Mental health, coping and related risk factors during the first 2 years of the COVID-19 pandemic in children: Nationally representative, multi-wave, cross-sectional results from 12 countries from the global COH-FIT study

Few multinational studies have assessed risk factors and coping strategies associated with the impact of the COVID-19 pandemic on children's mental health over time. The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is the largest transcontinental, multi-wave, cross-sectional survey collecting multi-nation data on well-being and psychopathology during the pandemic. We analyzed country-specific, general-population-based, representative COH-FIT data of 6067 children aged 6-13 years from 12 countries across repeated cross-sectional waves over a period of >2 years (Apr/2020-May/2022), addressing through current and retrospective assessment pre- to intra-pandemic changes in well-being (WHO-5) and general psychopathology scores (P<sub>c</sub>) (0-100) in relation to COVID-related deaths, stringency index, eight a priori risk factors, and 16 coping strategies in different responders at each wave. From pre- to intra-pandemic, WHO-5 scores decreased (-4.59, 95 %CI=-6.18 to -2.99, p < 0.001), while PC-scores increased (+6.68, 95 %CI=4.48-8.88, p < 0.001) significantly, following distinct time patterns but both returning to near pre-pandemic levels. Changes in both scores varied by country. WHO-5 scores correlated strongly with P<sub>C</sub> and subdomain scores. Both score changes were significantly but minimally associated to COVID-19 deaths/stringency index. The proportion of children screening positive for depression increased from 3.9 % to 8.3 % (χ²=145.70, p < 0.001) and for major depression from 0.6 % to 2.2 % (χ²=68.64, p < 0.001) intrapandemic. WHO-5 and P<sub>C</sub>-score changes were significantly associated with female gender, school closure, and pre-existing physical and mental conditions, with cumulative effects. The five most frequently endorsed coping strategies were family contact (85.2 %), friends (67.3 %), outdoor play (54.0 %), pet interaction (51.5 %), and internet use (50.9 %). Identified risk groups and coping strategies can inform targeted interventions and global public health policy. Trial Registration: ClinicalTrials.gov; Identifier: NCT04383470.

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Journal
European Neuropsychopharmacology
Published
2025-12-18
DOI
https://doi.org/10.1016/j.euroneuro.2025.112741
Citations
1
Primary Topic
COVID-19 and Mental Health
Type
article
Field-Weighted Citation Impact
2.31
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article

Mental health, coping and related risk factors during the first 2 years of the COVID-19 pandemic in children: Nationally representative, multi-wave, cross-sectional results from 12 countries from the global COH-FIT study

Karol Adam Kamiński, Katharina Domschke, Luana V. Aparicio, Momoko Kitazawa et al.
1 citations
European Neuropsychopharmacology
COVID-19 and Mental Health
2.31
article

Mental health, coping and related risk factors during the first 2 years of the COVID-19 pandemic in children: Nationally representative, multi-wave, cross-sectional results from 12 countries from the global COH-FIT study

Karol Adam Kamiński, Katharina Domschke, Luana V. Aparicio, Momoko Kitazawa, Marie‐Odile Krebs, Łukasz Kiszkiel, Soraya Seedat, Celso Arango, Francesco Monaco, Antonia Errázuriz, John M. Kane, Brendon Stubbs, Elisabetta Scanferla, Scott B. Teasdale, Natascia Brondino, JOHN S. G. WELLS, Diego Hidalgo‐Mazzei, Andreas Meyer‐Lindenberg, Norman Sartorius, Akihiro Takamiya, Judit Balázs, Wojciech M. Marlicz, Andres R. Schneeberger, Aïcha Dahdouh, Samuele Cortese, Ana Inés Machado, Pedro Morgado, Per Vendsborg, Takoua Brahim, Şerban Turliuc, Kai G. Kahl, Chavit Tunvirachaisakul, Andrea Boscutti, Eva Andrlíková, Ahmed Mhalla, Sibylle Winter, Aleix Solanes, Tudor Ciuhodaru, Daniel Guinart, Cemal Onur Noyan, André F. Carvalho, Elena Righi, Jihed Sehli, Ta‐Wei Guu, Serge Brand, Philippe Conus, Thitiporn Supasitthumrong, Jeff Daskalakis, Zsolt Unoka, Jerzy Samochowiec, Taishiro Kishimoto, Valentin Matei, Denisa Manková, Sofia Brissos, Samira Hadi, Εmilia Vassilopoulou, Adrian V. Horodnic, Joseph Firth, Thérèse van Amelsvoort, Dimitris Efthymiou, Praveenlal Kuttichira, István Bitter, Javier González‐Peñas, Jim van Os, Ruud van Winkel, Guido Cereda, Sabina Heuss, Paweł Sowa, Masoud Sadeghi, Jieting Zhang, Kuan‐Pin Su, Jun Soo Kwon, Thelma Sanchez, Paolo Enrico, Omonefe Joy Seb‐Akahomen, Julie Bourgin, Mara Parellada, Кuanysh Altynbekov, Larisa Movina, Edilberto Pena, Davy Vancampfort, Karolina Skonieczna‐Żydecka, Igor Łoniewski, James Mugisha, Leonardo Zoccante, Maria Marlicz, Michael H. J. Maes, Giovanni Croatto, Nicola Veronese, Tarek Okasha, Joaquim Raduà, Nicolás Crossley, Christian G. Huber, Lakshmi N. Yatham, Andrés Estradé, Iris E. Sommer, Angela Favaro, Covadonga M. Díaz‐Caneja, Merete Nordentoft, Minah Kim, Ovidiu Alexinschi, Philip A. P. M. Gorwood, Evan Matthews, Georgina Spies, Lydia Fortea, Michael Bauer, Mark J. Millan, Jess G. Fiedorowicz, Dena Sadeghi Bahmani, Bawo Onesirosan James, Jacopo Demurtas, Mihaela Honciuc, Maryam Moghadasin, Felipe Barreto Schuch, Norma Verdolini, Jackie Curtis, Ai Koyanagi, Karolína Janků, José M. Rubio, Teerayuth Rungnirundorn, Alejandro Anselmi, Diego De Leo, Tae Young Lee, Xinli Chi, Afzal Javed, Oleg Papsuev, Shunya Kurokawa, Damir Krinitski, Natalia Estrade, Lau Caspar Thygesen, Carlos Gustavo Costardi, Dorien H. Nieman, Nikolay Negay, Jialin Fan, Roland von Känel, Samira S. Valvassori, Golam Rabbani, Marco Colizzi, Lin Yang, Miquel À. Fullana, Paolo Fusar‐Poli, Konstantinos Tsamakis, Jhoanne Merlyn Luiz, Eduard Vieta, Sarah Sullivan, Pál Czobor, Philip B. Ward, Wolfgang Marx, André R. Brunoni, Elena Dragioti, Paolo Brambilla, Carlos López‐Jaramillo, Anna M. Moniuszko-Malinowska, Agorastos Agorastos, Sofie Have Hoffmann, Oleg Aizberg, Philippe de Timary, Muhammad Iqbal Afridi, Elena Aschauer, Liviu Oprea, Hatice Aksu, Raquel Roman, Laís Fonseca, Jari Tiihonen, Andrea Pfennig, Lotfi Gaha, Dragana Ignjatović Ristić, Yuki Tazawa, Pierluigi Politi, Yasser Abu Jamei, Nesrin Dılbaz, Guilherme V. Polanczyk, Michael Berk, Simon Rosenbaum, M. Sand, Aslı Enez Darçın, Monika Schlögelhofer, Trevor Thompson, Gregor Hasler, Cristiano Gerunda, Saltanat Nurmagambetova, Stefan Borgwardt, Bernardo Ng, Ary Gadelha, Antonia San José Cáceres, Marco Solmi, Kim Q., Gonzalo Arrondo, Dimitris Mavridis, P. Ifteni, Álvaro Andreu-Bernabeu, Cecilia Cracco, Liye Zou, Alexandra Boloș, Andreas Bechdolf, H.N. Aschauer, Ching-Fang Sun, Pierre‐Michel Llorca, Farshad Sheybani, Jane Elizabeth Hamilton, Nikolaos Koutsouleris, Can Jiao, Jinhee Lee, Xin Yu, Jae Il Shin, Ariful Haque, Christoph U. Correll, Ramón Arellano, Diego Saccon, M. Weiser, Vasilios P. Bozikas, Roy Abraham Kallivayalil, Anna Mosina, Valentina Ciappolino
article en
1 citations

Abstract

Few multinational studies have assessed risk factors and coping strategies associated with the impact of the COVID-19 pandemic on children's mental health over time. The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is the largest transcontinental, multi-wave, cross-sectional survey collecting multi-nation data on well-being and psychopathology during the pandemic. We analyzed country-specific, general-population-based, representative COH-FIT data of 6067 children aged 6-13 years from 12 countries across repeated cross-sectional waves over a period of >2 years (Apr/2020-May/2022), addressing through current and retrospective assessment pre- to intra-pandemic changes in well-being (WHO-5) and general psychopathology scores (P<sub>c</sub>) (0-100) in relation to COVID-related deaths, stringency index, eight a priori risk factors, and 16 coping strategies in different responders at each wave. From pre- to intra-pandemic, WHO-5 scores decreased (-4.59, 95 %CI=-6.18 to -2.99, p < 0.001), while PC-scores increased (+6.68, 95 %CI=4.48-8.88, p < 0.001) significantly, following distinct time patterns but both returning to near pre-pandemic levels. Changes in both scores varied by country. WHO-5 scores correlated strongly with P<sub>C</sub> and subdomain scores. Both score changes were significantly but minimally associated to COVID-19 deaths/stringency index. The proportion of children screening positive for depression increased from 3.9 % to 8.3 % (χ²=145.70, p < 0.001) and for major depression from 0.6 % to 2.2 % (χ²=68.64, p < 0.001) intrapandemic. WHO-5 and P<sub>C</sub>-score changes were significantly associated with female gender, school closure, and pre-existing physical and mental conditions, with cumulative effects. The five most frequently endorsed coping strategies were family contact (85.2 %), friends (67.3 %), outdoor play (54.0 %), pet interaction (51.5 %), and internet use (50.9 %). Identified risk groups and coping strategies can inform targeted interventions and global public health policy. Trial Registration: ClinicalTrials.gov; Identifier: NCT04383470.

European NeuropsychopharmacologyVol. 104
Semmelweis University (HU), Linköping University (SE), Eötvös Loránd University (HU), Ain Shams University (EG), South African Medical Research Council (ZA), Griffith University (AU), University of Modena and Reggio Emilia (IT), University of Copenhagen (DK), Alberta Health Services (CA), University of Naples - L'Orientale (IT), Üsküdar University (TR), University of Udine (IT), The University of Sydney (AU), Jinnah Postgraduate Medical Center (PK), Cliniques Universitaires Saint-Luc (BE), Feinstein Institute for Medical Research (US), University Medical Center Groningen (NL), Université Oran 1 Ahmed Ben Bella (DZ), University of Padua (IT), Seoul National University (KR), University of British Columbia (CA), University of Kragujevac (RS), Medical University of Białystok (PL), Deakin University (AU), University of Ottawa (CA), University of Fribourg (CH), Inserm (FR), Chulalongkorn University (TH), Carol Davila University of Medicine and Pharmacy (RO), Pontificia Universidad Católica de Chile (CL), Mashhad University of Medical Sciences (IR), University of Monastir (TN), University of Nicosia (CY), University of Southern Denmark (DK), Shenzhen University (CN), Kharazmi University (IR), King's College London (GB), China Medical University (TW), University of Basel (CH), University of Milan (IT), Utrecht University (NL), Yonsei University (KR), University of Ioannina (GR), South London and Maudsley NHS Foundation Trust (GB), Peking University (CN), University of Zurich (CH), Keio University (JP), Université Paris Cité (FR), Aristotle University of Thessaloniki (GR), Heidelberg University (DE), University of Pavia (IT), Medical University of Warsaw (PL), Sheba Medical Center (IL), Jubilee Mission Medical College and Research Institute (IN), Ottawa Hospital (CA), South Essex Partnership University Foundation NHS Trust (GB), University Medical Center Freiburg (DE), Instituto de Salud Carlos III (ES), Jinnah Sindh Medical University (PK), Niuvanniemi Hospital (FI), University Hospital Heidelberg (DE), Pushpagiri Medical College (IN), Seoul National University Hospital (KR), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), University of Manchester (GB), Hospital General Universitario Gregorio Marañón (ES), FHNW University of Applied Sciences and Arts Northwestern Switzerland (CH), University Medical Center Utrecht (NL), Grigore T. Popa University of Medicine and Pharmacy (RO), Transylvania University of Brașov (RO), University Town of Shenzhen (CN), Kyungpook National University (KR), Universidade Federal de Santa Maria (BR), Maastricht University (NL), Medizinische Hochschule Hannover (DE), Universidad de Antioquia (CO), University of Bristol (GB), IEEE Computer Society (US), University of California San Diego (US), Kermanshah University of Medical Sciences (IR), Mental Health Foundation (GB), Klinik Hietzing (AT), Centro de Investigación Biomédica en Red de Salud Mental (ES), Belarusian Medical Academy of Post-Graduate Education (BY), University Hospital of Zurich (CH), GZO Spital Wetzikon (CH), University of Clermont Auvergne (FR), Central Institute of Mental Health (DE), Hellenic Agency for Local Development and Local Government (GR), The Geneva Association (CH), Hospital Clínic de Barcelona (ES), Alberta Cancer Foundation (CA), Wiener Krankenanstaltenverbund (AT), European Biomedical Research Institute of Salerno (IT), Clinica de Pneumologie Iaşi (RO), Psykiatrien i Region Syddanmark (DK), Ospedale per gli Infermi (IT), China Medical University Hospital (TW), Asociación Mexicana de Psicología y Desarrollo Comunitario (MX), Kazakhstan Medical University (KZ), Centre Hospitalier Universitaire de Clermont-Ferrand (FR), Parc Sanitari Sant Joan de Déu (ES), Institut de Psychiatrie et Neurosciences de Paris (FR), Hospital Del Mar (ES), Mind Australia (AU), Berlin Institute of Health at Charité - Universitätsmedizin Berlin (DE), FHU Neurovasc (FR), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR), Moscow Regional Psychiatry Hospital No.5 (RU), Child Health Research Foundation (BD), ABS Consulting (United States) (US), Amsterdam University Medical Centers (NL), Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo (IT), Tees, Esk and Wear Valleys NHS Foundation Trust (GB), The University of Texas Health Science Center (US), Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES), University Hospital Carl Gustav Carus (DE), Peking University Sixth Hospital (CN), Psychiatric Medical Center (AM), Hôpital de l'enfance (CH), Universitäre Psychiatrische Kliniken Basel (CH), National Institute of Mental Health (CZ), University of Southampton (GB), Kyambogo University (UG), Mindgardens Neuroscience Network, Clienia AG, University of Greenwich (GB), Carilion Clinic (US), University of Palestine (PS), Universitat de Barcelona (ES), Waterford Institute of Technology (IE), Adnan Menderes University (TR), Universidade do Extremo Sul Catarinense (BR), Charité - Universitätsmedizin Berlin (DE), University of Glasgow (GB), Pomeranian Medical University (PL), University of Veterinary and Animal Sciences (PK), Ludwig-Maximilians-Universität München (DE), Universidad Católica del Uruguay (UY), Universidad de Navarra (ES), Universidade Federal de São Paulo (BR), University of Palermo (IT), University of Lübeck (DE), University of Lausanne (CH), KU Leuven (BE), University of Minho (PT)
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