December 8, 2020

expert reaction to longitudinal study of depression symptoms in children during the COVID-19 lockdown

A study published in Archives of Disease in Childhood looks at longitudinal increases in childhood depression symptoms during COVID-19 lockdown.

Dr Wendy Sims-Schouten, Reader (Associate Professor) in Childhood Studies, University of Portsmouth, said:

“This study, which is the first of its kind, has found a significant increase in depressive symptoms in children (aged 7.6–11.6 years old), during the UK lockdown. At the same time there were no significant changes in anxiety and emotional problems. Of course it is important to distinguish between ‘depressive symptoms’ and ‘depression’, the first referring to signs of depression(in relation to mood, loss of interest and so on),that can vary from mild to severe, the latter a low mood that lasts for weeks or months and affects daily life.

Although the study does not have the statistical power to detect clinically meaningful changes, it nevertheless provides useful and significant insights, especially as regards future lockdown policies in relation to complete or partial school closures. Yet, there is a need to follow this up with larger scale epidemiological studies that establish which children are most at risk and tracks their future recovery. This is particularly relevant considering the limitations in demographic data collected as part of the study, which includes socioeconomic status (SES) and gender, but makes no mention of ethnic and cultural backgrounds of the children and families, including issues around ethnic inequalities. This is a shame in light of research that highlights marked ethnic variation amongst mental health service users across the UK, and adverse experiences reported by families from ethnic minority communities in light of the current pandemic.”

Prof Dame Til Wykes, Vice Dean Psychology and Systems Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said:

“This is one of the few studies that tested people before and after the pandemic. The results differ somewhat those from ONS surveys which had a more representative sample. There is little doubt that both children and adults have had worse mental health during the pandemic. Studies investigating mental health problems earlier in the pandemic have shown increases in anxiety but this study only found increases in depression as judged by caregivers and teachers. It is not clear whether these different results are because of the reporters, the region where this took place or a cohort effect (e.g. only those who were concerned about mental health returned the questionnaires).”

Prof Craig Morgan, Professor of Social Epidemiology and Head of the Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King’s College London, said:

“We urgently need robust data on the mental health of young people and how this has developed and fluctuated through the different stages of the pandemic to inform policy responses and to help mitigate adverse effects. This study is of value because the team had data on mental health pre-pandemic against which to compare mental health among young people aged 7 – 12 years during the pandemic.

“However, the headline in the press release of a steep rise in depressive symptoms overstates what was found and the level of certainty about what was found.

“First, most indicators in the study showed no increase pre- and post-pandemic, including a general measure of emotional problems which includes items on sadness and depression.

“Second, of the 15 items measuring mental health in the study, only 4 showed an increase (albeit these 4 items were indicators of depressive symptoms).

“Third, there are seemingly contradictory findings. For example, there was no increase in scores on the item ‘my child is often unhappy, downhearted, or tearful’ (from the strengths and difficulties questionnaire) but there was an increase for the item ‘my child feels sad or empty’. This inconsistency suggests considerable caution is needed in drawing any conclusions about increases in depressive symptoms.

“Finally, as the authors note, the sample was relatively small, which in general urges caution in interpreting the results.

“This is not to suggest problems have not increased. Rather, it’s to say we need to be more cautious in drawing the inference that this study shows a steep rise in depressive symptoms.”

‘Longitudinal increases in childhood depression symptoms during the COVID-19 lockdown’ by Giacomo Bignardi et al. was published in Archives of Disease in Childhood at 23:30 UK time on Tuesday 8 December.

DOI: 10.1136/archdischild-2020-320372

Declared interests

None received.