key: cord-0684299-8n6v53o0 authors: Stavridou, Androniki; Stergiopoulou, Angeliki‐Argyroula; Panagouli, Eleni; Mesiris, Gerasimos; Thirios, Athanasios; Mougiakos, Theodoros; Troupis, Theodore; Psaltopoulou, Theodora; Tsolia, Maria; Sergentanis, Theodoros; Tsitsika, Artemis title: Psychosocial consequences of COVID ‐19 in children, adolescents and young adults: a systematic review. date: 2020-08-25 journal: Psychiatry Clin Neurosci DOI: 10.1111/pcn.13134 sha: 834c547b2770564afe7383a6a8564b010114163d doc_id: 684299 cord_uid: 8n6v53o0 nan Isolation could be a risk factor for deterioration in mental health, including depressive and anxiety symptoms, distress, fear, post-traumatic stress and insomnia. 2 Commenting on anxiety disorders, the fear of COVID-19, widely known as "coronaphobia'', enhanced anxiety symptoms, with a further aggravating role mediated by isolation at home. 2 Individuals with anxiety disorders tended to be preoccupied with excessive hand washing, extreme cautiousness, social distancing measures and unnecessary shopping. 3 Furthermore, a strong correlation between family relations and fear of contracting COVID-19 was noted. 4 Focusing especially on the COVID-19 infected patients, they were also affected, expressing high anxiety levels, as reported in SARS and MERS patients in the past. 5 Mild to moderate depressive symptoms were also often expressed 1 , similarly to those recorded in SARS and MERS period 6 , but at a geographically larger extent. This article is protected by copyright. All rights reserved. According to the findings, the situation imposed by social distancing and isolation, affected the emotional reaction of the public broadly, causing not only distress, but also frustration, irritability, hopelessness, little interest or pleasure in activities, reduction in outdoor activities, extensive mobile use and negative emotions about COVID-19. 1, 2, 7 Moreover, an increase in violence, during the pandemic, especially in adolescents and young adults, was reported in the USA. In the COVID-19 pandemic period, behavioral changes were identified also in children and adolescents with Autism Spectrum Disorder (ASD) Attention-Deficit/Hyperactivity Disorder (ADHD). Children with ASD, monitored by their parents, more frequently failed to follow through simple instructions, lost their independence and communication skills, engaged in problematic interactions with their parents, and performed pranks for attention. 8 A series of guidelines, techniques and physical exercises, have been promoted in order to help ASD children remain calm during the pandemic. 8 Children with ADHD, on the other hand, were reported by their parents as uncontrollably angry, unable to stay focused and perform everyday routine. 9 New guidelines are established to help address the mental health issues in children which propose that monitoring medication and maintaining a strict sleep schedule,could be beneficial. 9,10 Although online therapy sessions were available and considered adequate, lack of face to face clinical evaluation limited their effectiveness. 11 Furthermore, according to our findings, children, adolescents and young adults stayed home, restricting their mobility to absolute necessity and practicing social This article is protected by copyright. All rights reserved. distance, due to school and university closure. 12 The loss of everyday peer to peer contact, uncertain academic career and use of online learning, created a new reality also in education. Screen time, not only for educational purposes, but also leisure activities increased, with excessive use of social media, online gaming and watching movies being more frequent. 12 Thus, physical activity was minimized and physicians suggested daily activities, such as aerobic, strength activities or bone strengthening, in order to avoid consequences of inactivity. Children and parents experienced every day challenges, and one important finding, was that parents seemed to be more anxiety-stricken than their children. 4 Crucial effort by parents was made in introducing stress relief activities, including reading and exercising, with online sources providing tips and activities. Also, parents with children with special needs, experienced more mood swings, excessive concern for COVID-19 impact, following the main findings. 4 The use of technology made a significant impact in the well-being of individuals, with health workers (such as doctors, psychiatrists, psychologists, social workers and others) to be available through online services. Despite the limitations of no physical interaction, telehealth was reported to be effective in diminishing and managing emotional and anxiety symptoms, not only in youth, but also in parents. 2, 4, 6, 12 In conclusion, a deterioration in mental health was highlighted, encompassing anxiety and mood symptoms, developmental, stressor-related and eating disorders, among children, adolescents and young adults during the COVID-19 pandemic. The This article is protected by copyright. All rights reserved. new reality in everyday life and education due to COVID-19, burdened the existing conditions, especially in children with neurodevelopmental disorders, where an enhancement in dysfunctional behaviors was noted. COVID-19 is a rapidly evaluating scientific and social field; therefore, further results are anticipated to rapidly accumulate. This article is protected by copyright. All rights reserved. Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19 The psychological impact of quarantine and how to reduce it: rapid review of the evidence This article is protected by copyright. All rights reserved The Effect of COVID-19 on Youth Mental Health How is COVID-19 affecting the mental health of children with Special Educational Needs and Disabilities and their families? PsyArXiv Prevalence and Factors Associated with Depression and Anxiety of Hospitalized Patients with COVID-19 Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic Mental Health Status Among Children in Home Confinement During the Coronavirus Disease A Model of Support for Families of Children with Autism Living in the COVID-19 Lockdown: Lessons from Italy Starting ADHD medications during the COVID-19 pandemic: recommendations from the European ADHD Guidelines Group ADHD management during the COVID-19 pandemic: guidance from the European ADHD Guidelines Group Acute stress, behavioural symptoms and mood states among school-age children with attention-deficit/hyperactive disorder during the COVID-19 outbreak Adolescents' Motivations to Engage in Social Distancing during the COVID-19 Pandemic: Associations with Mental and Social Health