Survey: COVID-19 Isolation Increases Pediatric Anxiety, Depression

Children who were living through isolation and school closures after the coronavirus 2019 (COVID-19) outbreak in China experienced significantly higher rates of depression and anxiety symptoms, according to a new survey.

The data were based on calls with students living in 2 cities in Hubei province. They shed light on some of the side effects of closing schools amid the ongoing pandemic. The data are published in a research letter in JAMA Pediatrics.

The city of Wuhan, now known as the early epicenter of the disease, ordered schools closed on January 23, and the city of Huangshi, about 50 miles away from Wuhan, enacted the same restriction the following day. In the case of Wuhan, students remained out of school until April 8. In Huangshi, schools reopened slightly earlier, on March 23.

Investigators from Huazhong University of Science and Technology, in Wuhan, worked alongside an investigator from the Arnold School of Public Health at the University of South Carolina in an attempt to better understand how the lengthy period of home confinement affected students in grades 2 to 6.

Investigators decided to focus on 2 primary schools in Hubei province, inviting 2330 students to participate in a survey between February 28 and March 5, by which point schools had been closed for more than a month. Of those invited, 1784 responded and completed the survey.

In addition to demographic information, students were also asked whether they were worried about being personally infected by SARS-CoV-2, the virus that causes COVID-19, and then respondents assessed for depression and anxiety symptoms using the Children’s Depression Inventory—Short Form (CDI-S) and the Screen for Child Anxiety Related Emotional Disorder.

The data showed that 22.6% of students reported symptoms of depression, and 18.9% of students had anxiety symptoms. While the majority of respondents, 1,109 children, resided in Huangshi, those who lived in Wuhan had higher CDI-S scores and more symptoms of depression.

The investigators found a correlation between fears about COVID-19 and depression; those who were worried about falling ill had higher rates of depressive symptoms, as did those children who said they were not optimistic about the epidemic.

Though other research has suggested that depression was a significant problem in Chinese primary schools even before the pandemic, the data for the new study suggest that rate has jumped from the reported pre-pandemic rate of 17%.

“During the outbreak of COVID-19, the reduction of outdoor activities and social interaction may have been associated with an increase in children’s depressive symptoms,” said corresponding author Ranran Song, PhD, MS, of the Huazhong University.

However, Song said the 2003 epidemic of Severe Acute Respiratory Syndrome was also found to be linked with psychological symptoms in school-aged children.

“These findings suggest that serious infectious diseases may influence the mental health of children as other traumatic experiences do,” Song said.

The investigators wrote they will continue to follow up with the same students as life begins to return to normal in Hubei province in an attempt to learn more about the long-term impacts of pandemics, as well as possible ways to reduce the mental health toll of such outbreaks.