COVID-19 pandemic-related aspects and predictors of emotional and behavioural symptoms in youth with pre-existing mental health conditions: results from Georgia, Lithuania, Romania, Serbia, and Turkey

Abstract

Objective

This study evaluated levels of and predictors of emotional and behavioral symptoms in youth with pre-existing mental health conditions over the early phase of the COVID-19 pandemic in 2020 across Georgia, Lithuania, Romania, Serbia, and Turkey.

Methods

The study included 421 children and adolescents aged 5 − 18 years with pre-existing mental health conditions and corresponding ongoing treatments. We used a parent- and/or child-report, which taps into a broad range of mental health symptoms and contextual factors thought to be particularly pertinent during periods of social restrictions. Data were collected simultaneously across the countries from May 2020 to August 2020.

Results

According to parents, 121 (33.1%) children had deteriorations in the overall quality of mental health over the COVID-19, 156 (43.1%) deteriorations in the quantity of mental health care received, while 82 (25.1%) mental health care received did not meet the needs. For 121 (49.8%) of children, there was worsening in the main presenting psychiatric symptom compared to January 2020, while for 64 (26.3%) there was some improvement. In total, 128 (43.9%) children reported worsened emotional and 118 (40.6%) behavioral symptoms. The COVID-related worry, parental emotional difficulties, and parent-child relationships emerged as the most relevant predictors for higher levels of emotional and behavioral difficulties.

Conclusions

This study found that the COVID-19 pandemic has considerably changed the daily lives of some children with pre-existing mental health conditions, where almost every second child had deteriorations in overall mental health or worsening of psychiatric symptoms.

Keywords:

• Cross-cultural
• pandemic
• anxiety
• depression

Acknowledgments

We would like to thank Emily Simonoff, who is guiding on behalf of the ECNP Child and Adolescent Psychopharmacology Network, COVID subgroup, the whole project related to a survey of mental health aspects of children and adolescents with pre-existing mental health conditions over the COVID -19 pandemic across different European and associated countries. We would like to thank also to all our patients and their families for taking part in the survey.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data are freely available upon a request to the authors.

Additional information

Notes on contributors

Dejan Stevanovic

Dejan Stevanovic, PhD, a child psychiatrist, is interested in cross-cultural psychiatry, neurodevelopmental disorders, and psychopharmacology. He is an ECNP Child and Adolescent Neuropsychopharmacology Network member and a co-founder of the International Child Mental Health – Study Group (ICMH-SG).

Burge Kabukcu Basay

Burge Kabukcu Basay, a child and adolescent psychiatrist, is an associate professor at the Pamukkale University Faculty of Medicine, Denizli, Turkey. She is interested in non-suicidal self-injury, adolescent psychopathologies, and ADHD.

Omer Basay

Omer Basay, a child and adolescent psychiatrist, is an associate professor at the Pamukkale University Faculty of Medicine, Denizli, Turkey. He is interested in ADHD, sluggish cognitive tempo, substance use disorders, and neuroscience.

Darius Leskauskas

Darius Leskauskas, PhD, a child and adolescent psychiatrist, is Head of the Child and adolescent psychiatry department in the Psychiatry Clinic of the Hospital of LUHS and he is affiliated as a professor at the Lithuanian University of Health Sciences.

Laura Nussbaum

Laura Nussbaum, PhD, is a senior child and adolescent psychiatrist, Head of Child and Adolescent Psychiatry University Clinic, and Head of Discipline - Department of Neurosciences, ‘Victor Babes’ University of Medicine, Timisoara, Romania. She is the President of the National Society of Child and Adolescent Psychiatry and Neurology.

Medea Zirakashvili

Medea Zirakashvili is a child and adolescent psychiatrist/neurologist at the Department of child and adolescent psychiatry, Mental Health Centre, Tbilisi, Georgia. She is also a PhD student in the School of Natural Sciences and Medicine at the Ilia State University, Georgia.