Associations between feelings/behaviors during COVID-19 pandemic lockdown and depression/anxiety after lockdown in a sample of Chinese children and adolescents

Background: Children and adolescents may be more susceptible to mental disorders due to COVID-19 pandemic than adults. This study aimed to identify correlated factors for depression/anxiety among children and adolescents after COVID-19 pandemic lockdown. Methods: An online survey by cluster sampling was conducted after lockdown in 5175 Chinese children and adolescents with informed consents from their parents. The 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scales with 10-point cutoff were used to measure depression and anxiety, separately. Stepwise logistic regression was conducted. Stata 15.1 Version was used. Results: 12.33% and 6.26% of all participants reported depression and anxiety after lockdown, separately. Suicidal ideation, quarreling with parents, insomnia, difficulty in concentrating during online learning, and anxious and depressed mood during lockdown were positively associated with depression and anxiety after lockdown. Missing teachers was negatively associated with both depression and anxiety. Living in urban and not living with parents were positively associated with depression. Limitations: The past history and familial history of mental disorders have not been collected. The recall biases for collecting self-reporting information might exist, and the causal inferences cannot be drawn. Conclusions: The prevalence of depression and anxiety in children and adolescents might decline a bit after lockdown but is still at a high level after lockdown. Gatekeepers should pay more attention to modifiable factors of psychological well-being in children and adolescents, including family and school contexts and even feelings and behaviors during COVID-19 pandemic lockdown.

Automated summary

This study found that specific factors such as suicidal ideation, quarreling with parents, insomnia, difficulty in concentrating during online learning, and anxious and depressed mood during lockdown were positively associated with depression and anxiety among children and adolescents after COVID-19 pandemic lockdown. Missing teachers was negatively associated with both depression and anxiety. Living in urban areas and not living with parents were positively associated with depression.