Research Review: The impact of the COVID ‐19 pandemic on the mental health of children and young people with pre‐existing mental health and neurodevelopmental conditions – a systematic review and meta‐analysis of longitudinal studies

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Main Authors: Brian C. F. Ching, Johnny Downs, Shuo Zhang, Hannah Abdul Cader, Jessica Penhallow, Elvina Voraite, Teodora Popnikolova, Alice Wickersham, Valeria Parlatini, Emily Simonoff
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Published: Wiley 2025
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author Brian C. F. Ching
Johnny Downs
Shuo Zhang
Hannah Abdul Cader
Jessica Penhallow
Elvina Voraite
Teodora Popnikolova
Alice Wickersham
Valeria Parlatini
Emily Simonoff
author_facet Brian C. F. Ching
Johnny Downs
Shuo Zhang
Hannah Abdul Cader
Jessica Penhallow
Elvina Voraite
Teodora Popnikolova
Alice Wickersham
Valeria Parlatini
Emily Simonoff
Brian C. F. Ching
Johnny Downs
Shuo Zhang
Hannah Abdul Cader
Jessica Penhallow
Elvina Voraite
Teodora Popnikolova
Alice Wickersham
Valeria Parlatini
Emily Simonoff
collection Wiley Open Access
contents Research Review: The impact of the COVID ‐19 pandemic on the mental health of children and young people with pre‐existing mental health and neurodevelopmental conditions – a systematic review and meta‐analysis of longitudinal studies Brian C. F. Ching Johnny Downs Shuo Zhang Hannah Abdul Cader Jessica Penhallow Elvina Voraite Teodora Popnikolova Alice Wickersham Valeria Parlatini Emily Simonoff Journal of Child Psychology and Psychiatry Background Systematic reviews have suggested mixed effects of the COVID‐19 pandemic on the mental health of children and young people. However, most included studies focused on the general population and were cross‐sectional. The long‐term impact on those with pre‐existing mental health and/or neurodevelopmental conditions remains unclear. Thus, we conducted a systematic review and meta‐analysis to examine the longitudinal impact of the pandemic on the mental health of this clinical population and potential explanatory factors. Methods Ovid Medline, Embase, APA PsycInfo and Global Health databases were searched between 1 January 2020 and 3 August 2023 (PROSPERO CRD42022383546). We included longitudinal studies that compared mental health symptoms between pre‐ and during pandemic and/or during pandemic timepoints in children and young people (≤18 years old) with pre‐existing mental and/or neurodevelopmental conditions. Outcomes included internalising, externalising and other symptoms. Risk of bias was rated using an adapted tool. Included studies were narratively synthesised and multi‐level meta‐analyses were conducted where the number of studies was sufficient. Results We identified 21 studies ( N  = 2,617) from 6,083 records. Studies differed across countries, diagnoses, measures, informants and timepoints. All had overall moderate‐to‐high risk of bias. Narrative synthesis found mixed evidence of symptom change, with individual studies showing increase/reduction/no change. Factors such as diagnosis, baseline symptom severity, age and sex/gender may explain variation in outcomes. Multi‐level meta‐analyses were feasible for a limited number of outcomes and found no significant changes in internalising and externalising symptoms pre‐ versus during pandemic or internalising symptoms between 2020 pandemic phases, and high heterogeneity was noted. Conclusions The impact of the pandemic on the mental health of children and young people with pre‐existing conditions varied according to individual and contextual vulnerabilities, which were not fully captured in pooled analyses. Further research needs to investigate longer‐term impacts and better stratify this vulnerable population. 10.1111/jcpp.14117 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1111/jcpp.14117
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spellingShingle Research Review: The impact of the COVID ‐19 pandemic on the mental health of children and young people with pre‐existing mental health and neurodevelopmental conditions – a systematic review and meta‐analysis of longitudinal studies
Brian C. F. Ching
Johnny Downs
Shuo Zhang
Hannah Abdul Cader
Jessica Penhallow
Elvina Voraite
Teodora Popnikolova
Alice Wickersham
Valeria Parlatini
Emily Simonoff
Journal of Child Psychology and Psychiatry
Research Review: The impact of the COVID ‐19 pandemic on the mental health of children and young people with pre‐existing mental health and neurodevelopmental conditions – a systematic review and meta‐analysis of longitudinal studies Brian C. F. Ching Johnny Downs Shuo Zhang Hannah Abdul Cader Jessica Penhallow Elvina Voraite Teodora Popnikolova Alice Wickersham Valeria Parlatini Emily Simonoff Journal of Child Psychology and Psychiatry Background Systematic reviews have suggested mixed effects of the COVID‐19 pandemic on the mental health of children and young people. However, most included studies focused on the general population and were cross‐sectional. The long‐term impact on those with pre‐existing mental health and/or neurodevelopmental conditions remains unclear. Thus, we conducted a systematic review and meta‐analysis to examine the longitudinal impact of the pandemic on the mental health of this clinical population and potential explanatory factors. Methods Ovid Medline, Embase, APA PsycInfo and Global Health databases were searched between 1 January 2020 and 3 August 2023 (PROSPERO CRD42022383546). We included longitudinal studies that compared mental health symptoms between pre‐ and during pandemic and/or during pandemic timepoints in children and young people (≤18 years old) with pre‐existing mental and/or neurodevelopmental conditions. Outcomes included internalising, externalising and other symptoms. Risk of bias was rated using an adapted tool. Included studies were narratively synthesised and multi‐level meta‐analyses were conducted where the number of studies was sufficient. Results We identified 21 studies ( N  = 2,617) from 6,083 records. Studies differed across countries, diagnoses, measures, informants and timepoints. All had overall moderate‐to‐high risk of bias. Narrative synthesis found mixed evidence of symptom change, with individual studies showing increase/reduction/no change. Factors such as diagnosis, baseline symptom severity, age and sex/gender may explain variation in outcomes. Multi‐level meta‐analyses were feasible for a limited number of outcomes and found no significant changes in internalising and externalising symptoms pre‐ versus during pandemic or internalising symptoms between 2020 pandemic phases, and high heterogeneity was noted. Conclusions The impact of the pandemic on the mental health of children and young people with pre‐existing conditions varied according to individual and contextual vulnerabilities, which were not fully captured in pooled analyses. Further research needs to investigate longer‐term impacts and better stratify this vulnerable population. 10.1111/jcpp.14117 http://creativecommons.org/licenses/by/4.0/
title Research Review: The impact of the COVID ‐19 pandemic on the mental health of children and young people with pre‐existing mental health and neurodevelopmental conditions – a systematic review and meta‐analysis of longitudinal studies
topic Journal of Child Psychology and Psychiatry
url https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.14117