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The COVID-19 pandemic has caused unprecedented changes in the lives of 1.6 billion children and adolescents. First non-representative studies from China, India, Brazil, the US, Spain, Italy, and Germany pointed to a negative mental health impact. The current study is the first nationwide representative study to investigate the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) and mental health of children and adolescents in Germany from the perspective of children themselves. A representative online survey was conducted among n = 1586 families with 7- to 17-year-old children and adolescents between May 26 and June 10. The survey included internationally established and validated instruments for measuring HRQoL (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), and depression (CES-DC). Results were compared with data from the nationwide, longitudinal, representative BELLA cohort study (n = 1556) conducted in Germany before the pandemic. Two-thirds of the children and adolescents reported being highly burdened by the COVID-19 pandemic. They experienced significantly lower HRQoL (40.2% vs. 15.3%), more mental health problems (17.8% vs. 9.9%) and higher anxiety levels (24.1% vs. 14.9%) than before the pandemic. Children with low socioeconomic status, migration background and limited living space were affected significantly more. Health promotion and prevention strategies need to be implemented to maintain children's and adolescents' mental health, improve their HRQoL, and mitigate the burden caused by COVID-19, particularly for children who are most at risk. (Orig.).

Background: The COVID-19 pandemic has disrupted the lives of children and adolescents worldwide. The German COPSY study is among the first population-based longitudinal studies to examine the mental health impact of the pandemic. The objective of the study was to assess changes in health-related quality of life (HRQoL) and mental health in children and adolescents and to identify the associated risk and resource factors during the pandemic. Methods: A nationwide longitudinal survey was conducted with two waves during the pandemic (May/June 2020 and December 2020/January 2021). In total, n = 1923 children and adolescents aged 7 to 17 years and their parents participated (retention rate from wave 1 to wave 2: 85%). The self-report and parent-proxy surveys assessed HRQoL (KIDSCREEN-10), mental health problems (SDQ with the subscales emotional problems, conduct problems, hyperactivity, and peer problems), anxiety (SCARED), depressive symptoms (CES-DC, PHQ-2) and psychosomatic complaints (HBSC-SCL). Mixed model panel regression analyses were conducted to examine longitudinal changes in mental health and to identify risk and resource factors. Results: The HRQoL of children and adolescents decreased during the pandemic, and emotional problems, peer-related mental health problems, anxiety, depressive and psychosomatic symptoms increased over time, however the change in global mental health problems from wave 1 to wave 2 was not significant, and some changes were negligible. Socially disadvantaged children and children of mentally burdened parents were at particular risk of impaired mental health, while female gender and older age were associated with fewer mental health problems. A positive family climate and social support supported the mental health of children and adolescents during the pandemic. Discussion: Health promotion, prevention and intervention strategies could support children and adolescents in coping with the pandemic and protect and maintain their mental health.

Purpose The KIDSCREEN questionnaires were developed by a collaborative effort of European pediatric researchers for use in epidemiologic public health surveys, clinical intervention studies, and research projects. The article gives an overview of the development of the tool, summarizes its extensive applications in Europe, and describes the development of a new computerized adaptive test (KIDS-CAT) based on KIDSCREEN experiences. Methods The KIDSCREEN versions (self-report and proxy versions with 52, 27, and 10 items) were simultaneously developed in 13 different European countries to warrant cross-cultural applicability, using methods based on classical test theory (CTT: descriptive statistics, CFA and MAP, internal consistency, retest reliability measures) and item response theory (IRT: Rasch modeling, DIF analyses, etc.). The KIDS-CAT was developed (in cooperation with the US pediatric PROMIS project) based on archival data of European KIDSCREEN health surveys using IRT more extensively (IRC). Results Research has shown that the KIDSCREEN is a reliable, valid, sensitive, and conceptually/linguistically appropriate QoL measure in 38 countries/languages by now. European and national norm data are available. New insights from KIDSCREEN studies stimulate pediatric health care. Based on KIDSCREEN, the Kids-CAT promises to facilitate a very efficient, precise, as well as reliable and valid assessment of QoL. Conclusions The KIDSCREEN has standardized QoL measurement in Europe in children as a valid and cross-cultural comparable tool. The Kids-CAT has the potential to further advance pediatric health measurement and care via Internet application.

Background Socioeconomic inequalities in mental health are already evident in early life. During the COVID-19 pandemic, many families experienced additional stress. This study examines the development of mental health problems in children and adolescents in relation to their family’s socioeconomic status in times of global crises, taking into account other risk and resource factors. Methods Data were used from the population-based BELLA study (pre-pandemic, N  = 1,580) and from the longitudinal COPSY study (post-/pandemic, N  = 1,586-1,701) with participants aged 7 to 22 years. Surveys were conducted before (BELLA T0, 2017), during (COPSY T1-T5, 2020–2022) and after the COVID-19 pandemic (COPSY T6-T7, 2023–2024) in Germany. Mental health problems (SDQ), socioeconomic status (parental education, net equivalent household income), and additional factors (parental psychopathology, social support, family cohesion) were examined. Prevalence in mental health problems, differences in mean values (SDQ) and panel regression analyses were calculated. Results Over the entire survey period, children and adolescents with a low socioeconomic status were more affected by mental health problems than their peers with a high status (e.g., pre-pandemic: 6.2% vs. 14.6%; post-pandemic: 11.0% vs. 18.3%). During the pandemic, mental health problems increased significantly in all status groups. Health inequality remained stable and even narrowed towards the end of the pandemic, whereby mean values in youth mental health problems were nearly the same for high and low educated parents in autumn 2022. After the pandemic, mental health inequalities started to re-increase. This pattern is also visible, but less pronounced, for household income. Personal resources, family cohesion, and social support served as protective factors for youth mental health. Conclusion Socioeconomic inequalities in the mental health of children and adolescents remain evident in times of global crisis. Over the course of the pandemic, these mental health inequalities have not increased and even equalized, but post-pandemic recovery effects are only visible for young people in higher socioeconomic status. However, there is still an ongoing need for targeted health promotion and prevention that strengthens personal and social resources especially, but not only, for socially disadvantaged children and families at both an individual and societal level.

The aims of this Patient Reported Outcome Measurement Information System (PROMIS) study were to (1) conceptualize children's subjective well-being (SWB) and (2) produce item pools with excellent content validity for calibration and use in computerized adaptive testings (CATs). Children's SWB was defined through semistructured interviews with experts, children (aged 8–17 years), parents, and a systematic literature review to identify item concepts comprehensively covering the full spectrum of SWB. Item concepts were transformed into item expressions and evaluated for comprehensibility using cognitive interviews, reading level analysis, and translatability review. Children's SWB comprises affective (positive affect) and global evaluation components (life satisfaction). Input from experts, children, parents, and the literature indicated that the eudaimonic dimension of SWB—that is, a sense of meaning and purpose—could be evaluated. Item pools for life satisfaction (56 items), positive affect (53 items), and meaning and purpose (55 items) were produced. Small differences in comprehensibility of some items were observed between children and adolescents. The SWB measures for children are the first to assess both the hedonic and eudaimonic aspects of SWB. Both children and youth seem to understand the concepts of a meaningful life, optimism, and goal orientation.

Background The COVID-19-pandemic has had a profound impact on the lives of adolescents worldwide. This study examined the subjective perception of the COVID-19 pandemic measures and its association with mental health and well-being (i.e., loneliness, life satisfaction and multiple health complaints) among 13- and 15-years-old adolescents from 22 countries. Methods Data from the cross-national Health Behaviour in School-aged Children (HBSC) 2021/22 study were used from representative samples of 22 countries (N = 67,544; 51.9% girls). The self-perceived impact of COVID-19 measure comprised 10 items asking about the impact on several dimensions of adolescent lives (e.g., relationships with family and friends, health, or eating behaviours). Measures of loneliness, multiple health complaints, and life satisfaction were included as indicators of mental health and well-being. A non-parametric multilevel latent class analysis considering individual and country-levels was conducted to identify classes of self-perceived impact of the COVID-19 measures. Multilevel logistic regression models adjusted by age and socioeconomic status were applied to assess the association between COVID-19 measure impact classes and mental health. Results Three classes were identified on individual level encompassing a neutral (51%), positive (31%), or negative (18%) perception of COVID-19 measures. A third of the adolescents reported a positive impact of the pandemic measures. The distribution of classes was heterogeneous within and across countries. Within the positive COVID-19 measure impact class, social relationships were the most important dimension, whereas mental health problems were mostly represented within the negative COVID-19 measure impact class. Girls with a negative perception of pandemic measures showed higher levels of loneliness and multiple health complaints and lower life satisfaction. 15-year-old adolescents and those with a low socioeconomic status reported higher levels of loneliness and lower life satisfaction. Conclusions The majority of adolescents perceived the pandemic measures as neutral or positive. Girls, 15-year-old adolescents, and those with low socioeconomic status were at higher risk of suffering from pandemic measures and associated problems of loneliness, multiple health complaints, and low life satisfaction. We conclude that adolescent’s mental health and well-being should be considered in the decision-making process by ensuring that the unique challenges of adolescents are adequately addressed in policies.

Background Mental health and health-related quality of life (HRQoL) in children and adolescents deteriorated during the COVID-19 pandemic. The aim of this population-based longitudinal study was to explore whether distinct mental health trajectories in youths can be identified over the course of the pandemic. Methods Mental health problems (MHP), psychosomatic symptoms and HRQoL were assessed at five time points between May 2020 and October 2022 in 744 children and adolescents aged 7 to 20 years using established instruments. We used generalized mixture modeling to identify distinct mental health trajectories and fixed-effects regressions to analyse covariates of the identified profiles of change. Results We found five distinct linear latent trajectory classes each for externalising MHP and psychosomatic symptoms and four trajectory classes for internalising MHP. For HRQoL, a single-class solution that indicates a common development process proved to be optimal. The largest groups remained almost stable at a low internalising and externalising symptom level (64 to 74%) and consistently showed moderate psychosomatic symptoms (79%), while 2 to 18% showed improvements across the pandemic. About 10% of the youths had consistently high internalising problems, while externalising problems deteriorated in 18% of youths. Class membership was significantly associated with initial HRQoL, parental and child burden, personal resources, family climate and social support. Conclusions The mental health of most children and adolescents remained resilient throughout the pandemic. However, a sizeable number of youths had consistently poor or deteriorating mental health. Those children and adolescents need special attention in schools and mental health care.

Zusammenfassung Hintergrund Lockdowns, Kontaktbeschränkungen, Schließung von Kinderbetreuungs‑, Schul- und Freizeiteinrichtungen während der COVID-19-Pandemie haben den Alltag von Kindern und Jugendlichen deutlich beeinträchtigt. Ziel der Arbeit (Fragestellung) Der Beitrag untersucht die Auswirkungen der Pandemie auf die psychische Gesundheit von Kindern und Jugendlichen in Deutschland. Material und Methoden Die bevölkerungsbezogene COPSY-Längsschnittstudie ( Co rona und Psy che) umfasst bisher 5 Befragungszeitpunkte (t1: Mai bis Juni 2020 bis t5: Sept. bis Okt. 2022). Es wurden etwa 1600 Eltern von 7‑ bis 17-Jährigen sowie 1000 Kinder und Jugendliche zwischen 11 und 17 Jahren mithilfe etablierter Instrumente zur psychischen Gesundheit befragt. Präpandemische Vergleichsdaten lieferte die repräsentative BELLA-Studie (Befragung zum seelischen Wohlbefinden und Verhalten). Ergebnisse Während der Pandemie stieg der Anteil von Kindern und Jugendlichen, die über eine geminderte gesundheitsbezogene Lebensqualität berichteten, von 15 % (präpandemisch) auf 48 % im ersten Jahr an und reduzierte sich 2022 auf 27 %. Damit war der Wert noch deutlich über dem vor Beginn der Pandemie. Ein ähnlicher Verlauf zeigte sich für psychische Auffälligkeiten: Deren Prävalenz stieg von 18 % (präpandemisch) auf 31 % an und reduzierte sich 2022 auf 23 %. Symptome für Ängstlichkeit und Depressivität folgten dem Trend. Lediglich Symptome der Depressivität sanken auf das präpandemische Niveau zurück. Hinsichtlich ihres Gesundheitsverhaltens bewegt sich ein Drittel der Kinder und Jugendlichen noch immer zu wenig. Diskussion Die psychische Gesundheit von Kindern und Jugendlichen wurde während der Pandemie lange ignoriert. Dringend müssen Unterstützung und finanzielle Mittel gewährt werden, um negative psychische Gesundheitseffekte zu reduzieren und Beeinträchtigungen durch erneute Krisen vorzubeugen.

ObjectivePsychogenic non-epileptic seizures (PNES), a common phenomenon in neurological settings, are regarded as a paroxysmal type of functional neurological disorder (FND). In a substantial proportion, PNES are disabling with poor long-term outcomes and high economic costs. Despite the clinical and financial consequences of PNES, there is still a lack of controlled clinical trials on the treatment of this challenging disorder. The study aims to evaluate the feasibility and collect first evidence of the efficacy of a group based-intervention in PNES-patients.MethodsA pilot randomized controlled feasibility study with a parallel-group design was performed in adult outpatients with PNES to evaluate a new body-focused group therapy (CORDIS) versus guided self-help groups. Self-assessment of dissociation (Dissociation Experience Scale—DES-20) and seizure severity (Liverpool Seizure Severity Scale—LSSS) were assessed two weeks before and two weeks after the treatment intervention and also six months after treatment as primary outcome parameters.ResultsA total of 53 patients were recruited from a specialized outpatient clinic, and out of those, 29 patients completed either the body-focused group therapy program (n = 15) or a guided self-help group (SHG) therapy (n = 14). When analyzing the ITT sample (n = 22 CORDIS group, n = 20 SHG), both groups showed an effect on seizure severity and level of dissociation. In the per protocol sample (n = 13 CORDIS group, n = 12 SHG), CORDIS was superior to the self-help group for reducing seizure severity 6 months after the treatment.SignificanceCORDIS is a newly developed body-focused group therapy program for adults with PNES. Further studies should include a multicentric design with a higher number of participants.