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Cited by 223COVID-19 and Mental HealthChild and Adolescent Psychosocial and Emotional DevelopmentHealth disparities and outcomes

Social isolation and its impact on child and adolescent development: a systematic review

Open access
Almeida, Isabelle Lina de Laia, Rego, Jaqueline Ferraz, Teixeira, Amanda Carvalho Girardi, Moreira, Marília Rodrigues·2022·Revista Paulista de Pediatria
DOI 10.1590/1984-0462/2022/40/2020385PMC PMC8543788
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Abstract

ABSTRACT Objective: This study aims to analyze the effects of social isolation on children's and teenagers’ development, with emphasis on the possible impacts over their physical and mental health. Data source: Review of the literature following the standards of PRISMA using the SciELO, LILACS and PubMed databases. The following key-words were used: “social isolation” and “child development”, “quarantine” and “adolescent development” according to the Medical Subject Headings (MESH) and their translation to the Portuguese. Studies in English, Portuguese and Spanish from inception were included. Data synthesis: 519 studies were screened and 12 were included in the systematic review. Five of those focused the psychology and social issues, two of them the effects of pandemics on these issues; four studies reported on impacts on general health and two consequences over the hypothalamus- hypophysis - adrenal axis and the cognitive and social development. Conclusions: The review shows a strong association between social isolation and anxiety and depression in children and adolescents. Social isolation leads to higher levels of cortisol and worse cognitive development. Therefore, the mental and physical health of children and adolescents need a careful follow up by health professionals during and after the COVID-19 pandemic.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review finds that social isolation in childhood and adolescence is strongly associated with anxiety, depression, and other psychosocial problems, and may also affect physical health, cortisol regulation, and cognitive development. The authors conclude that children and adolescents need careful physical and mental health follow-up during and after the COVID-19 pandemic.

Key findings

  • Across 12 included studies, social isolation was linked to depression, anxiety, loneliness, suicidal ideation, and PTSD symptoms. For example, Saurabh et al. reported increased worry (68.59%; p=0.069), helplessness (66.11%; p=0.039), fear (61.98%; p=0.001), and nervousness (60.33%; p=0.001) during quarantine; Sprang et al. found isolated children were 30% more likely to meet PTSD criteria and had a four-times higher average test score.
  • Longitudinal studies linked childhood social isolation to adult health risks: Danese et al. reported higher risks of adult depression (RR 1.76; 95%CI 1.12–2.77), CRP >3 mg/L (RR 1.60; 95%CI 1.04–2.47), and metabolic disease (RR 1.96; 95%CI 1.21–3.17); Caspi et al. reported adult health problems (RR 1.37; 95%CI 1.17–1.61); Lacey et al. reported cumulative adult BMI, smoking, and alcoholism risk (RR 2.58; 95%CI 1.46–4.56).
  • Social isolation was associated with higher cortisol and altered HPA-axis activity: Martin et al. found isolation was the only behavioral pattern that increased cortisol (p=0.040), and Koss et al. found isolated children had less pronounced daytime cortisol and that better social care was associated with higher morning cortisol (p<0.001) and more pronounced daily reductions (p<0.010).
  • Cognitive and social development were worse in isolated children: Fox et al. found lower IQ scores and significantly lower WISC verbal comprehension scores at 8 years [F(8,110)=3.09; p=0.004, η2=0.180].

Methods

  • Systematic review following PRISMA and PICO, searching SciELO, LILACS, and PubMed in July 2020 for English, Portuguese, and Spanish original observational studies without temporal delimitation; editorials, commentaries, reviews, and studies addressing only adults were excluded.
  • Three authors independently and blindly selected studies and resolved differences by consensus; 519 records were screened, 83 evaluated in full text, 11 included, and one additional study identified from references, totaling 12 studies.
  • Methodological quality was assessed with the AHRQ checklist (11 items; scores 0–11: low 0–3, moderate 4–7, high 8–11). Included studies were mostly prospective cohorts, with two retrospective cohorts, published between 1990 and 2020.

Limitations

  • The paper states that including a study conducted during the COVID-19 pandemic made it impossible to fully assess long-term consequences of isolation in young people, and that some included studies had lower methodological quality scores.
  • The text also makes evident heterogeneity across studies in designs, populations, outcome measures, and follow-up durations, as well as small samples and low diversity in some studies.
  • Several findings rely on self-report or parent/guardian recall, and some studies had incomplete data or measurement at only one developmental stage, which limits causal and longitudinal interpretation.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1590/1984-0462/2022/40/2020385

Cites

27 of 27 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 71 cited sources checked · 0 supported · 0 flagged

  • Findingnone given

    The review shows a strong association between social isolation and anxiety and depression in children and adolescents.

    “The review shows a strong association between social isolation and anxiety and depression in children and adolescents.”
    Quote in the paperSubstantial claim
  • Findingcitation

    Quarantine increased the incidence of psychological problems, such as fear, nervousness, and boredom.

    “Quarantine increased the incidence of psychological problems, such as fear, nervousness, and boredom.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] Saurabh K, 2020, Compliance and psychological impact of quarantine in children and adolescents due to covid-19 pandemic, Indian J Pediatr source

      Not checked in the free run.

  • Findingcitation

    Socially isolated children were at significantly higher risk of health problems in adulthood compared to non-isolated children.

    “Socially isolated children were at significantly higher risk of health problems in adulthood compared to non-isolated children.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16] Koss KJ, 2014, Social deprivation and the HPA axis in early development, Psychoneuroendocrinology source

      Not checked in the free run.

  • Findingcitation

    In all stages of childhood and adolescence analyzed, there was a correlation between loneliness and the manifestation of depressive symptoms.

    “In all stages of childhood and adolescence analyzed, there was a correlation between loneliness and the manifestation of depressive symptoms.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [14] Vanhalst J, 2012, The interplay of loneliness and depressive symptoms across adolescence: exploring the role of personality traits, J Youth Adolesc source

      Not checked in the free run.

  • Findingcitation

    After two weeks of isolation, participants showed an increase in symptoms of anxiety and depression.

    “After two weeks of isolation, participants showed an increase in symptoms of anxiety and depression.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [18] Li HY, 2020, The psychological impacts of a COVID-19 outbreak on college students in China: a longitudinal study, Int J Environ Res Public Health source

      Not checked in the free run.

  • Classified as probably not a substantial claim. 16
  • May combine two claims. 26
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    519 studies were screened and 12 were included in the systematic review.

    “519 studies were screened and 12 were included in the systematic review.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the included studies, five focused on psychology and social issues, two on the effects of pandemics on these issues, four on general health, and two on the hypothalamic-pituitary-adrenal axis and cognitive and social development.

    “Five of those focused the psychology and social issues, two of them the effects of pandemics on these issues; four studies reported on impacts on general health and two consequences over the hypothalamus- hypophysis - adrenal axis and the cognitive and social development.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Only two included studies were of the retrospective cohort type.

    “Only two studies were of the retrospective cohort type, 3 , 10”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The 12 selected articles were published between 1990 and 2020.

    “The 12 selected articles 3 , 6 , 10 , 13 – 21 were published between 1990 and 2020”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Among the prospective cohort articles, four had a duration of more than 15 years, and three followed the children from birth.

    “Among the prospective cohort articles, 6 , 13 – 21 four 6 , 13 , 17 , 21 had a duration of more than 15 years, of these, three 6 , 13 , 17 followed the children from birth.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The included studies were carried out with varied samples from countries on different continents: Oceania, Asia, Europe, and America.

    “the studies were carried out with varied samples from countries on different continents: Oceania, 6 , 17 Asia, 3 , 18 Europe, 14 , 19 – 20 and America. 10 , 13 , 16”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The authors divided the chosen studies into categories according to the area impacted by social isolation: five psychosocial, four general health, two hypothalamic-pituitary-adrenal axis, and one cognitive and social development.

    “the authors divided the chosen studies into four categories, according to the area that the article raised as being impacted by social isolation during childhood and adolescence. Thus, the division of texts took place in five articles in the psychosocial area (Table 2), 3 , 10 , 13 , 14 , 18 four articles in the health area in general (Table 3), 6 , 17 , 20 , 21 two articles in the area of the”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    In general, six included studies worked with children and adolescents, four only with children, and two only with adolescents.

    “In general, six studies worked with children and adolescents, 3 , 6 , 10 , 13 , 17 , 21 four only with children, 15 , 16 , 19 , 20 and two only with adolescents 14 , 18 (Table 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Children with a high level of loneliness are more likely to be depressed, aggressive, and have suicidal ideation.

    “Children with a high level of loneliness are more likely to be depressed, aggressive, and have suicidal ideation.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] Schinka KC, 2013, Psychosocial predictors and outcomes of loneliness trajectories from childhood to early adolescence, J Adolesc source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The reduction in habitual physical activity caused by social isolation increased the amount of fat in body composition and reduced the achievement of physical performance during growth.

    “The reduction in habitual physical activity caused by social isolation increased the amount of fat in the body composition and reduced the achievement of physical performance during growth.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] Andersen KL, 1980, Physical performance capacity of children in Norway. V. The influence of social isolation on the rate of growth in body size and composition and on the achievement in lung function and maximal aerobic power of children in a rural community, Eur J Appl Physiol Occup Physiol

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Adverse conditions experienced in childhood, such as social isolation, increase the likelihood of depression, cardiovascular disease, and metabolic diseases in adulthood.

    “Adverse conditions experienced in childhood, such as social isolation, increase the likelihood of depression, cardiovascular disease, and metabolic diseases in adulthood.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] Danese A, 2009, Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation, and clustering of metabolic risk markers, ArchPediatrAdolesc Med

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Social isolation is associated with suicidal ideation at age 15, with OR 10.90 (p=0.001) for low versus growing loneliness and OR 18.89 (p=0.009) for low versus chronic loneliness.

    “The authors also collected statistical data on the association between social isolation and suicidal ideation, in the assessment made at age 15, and concluded that this relationship proved to be very strong on two occasions: in the comparison between the low level and the growing level of loneliness (OR 10.90; p=0.001), and between the low and the chronic level of loneliness (OR 18.89; p=0.009).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] Schinka KC, 2013, Psychosocial predictors and outcomes of loneliness trajectories from childhood to early adolescence, J Adolesc source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Vanhalst et al. pointed out a vicious circle relationship between loneliness and depression, with loneliness being a strong predictor of depression and vice versa.

    “Vanhalst et al. 14 pointed out a vicious circle relationship between such factors, with loneliness being a strong predictor of depression and vice versa [chi-square(39)=170.79; p<0.001; comparative fit index (CFI)=0.92; root mean square error of approximation ([RMSEA]=0.09).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Vanhalst J, 2012, The interplay of loneliness and depressive symptoms across adolescence: exploring the role of personality traits, J Youth Adolesc source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Socially isolated children had higher levels of CRP in middle age and were more likely to have psychological changes in adulthood.

    “Socially isolated children had higher levels of CRP in middle age and were more likely to have psychological changes in adulthood.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] Andersen KL, 1980, Physical performance capacity of children in Norway. V. The influence of social isolation on the rate of growth in body size and composition and on the achievement in lung function and maximal aerobic power of children in a rural community, Eur J Appl Physiol Occup Physiol

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Children in isolation exhibited less pronounced daytime cortisol compared to non-isolated peers of the same age, and these differences did not diminish over the two-year period.

    “Children in isolation exhibited less pronounced daytime cortisol compared to non-isolated peers of the same age; these differences did not diminish over the two-year period.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16] Koss KJ, 2014, Social deprivation and the HPA axis in early development, Psychoneuroendocrinology source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Institutionalization during childhood results in the child's social isolation and becomes detrimental to his cognitive and social development.

    “Institutionalization during childhood results in the child's social isolation and becomes detrimental to his cognitive and social development.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [19] Fox NA, 2011, The effects of severe psychosocial deprivation and foster care intervention on cognitive development at 8 years of age: findings from the Bucharest Early Intervention Project, J Child Psychol Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Psychological problems, including anxiety, sadness, depression, and guilt, are direct consequences of the confinement process in children and adolescents.

    “Psychological problems, including anxiety, sadness, depression, and guilt, were raised as direct consequences of the confinement process. 3 , 18”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [3] Saurabh K, 2020, Compliance and psychological impact of quarantine in children and adolescents due to covid-19 pandemic, Indian J Pediatr source

      Not checked in the free run.

    • cites [18] Li HY, 2020, The psychological impacts of a COVID-19 outbreak on college students in China: a longitudinal study, Int J Environ Res Public Health source

      Not checked in the free run.

    • Rests on an assumption: The associations between social isolation and adverse outcomes reported in the included observational studies reflect causal effects of social isolation.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Children's physical activity habit depends on social contact with friends.

    “It was described that the children's physical activity habit depends on social contact with friends.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Andersen KL, 1980, Physical performance capacity of children in Norway. V. The influence of social isolation on the rate of growth in body size and composition and on the achievement in lung function and maximal aerobic power of children in a rural community, Eur J Appl Physiol Occup Physiol

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Only isolation behavior showed variation according to the level of cortisol (p=0.040).

    “concluded that only isolation showed variation according to the level of cortisol (p=0.040).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] Sanchez-Martin JR, 2001, Social behavior, cortisol, and sIgA levels in preschool children, J Psychosom Res source

      Not checked in the free run.

  • May combine two claims.

    Interpretationnone given

    Social isolation leads to higher levels of cortisol and worse cognitive development.

    “Social isolation leads to higher levels of cortisol and worse cognitive development.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The observational associations between social isolation and health outcomes in the included studies reflect causal effects of social isolation.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    This review was prepared according to the PRISMA standards.

    “This review article was prepared according to the items in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) list. 11”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] Moher D, 2009, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, BMJ source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The selection of studies was made by three authors independently and blindly, with differences resolved by consensus.

    “The selection of studies was made by three authors, independently and blindly, meeting the inclusion and exclusion criteria. Any differences between the authors were resolved by consensus.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    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”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [4] Holmes EA, 2020, Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science, Lancet Psychiatry source

      Not checked in the free run.

    • cites [5] Jiao WY, 2020, Behavioral and emotional disorders in children during the COVID-19 epidemic, J Pediatr source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    These factors have a profound impact on brain plasticity and, therefore, on cognitive and emotional development.

    “There is ample evidence that these factors have a profound impact on brain plasticity and, therefore, on cognitive and emotional development. 7”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] Pagliarone AC, 2009, Stress: review about the effects on the immune system, Biosaúde

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    As the changes caused by COVID-19 are sudden and cover many aspects of daily life, adverse reactions tend to worsen, impairing human reflexive function.

    “As the changes caused by COVID-19 are sudden and cover many aspects of our daily lives, these adverse reactions tend to worsen, impairing human reflexive function. 9”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Camoirano A, 2017, Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it, Front Psychol source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Social isolation can generate a sedentary lifestyle, and children in such condition can be harmed in their growth and functional development.

    “Social isolation can generate a certain sedentary lifestyle, and children in such a condition can be harmed in their growth and functional development.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The associations between social isolation and adverse outcomes reported in the included observational studies reflect causal effects of social isolation.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Psychological factors such as depression and anxiety play an important role in the development and progression of heart disease, obesity, and hypertension.

    “Psychological factors such as depression and anxiety play an important role in the development and progression of heart disease, 33 obesity, 34 and hypertension. 35”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [33] Pacheco AJ, 2015, Depression in people with heart disease: Relationship with anxiety and perceived control, Rev Port Enferm Saúde Mental

      Not checked in the free run.

    • cites [34] Pereira C, 2014, A psychopathological perspective of obesity, Arq Med

      Not checked in the free run.

    • cites [35] Fonseca FC, 2009, The influence of emotional factors on the arterial hypertension, J Bras Psiquiatr

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Isolation during childhood affects school performance and makes the socialization process more difficult with colleagues, creating a vicious circle between isolation and difficulty in the learning process.

    “which affects school performance and makes the socialization process more difficult with colleagues, creating a vicious circle between isolation and difficulty in the learning process. 31”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [31] Krull J, 2018, Does social exclusion by classmates lead to behaviour problems and learning difficulties or vice versa? A cross-lagged panel analysis, Eur J Spec Needs Educ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In Brazil, suicidal ideation showed a growth of 40% in the age group between 10 and 14 years and 33.5% between 15 and 19 years old in the last 10 years.

    “suicidal ideation, which is already a growing problem in our reality, showed, in Brazil, a growth of 40% in the age group between 10 and 14 years of age and 33.5% between 15 and 19 years old in the last 10 years, 30”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] Bouzas I, 2017, Suicídio, Adolesc Saúde

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The present article included studies whose methodological quality was assessed with lower scores.

    “In addition, the present article included studies whose methodological quality was assessed with lower scores.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Solitary behaviors lead to a sedentary lifestyle and its consequences.

    “Therefore, solitary behaviors lead to a sedentary lifestyle and its consequences.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The associations between social isolation and adverse outcomes reported in the included observational studies reflect causal effects of social isolation.

  • May combine two claims.

    Premisecitation

    Anxiety disorders can affect school dropout, excessive use of pediatric services, and the appearance of psychiatric disorders in adulthood.

    “Anxiety disorders can affect school dropout, excessive use of pediatric services, given the somatic complaints related to anxiety, and the appearance of psychiatric disorders in adulthood, making social and family life more difficult. 29”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] Asbahr FR, 2004, Anxiety disorders in childhood and adolescence: clinical and neurobiological aspects, J Pediatr source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Depression is associated with a higher risk of smoking and suicidal ideation.

    “with a higher risk of smoking and suicidal ideation, 27”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Glied S, 2002, Consequences and correlates of adolescent depression, Arch PediatrAdolesc Med source

      Not checked in the free run.

  • The quote only partly states this claim.

    Interpretationreasoning

    Long-term isolation can have consequences on adult health, including depression, heart disease, obesity, hypertension, diabetes, among others.

    “Some consequences that long-term isolation can have on adult health were also raised, with problems such as depression, heart disease, obesity, hypertension, diabetes, among others being highlighted.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The associations between social isolation and adverse outcomes reported in the included observational studies reflect causal effects of social isolation.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Obesity is associated with an increased risk of several chronic diseases, including high blood pressure, type II diabetes mellitus, hypercholesterolemia, coronary heart disease, and others.

    “obesity is associated with an increased risk of several chronic diseases, including high blood pressure, type II diabetes mellitus, hypercholesterolemia, coronary heart disease, and others. 34”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] Pereira C, 2014, A psychopathological perspective of obesity, Arq Med

      Not checked in the free run.

35 of 35

  • The paper relies on this without support.

    Social isolation during the COVID-19 pandemic is sufficiently similar to the quarantine and social isolation conditions in the included studies to generalize their findings to current children and adolescents.

    “Considering the above and the current context of the COVID-19 pandemic, the objective of this work was to conduct a systematic literature review to address the effects of social isolation on the development of children and adolescents, taking into account the consequences in the medium and long term, as well as to understand the possible results of these actions on the human organism.”

  • The paper relies on this without support.

    The observational associations between social isolation and health outcomes in the included studies reflect causal effects of social isolation.

    “Social isolation leads to higher levels of cortisol and worse cognitive development.”

  • The paper relies on this without support.

    Social distancing can aggravate or generate functional and behavioral difficulties in children and adolescents.

    “Social distancing can aggravate or generate functional and behavioral difficulties in this age group.”

  • The paper relies on this without support.

    The stress scenario of social isolation alters physical activity and sleep, which are essential for general development.

    “It is also noted that this stress scenario alters physical activity and sleep, essential for general development.”

  • The paper relies on this without support.

    The findings from studies of different types of social isolation (e.g., quarantine, social deprivation, foster care) can be combined to draw conclusions about social isolation in general.

    “three studies reflected on the impact that pandemics and their control measures, such as isolation and quarantine, can cause on children and adolescents.”

  • The paper relies on this without support.

    The associations between social isolation and adverse outcomes reported in the included observational studies reflect causal effects of social isolation.

    “A strong relationship between such behavior and depressive symptoms has been raised”

  • The paper relies on this without support.

    The COVID-19 pandemic control measures (isolation/quarantine) are sufficiently similar to other forms of social isolation to inform conclusions about child development.

    “three studies reflected on the impact that pandemics and their control measures, such as isolation and quarantine, can cause on children and adolescents.”

  • The paper relies on this without support.

    The included studies' methodological quality, despite lower scores, does not invalidate the review's conclusions.

    “Despite these limitations, this systematic review brought important analyses on the impact of social isolation on the development of children and adolescents”

  • The paper relies on this without support.

    High cortisol levels contribute to increased BMI.

    “which is widely recognized as an impacting factor for another consequence of social isolation, the increase in BMI.”
9 of 9

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The adverse effects of social isolation are particularly apparent for adolescents.

    “The adverse effects of social isolation are particularly apparent for adolescents (Almeida et al., 2021; Orben et al., 2020).”

    From Oxytocin neurons mediate the effect of social isolation via the VTA circuits (2022) · cites this paper as Almeida et al., 2021

  • Social isolation during adolescence can exacerbate mental health problems.

    “Indeed, adolescence is a critical period for not only social interaction (Larsen and Luna, 2018; ) but also the emergence of psychiatric diseases (Orben et al., 2020; Marco et al., 2011), and social isolation during adolescence can exacerbate mental health problems (Larsen and Luna, 2018; Almeida et al., 2021; ; Graf et al., 2021; Andersen, 2021).”

    From Oxytocin neurons mediate the effect of social isolation via the VTA circuits (2022) · cites this paper as Almeida et al., 2021

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Direction of the Koss cortisol comparison reverses

    Major

    Table 4 attributes less pronounced daytime cortisol to isolated children. The Discussion attributes less pronounced rates to the first group it names: children with normal social life.

  • Andersen study year differs from its reference

    Minor

    Table 1 dates the Andersen study to 1990, whereas reference 20 dates it to 1980.

  • A 15-year follow-up is described as longer than 15 years

    Minor

    The Results includes Schinka et al. among studies lasting more than 15 years, but Table 1 says its newborn participants were followed only until age 15.

  • Vanhalst study year differs from its reference

    Minor

    Table 1 dates the Vanhalst study to 2011, whereas reference 14 dates it to 2012.

  • Table 3 assigns Caspi the Koss reference number

    Minor

    Table 3 labels Caspi as reference 16, but Table 1 identifies Caspi as reference 17 and Koss as reference 16.

  • Pandemic-related study count differs

    Minor

    The abstract says two psychosocial studies addressed pandemics, while the Discussion identifies three.

6 of 6

Cites

Flagged first, then by citations

Research works printed but not linked: 10

  1. Pagliarone AC, 2009, Stress: review about the effects on the immune system, Biosaúde, 11, 57
  2. Linhares MB, 2020, Reflections based on Psychology about the effects of COVID-19 pandemic on child development, Estud Psicol (Campinas), 37, 1
  3. Caspi A, 2006, Socially isolated children 20 years later: risk of cardiovascular disease, Arch Pediatr Adolesc Med, 160, 805, 10.1001/archpedi.160.8.805 · DOI · Paper page
  4. Andersen KL, 1980, Physical performance capacity of children in Norway. V. The influence of social isolation on the rate of growth in body size and composition and on the achievement in lung function and maximal aerobic power of children in a rural community, Eur J Appl Physiol Occup Physiol, 45, 155
  5. Kandel DB, 1982, Epidemiology of depressive mood in adolescents: an empirical study, Arch Gen Psychiatry, 39, 1205, 10.1001/archpsyc.1982.04290100065011 · DOI
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Cited by

Sorted by citations

Authors
Almeida, I. L. D. L., Rego, J. F., Teixeira, A. C. G., & Moreira, M. R.
Affiliations
Universidade Federal de Uberlândia (BR)
Corresponding author
Almeida, Isabelle Lina de Laia
ORCID
Venue
Revista Paulista de Pediatria
Publisher
FapUNIFESP (SciELO)
Published
2022
Volume
40
Pages
e2020385-e2020385
ISSN
  • 0103-0582 (ISSN-L)
  • 1984-0462
DOI
10.1590/1984-0462/2022/40/2020385
PMC
PMC8543788
OpenAlex
W3204539510
Semantic Scholar
78957b596a456d077e3c597470190770b6d7e200
Cited by
223
References
27
Citations by year
2026: 27 · 2025: 69 · 2024: 62 · 2023: 42 · 2022: 23
FWCI
4.25
Type
journal article
Language
en
Open access
Licence
Locations
  • Revista Paulista de Pediatria (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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 › Health › Health disparities and outcomes
Keywords
social isolation, child development, adolescent development, COVID-19 pandemic, quarantine, anxiety, depression, cortisol, hypothalamic-pituitary-adrenal axis, cognitive development, mental health, physical health
MeSH terms
COVID-19, Adolescent, Adolescent Behavior, Child, Child Behavior, Child Development, Humans, Mental Health, Social Change, Social Isolation, Adolescent Development

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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