Trajectories of mental health in children and adolescents during the COVID-19 pandemic: findings from the longitudinal COPSY study

Anne Kaman; Janine Devine; Markus Antonius Wirtz; Michael Erhart; Maren Boecker; Ann-Kathrin Napp; Franziska Reiss; Fionna Zoellner; Ulrike Ravens-Sieberer

doi:10.1186/s13034-024-00776-2

Trajectories of mental health in children and adolescents during the COVID-19 pandemic: findings from the longitudinal COPSY study

Child Adolesc Psychiatry Ment Health. 2024 Jul 18;18(1):89. doi: 10.1186/s13034-024-00776-2.

Authors

Affiliations

¹ Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
² Department of Research Methods, Freiburg University of Education, Freiburg im Breisgau, Germany.
³ Alice Salomon University of Applied Science, Berlin, Germany.
⁴ Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital, Aachen, Germany.
⁵ Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany.
⁶ Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ravens-sieberer@uke.de.

Abstract

Background: Mental health and health-related quality of life (HRQoL) in children and adolescents deteriorated during the COVID-19 pandemic. The aim of this population-based longitudinal study was to explore whether distinct mental health trajectories in youths can be identified over the course of the pandemic.

Methods: Mental health problems (MHP), psychosomatic symptoms and HRQoL were assessed at five time points between May 2020 and October 2022 in 744 children and adolescents aged 7 to 20 years using established instruments. We used generalized mixture modeling to identify distinct mental health trajectories and fixed-effects regressions to analyse covariates of the identified profiles of change.

Results: We found five distinct linear latent trajectory classes each for externalising MHP and psychosomatic symptoms and four trajectory classes for internalising MHP. For HRQoL, a single-class solution that indicates a common development process proved to be optimal. The largest groups remained almost stable at a low internalising and externalising symptom level (64 to 74%) and consistently showed moderate psychosomatic symptoms (79%), while 2 to 18% showed improvements across the pandemic. About 10% of the youths had consistently high internalising problems, while externalising problems deteriorated in 18% of youths. Class membership was significantly associated with initial HRQoL, parental and child burden, personal resources, family climate and social support.

Conclusions: The mental health of most children and adolescents remained resilient throughout the pandemic. However, a sizeable number of youths had consistently poor or deteriorating mental health. Those children and adolescents need special attention in schools and mental health care.

Keywords: Externalising mental health problems; Internalising mental health problems; Psychosomatic symptoms; Quality of life; Youths.