Background In response to the WHO recommended measures of physical and social distancing to mitigate person-to-person transmission, most countries decided to close schools as part of a physical distancing policy to slow transmission of COVID-19 and to ease the burden on health systems. Schools were closed in more than 160 countries by mid-July 2020 due to the COVID-19 pandemic. Public health measures taken to prevent the spread of the pandemic can potentially impact the mental health of children. Not much is known about the long-term impact of large-scale disease outbreaks on the mental health of children and adolescents.
Objectives To assess the prevalence and risk factors of childhood depression during the Covid-19 lock-down among school children.
Methods After 100 days of lock-down, a voluntary, anonymous survey questionnaire was sent by WhatsApp to parents of school-aged children (5–16 years) in Chennai. The Short Mood and Feelings questionnaire was employed as an objective screening tool to assess depression, with a score of 12 used as the cut-off which is recommended by the Child Outcomes Research Consortium, United Kingdom. All data were analyzed using Statistical Package for Social Science (SPSS, version 17) for Microsoft Windows. A chi-squared test was used for comparison between two attributes with OR 95% CI. Multiple logistic regression was used. A two-sided p value < 0.05 was considered statistically significant. Ethics approval was obtained for this research study.
Results There were 874 responses. Our survey revealed the incidence of childhood depression to be 13.7%, indicating that children are likely to be experiencing increasing depression exacerbated by the pandemic and the lock-down. Boys were less likely to be depressed than girls (OR 0.495, P value 0.000). Eleven- to 16-year-olds were more likely to be depressed than 5- to 10-year-old children (OR 1.519, P 0.035). Children who had more than 4 hours online education were more likely to have depression (OR 1.757, P= 0.037). Children who used a cell phone for online classes were more likely to have depression compared to other devices, such as tabs or laptops (OR 2.142, P 0.000). Children who slept less than 8 hours a day were more likely to have depression (OR 2.441, P 0.000). Children who either did not sleep in the afternoon or slept less than 1 hour were less likely to have depression (OR 0.522, P 0.010). Children who were interacting with family over 1 hour per day were less likely to have depression (OR 2.985, P 0.000).
Conclusions Overzealous online education, lack of adequate sleep and failure to spend quality time with family and can negatively impact the mental health of school children. Public health policy makers and health care professionals need to acknowledge that pandemics (especially when associated with lock-down) can potentially negatively impact the psychological well-being of school-age children. In the event of similar future pandemics, strategies need to be in place to safeguard the psychological well-being of individuals by offering them timely and appropriate psychological support, as well as taking the appropriate steps in the effective management of those already affected psychologically.
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