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. 2021 May 25;5(1):e001043. doi: 10.1136/bmjpo-2021-001043

Table 1.

Studies on mental health and general health

First author (journal) Country (ies) Type of study Main subject Objectives Age (n) Lockdown /school closure and time of data collection Outcome measures Other factors (inequalities) Summary of results
 NR, et al. (J Youth Adolesc) Australia (New South Wales) Cohort study (Risks to Adolescent Wellbeing Project, the
RAW Project)
Mental health, life satisfaction To assess the impact of the COVID-19 pandemic on adolescents’ mental health, and moderators of change, as well as assessing the factors perceived as causing the most distress. 13–16 years (response rate 53% at time T2 during lockdown, n=248) T1=previous year (2019) T2=2 months after start lockdown) May 5 to May 14 Generalised Anxiety, Depressive symptoms, Student’s Life Satisfaction Scale (SLSS) Age, sex, schooling, peer and family relationships, social connection, media exposure, COVID-19 related stress, and adherence to government stay-at-home directives at T2 Significant increase in depressive symptoms and anxiety, and a significant decrease in life satisfaction from T1 to T2, higher among girls. Moderators were COVID-19-related worries, online learning difficulties, and increased conflict with parents as predictors of increases in mental health problems from T1 to T2. Adherence to stay-at-home and feeling socially connected during the lockdown protected against poor mental health.
Ezpeleta L, et al. (Int J Environ Res Public Health)20 Barcelona (Spain) Cohort study (started 10 years ago) Mental health To assess life conditions during lockdown associated with mental health problems in children, and to analyse the mental health status of the population during the lockdown period. 226 parents (mainly mothers) answered the questionnaire (response rate 55%). Mean age=13.9 years Lockdown March 13 to May 24.
Questionnaires answered on June.
Compare results with 2019
SDQ parent-proxy version Physical environment, COVID-19
disease, the adults sharing the house, adolescents’ relationships, activities, and feelings/behaviours
Total difficulties increased and peer, and prosocial, after adjusting for previous pathology. Effect size small to medium.
Zhang L, et al. (JAMA Net Open)21 China (Chizhou, Anhui Province) Cohort Mental health To investigate psychological symptoms, nonsuicidal self-injury, and suicidal ideation, plans, and attempts among a cohort of children and adolescents Age range 9:3–15.9. Mean age: 12.6 years
fourth to eighth grades.
N=1241 out of 1387 participants in two waves
Two waves: wave 1, early November 2019; and 2 weeks after school reopening (wave 2, mid-May 2020). After 3 months of lockdown, schools in Chizhou were reopened on April 26 Data on depressive and anxious symptoms (Mood and Feelings Questionnaire; MacArthur Health & Behavior Questionnaire), nonsuicidal self-injury, suicide ideation, suicide plan, and suicide attempt were collected in two waves Adjusting for age, sex, body mass index, self-perceived household economic status, family cohesion, parental conflict, academic stress, parental educational level, family adverse life events, self-perceived health, sleep duration, and sleep disorders. The prevalence of mental health outcomes among students in wave 2 increased significantly from levels at wave 1: depressive symptoms (24.9% vs 18.5%; adjusted OR (aOR), 1.50 (95% CI, 1.18–1.90); nonsuicidal self-injury (42.0% vs 31.8%; aOR, 1.35(95% CI, 1.17–1.55)°; suicide ideation (29.7% vs 22.5% aOR, 1.32(95%CI, 1.08–1.62); suicide plan (14.6% vs 8.7%; aOR, 1.71(95% CI, 1.31–2.24); and suicide attempt (6.4% vs 3.0% aOR, 1.74(95% CI, 1.14–2.67). No differences in anxiety symptoms.
Tromans S, et al. (Br J Psy Open)23 Leicester-UK Electronic data register of aproximately 1 000 000 hab of the NHS Mental health To describe secondary mental health service utilisation prelockdown and during lockdown Gral population. Children and adolescents’ mental healthcare services (CAMHS) January 27–March 22 compared with March 23–May 17 (lockdown) Mental health admissions and referrals Admissions pre-lockdown n=14; lockdown n=17, referrals pre-lockdown n=2193; lockdown n=1081.
Isumi A, et al. (Child Abuse Negl)22 Japan Data on mortality by age in Japan Suicides To investigate the acute effect of the first wave of the COVID-19 pandemic on suicide among children and adolescents during school closure in Japan. Total number of suicides among children<20 years School closure March–May 2020. Compare March to May 2020 with the same data on 2018 and 2019 Suicide incidence rate ratio (IRR) by month No change in suicide rates during the school closure (iIRR=1.15, 95% CI: 0.81 to 1.64) and no interaction with school closure.