (2022) · Research Square · doi:10.21203/rs.3.rs-2268953/v1
COVID-19 and the developing brain
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Reflections on an ongoing pilot using the ADDRESSING Model
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Healing Broken Bones and Fixing Fractured Connections
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Editorial: Social cognition and mental health among children and youth
Zhi, K., Xia, L., Bueno, D., Chen, Y., Li, Z., & Laranjeira, C. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1228526
“Long-term effects of stress, such as COVID-19, have the potential to seriously endanger developing children’s and youth’s social cognition and mental health (Marques de Miranda et al., 2020; Theberath et al., 2022).”
BackgroundMcDougal, L., Majnoonian, A., Stone, G., & Fielding-Miller, R. K. (2023) · PLoS ONE · doi:10.1371/journal.pone.0288628
Manifestações psicopatológicas e cognitivas associadas à infecção pelo vírus SARS-CoV-2
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“…also alerted the public to concerns over children ’ s health, which stemmed from increased screen time, decreased physical activity levels, poor nutrition habits, weight gain (Bennett et al., 2021), and mental health issues such as depression, stress, fear, and confusion (Theberath et al., 2022).”
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“This has had a significant impact on emotional well-being and societal mindset, especially on the mental health of children and adolescents [2].”
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Internalisierende Störungen bei Kindern und Jugendlichen
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“13,14 In addition, literature shows that COVID-19 caused different mental behaviors among youngsters by worsening the child’s mental health outcomes which was further reflected by the socioeconomic status of the family.”
Bernardo, G. D., Ferraro, V. A., Zanconato, S., & Carraro, S. (2024) · doi:10.56164/pediatrrespirj.2024.38
Goddard, J. A., Pagnotta, V. F., Duncan, M. J., Sudiyono, M., Pickett, W., Leatherdale, S. T., & Patte, K. A. (2024) · Promotion de la santé et prévention des maladies chroniques au Canada · doi:10.24095/hpcdp.44.3.04f
Impact of the COVID‑19 pandemic on emergency transport times for patients with urological diseases
Minami, M., Miyauchi, M., Eitoku, M., Kawauchi, A., Fukuhara, H., Ashida, S., Karashima, T., Inoue, K., Suganuma, N., & Nishiyama, K. (2024) · World Academy of Sciences Journal · doi:10.3892/wasj.2024.240
Saleem, A., & Tariq, U. (2024) · Infectious diseases News Opinions Training · doi:10.33029/2305-3496-2024-13-1-27-34
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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