Isolation During Pandemic May Increase Depression Among Young People
A rapid systematic review recently published in the Journal of the American Academy of Child & Adolescent Psychiatry suggests that isolation and loneliness during the COVID-19 pandemic may lead to increased levels of depression and possibly anxiety in children and adolescents. It recommends offering preventative support and early intervention where possible.
“Our findings highlight the need to focus on enabling social connection between children and young people in every way possible in the current context and as lockdown eases,” said researcher Maria E. Loades, DClinPsy, MA, of the University of Bath in the United Kingdom (UK). “Reconnecting socially, including through play, should be prioritized.”
Here, Dr. Loades discusses the reasons for the research, key findings, clinical implications, and future research on the topic.
What led you and your colleagues to conduct this research?
With the advent of lockdown here in the UK and around the world, myself and Eleanor Chatburn, MA, one of the study team, were sharing our concerns about how the disease containment measures could impact on the mental health of children and young people. As clinical psychologists who are trained as both scientists and practitioners, we decided that we needed to pull together all the existing evidence to find out what is known about how being socially isolated from their peers and being lonely impacts on children and young people’s mental health.
Please briefly describe your study and its findings.
We conducted a systematic review of all the existing evidence. This means that we systematically searched all the existing research studies using carefully defined search terms designed to find all the studies that have been conducted looking at social isolation or loneliness and mental health and children or young people. We found over 60 studies that were relevant to our review. We found strong evidence that loneliness is linked to depression and anxiety, both concurrently and prospectively. Being lonely increases the chances of developing mental health problems up to a decade later. There is some evidence that the duration of loneliness is more strongly associated with subsequent depression than the intensity of loneliness. We found only one study which had looked at mental health outcomes for children in a pandemic context, and this study found increased rates of mental health service use, and increased rates of trauma symptoms in those who had experienced disease containment measures (quarantine or social distancing) compared to those who had not. Therefore, little is known about the mental health impacts of disease containment in a pandemic context and much more research is needed, but there is an initial indication from the literature of a detrimental impact on mental health for children and young people.
Were any of the outcomes particularly surprising?
We were surprised that so little is known about the mental health impacts of social isolation and the mental health impacts on children and young people, both in the pandemic context, but also in other contexts such as in children and young people who are socially isolated due to exclusion from school or physical health conditions such as being immunosuppressed.
What are the possible near-term applications of these findings in clinical practice?
Our findings highlight the need to focus on enabling social connection between children and young people in every way possible in the current context and as lockdown eases. Reconnecting socially, including through play, should be prioritized. In addition, promoting well-being through whole school and community-based approaches, as well as providing timely and accessible targeted and specific help for children and young people who struggle with their mental health going forward, is key. At a nationwide level, public health messaging could be utilized to disseminate messages about how to promote mental health and well-being.
Do you have any other research planned on this topic, or are there further studies you feel are needed?
We are excited to see the emerging evidence from studies that are ongoing in the COVID-19 context, including for example, the Co-SPACE and ARC studies being run by the University of Oxford. These studies have been recruiting participants online, including parents (Co-SPACE) and adolescents (ARC). The participants have been completing questionnaires which will help us to understand some of the needs of children, young people, and their families and to get a snapshot of how they are coping. Because these studies are opt-in studies, they are not necessarily generalizable to everyone, so it will also be important to find ways of exploring and investigating how families who do not access the internet or may not be motivated to take part in online surveys are managing. This includes understanding how children and young people in low- and middle-income countries, who may not have access to technology as a means of keeping in touch, are doing.
References
Dr. Maria Loades is a senior lecturer/clinical tutor for the doctorate in clinical psychology program at the University of Bath, United Kingdom. She has worked a variety of mental health settings, including adult mental health, a children’s inpatient unit, and various community Child and Adolescent Mental Health Services. She completed a postgraduate diploma in cognitive behavior therapy for children, young people, and families at the Anna Freud Centre/University College London in 2013, and a postgraduate certificate in the supervision of applied psychology practice at the University of Oxford in 2015. Dr. Loades secured a National Institute for Health Research doctoral research fellowship in 2016 to further her research into depression in pediatric Chronic Fatigue Syndrome. Her research interests also include developing and delivering cognitive and/or behavioral treatments for children and young people with depression, including those with chronic illnesses, therapist competence in delivering cognitive behavioral therapy (CBT), particularly in the field of child and adolescent mental health, and CBT supervision.