Changes in child and adolescent mental health across the COVID‐19 pandemic (2018–2023): Insights from general population and clinical samples in the Netherlands
Hedy A. vanOers,
Hekmat Alrouh,
Jacintha M. Tieskens,
Michiel A. J. Luijten,
Rowdy deGroot,
Emma Broek,
Daniël van derDoelen,
Helen Klip,
Ronald DeMeyer,
Malindi van derMheen,
I. Hyun Ruisch,
Germie van denBerg,
Hilgo Bruining,
Jan Buitelaar,
Rachel van derRijken,
Pieter J. Hoekstra,
Marloes Kleinjan,
Ramón Lindauer,
Kim J. Oostrom,
Wouter Staal,
Robert Vermeiren,
Ronald Cornet,
Lotte Haverman,
Arne Popma,
Meike Bartels,
Tinca J. C. Polderman,
Josjan Zijlmans
Affiliations
Hedy A. vanOers
Amsterdam UMC Location University of Amsterdam Emma Children's Hospital Child and Adolescent Psychiatry & Psychosocial Care Amsterdam The Netherlands
Hekmat Alrouh
Vrije Universiteit Amsterdam Department of Biological Psychology Amsterdam The Netherlands
Jacintha M. Tieskens
LUMC Curium – Child and Adolescent Psychiatry Leiden University Medical Center Leiden The Netherlands
Michiel A. J. Luijten
Amsterdam UMC Location University of Amsterdam Emma Children's Hospital Child and Adolescent Psychiatry & Psychosocial Care Amsterdam The Netherlands
Rowdy deGroot
Amsterdam University Medical Center University of Amsterdam Department of Medical Informatics Amsterdam The Netherlands
Emma Broek
LUMC Curium – Child and Adolescent Psychiatry Leiden University Medical Center Leiden The Netherlands
Daniël van derDoelen
Karakter Child and Adolescent Psychiatry University Centre Nijmegen The Netherlands
Helen Klip
Karakter Child and Adolescent Psychiatry University Centre Nijmegen The Netherlands
Ronald DeMeyer
Praktikon Nijmegen The Netherlands
Malindi van derMheen
Amsterdam Public Health Mental Health Amsterdam The Netherlands
I. Hyun Ruisch
University of Groningen University Medical Center Groningen Department of Child and Adolescent Psychiatry & Accare Child Study Center Groningen The Netherlands
Germie van denBerg
Netherlands Youth Institute Utrecht The Netherlands
Hilgo Bruining
Amsterdam UMC Location University of Amsterdam Emma Children's Hospital Child and Adolescent Psychiatry & Psychosocial Care Amsterdam The Netherlands
Jan Buitelaar
Karakter Child and Adolescent Psychiatry University Centre Nijmegen The Netherlands
Rachel van derRijken
Praktikon Nijmegen The Netherlands
Pieter J. Hoekstra
University of Groningen University Medical Center Groningen Department of Child and Adolescent Psychiatry & Accare Child Study Center Groningen The Netherlands
Marloes Kleinjan
Trimbos Institute Utrecht The Netherlands
Ramón Lindauer
Amsterdam University Medical Center University of Amsterdam Department of Child and Adolescent Psychiatry Amsterdam The Netherlands
Kim J. Oostrom
Amsterdam UMC Location University of Amsterdam Emma Children's Hospital Child and Adolescent Psychiatry & Psychosocial Care Amsterdam The Netherlands
Wouter Staal
Karakter Child and Adolescent Psychiatry University Centre Nijmegen The Netherlands
Robert Vermeiren
LUMC Curium – Child and Adolescent Psychiatry Leiden University Medical Center Leiden The Netherlands
Ronald Cornet
Amsterdam Public Health Methodology Amsterdam The Netherlands
Lotte Haverman
Amsterdam UMC Location University of Amsterdam Emma Children's Hospital Child and Adolescent Psychiatry & Psychosocial Care Amsterdam The Netherlands
Arne Popma
Amsterdam Public Health Mental Health Amsterdam The Netherlands
Meike Bartels
Amsterdam Public Health Mental Health Amsterdam The Netherlands
Tinca J. C. Polderman
Amsterdam Public Health Mental Health Amsterdam The Netherlands
Josjan Zijlmans
Amsterdam Public Health Mental Health Amsterdam The Netherlands
Abstract Background The COVID‐19 pandemic negatively affected child and adolescent mental health and at the end of the pandemic (April 2022) child mental health had not returned to pre‐pandemic levels. We investigated whether this observed increase in mental health problems has continued, halted, or reversed after the end of the pandemic in children from the general population and in children in psychiatric care. Methods We collected parent‐reported and child‐reported data at two additional post‐pandemic time points (November/December 2022 and March/April 2023) in children (8–18 years) from two general population samples (N = 818–1056 per measurement) and one clinical sample receiving psychiatric care (N = 320–370) and compared these with data from before the pandemic. We collected parent‐reported data on internalizing and externalizing problems with the Brief Problem Monitor and self‐reported data on Anxiety, Depressive symptoms, Sleep‐related impairments, Anger, Global health, and Peer relations with the Patient‐Reported Outcomes Measurement Information System (PROMIS®). Results In the general population, parents reported no changes in externalizing problems but did report higher internalizing problems post‐pandemic than pre‐pandemic (p < 0.001). Children also reported increased mental health problems post‐pandemic, especially in anxiety and depression, to a lesser extent in sleep‐related impairment and global health, and least in anger (all ps < 0.01). In the clinical sample, parents reported higher internalizing (p < 0.001), but not externalizing problems post‐pandemic compared to the start of the pandemic. Children reported greatest increases in problems in anxiety, depression, and global health, to a lesser extent on sleep‐related impairment, and least on anger (all ps < 0.05). Conclusions Child mental health problems in the general population are substantially higher post‐pandemic compared to pre‐pandemic measurements. In children in psychiatric care mental health problems have increased during the pandemic and are substantially higher post‐pandemic than at the start of the pandemic. Longitudinal and comparative studies are needed to assess what the most important drivers of these changes are.