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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 Publisher Pubmed



Agorastos A ; Thompson T ; Solmi M ; Cortese S ; Estrade A ; Radua J ; Dragioti E ; Vancampfort D ; Thygesen LC ; Aschauer H ; Schlogelhofer M ; Aschauer E ; Schneeberger A ; Huber CG Show All Authors
Authors
  1. Agorastos A
  2. Thompson T
  3. Solmi M
  4. Cortese S
  5. Estrade A
  6. Radua J
  7. Dragioti E
  8. Vancampfort D
  9. Thygesen LC
  10. Aschauer H
  11. Schlogelhofer M
  12. Aschauer E
  13. Schneeberger A
  14. Huber CG
  15. Hasler G
  16. Conus P
  17. Do Cuenod KQ
  18. Von Kanel R
  19. Arrondo G
  20. Fusarpoli P
  21. Gorwood P
  22. Llorca PM
  23. Krebs MO
  24. Scanferla E
  25. Kishimoto T
  26. Rabbani G
  27. Skoniecznazydecka K
  28. Brambilla P
  29. Favaro A
  30. Takamiya A
  31. Zoccante L
  32. Colizzi M
  33. Bourgin J
  34. Kaminski K
  35. Moghadasin M
  36. Seedat S
  37. Matthews E
  38. Wells J
  39. Vassilopoulou E
  40. Gadelha A
  41. Su KP
  42. Kwon JS
  43. Kim M
  44. Lee T
  45. Papsuev O
  46. Mankova D
  47. Boscutti A
  48. Gerunda C
  49. Saccon D
  50. Righi E
  51. Monaco F
  52. Croatto G
  53. Cereda G
  54. Demurtas J
  55. Brondino N
  56. Veronese N
  57. Enrico P
  58. Politi P
  59. Ciappolino V
  60. Pfennig A
  61. Bechdolf A
  62. Meyerlindenberg A
  63. Kahl KG
  64. Domschke K
  65. Bauer M
  66. Koutsouleris N
  67. Winter SM
  68. Borgwardt S
  69. Bitter I
  70. Balazs J
  71. Czobor P
  72. Unoka Z
  73. Mavridis D
  74. Tsamakis K
  75. Bozikas VP
  76. Tunvirachaisakul C
  77. Maes M
  78. Rungnirundorn T
  79. Supasitthumrong T
  80. Haque A
  81. Brunoni AR
  82. Costardi CG
  83. Schuch FB
  84. Polanczyk G
  85. Luiz JM
  86. Fonseca L
  87. Aparicio LV
  88. Valvassori SS
  89. Nordentoft M
  90. Vendsborg P
  91. Hoffmann SH
  92. Sehli J
  93. Sartorius N
  94. Heuss SC
  95. Guinart D
  96. Hamilton J
  97. Kane J
  98. Rubio J
  99. Sand M
  100. Koyanagi A
  101. Solanes A
  102. Andreubernabeu A
  103. Caceres ASJ
  104. Arango C
  105. Diazcaneja CM
  106. Hidalgomazzei D
  107. Vieta E
  108. Gonzalezpenas J
  109. Fortea L
  110. Parellada M
  111. Fullana MA
  112. Verdolini N
  113. Andrlikova E
  114. Janku K
  115. Millan MJ
  116. Honciuc M
  117. Moniuszkomalinowska A
  118. Loniewski I
  119. Samochowiec J
  120. Kiszkiel L
  121. Marlicz M
  122. Sowa P
  123. Marlicz W
  124. Spies G
  125. Stubbs B
  126. Firth J
  127. Sullivan S
  128. Darcin AE
  129. Aksu H
  130. Dilbaz N
  131. Noyan O
  132. Kitazawa M
  133. Kurokawa S
  134. Tazawa Y
  135. Anselmi A
  136. Cracco C
  137. Machado AI
  138. Estrade N
  139. De Leo D
  140. Curtis J
  141. Berk M
  142. Carvalho AF
  143. Ward P
  144. Teasdale S
  145. Rosenbaum S
  146. Marx W
  147. Horodnic AV
  148. Oprea L
  149. Alexinschi O
  150. Ifteni P
  151. Turliuc S
  152. Ciuhodaru T
  153. Bolos A
  154. Matei V
  155. Nieman DH
  156. Sommer I
  157. Van Os J
  158. Van Amelsvoort T
  159. Sun CF
  160. Guu TW
  161. Jiao C
  162. Zhang J
  163. Fan J
  164. Zou L
  165. Yu X
  166. Chi X
  167. De Timary P
  168. Van Winkel R
  169. Ng B
  170. Pena E
  171. Arellano R
  172. Roman R
  173. Sanchez T
  174. Movina L
  175. Morgado P
  176. Brissos S
  177. Aizberg O
  178. Mosina A
  179. Krinitski D
  180. Mugisha J
  181. Sadeghibahmani D
  182. Sheybani F
  183. Sadeghi M
  184. Hadi S
  185. Brand S
  186. Errazuriz A
  187. Crossley N
  188. Ristic DI
  189. Lopezjaramillo C
  190. Efthymiou D
  191. Kuttichira P
  192. Kallivayalil RA
  193. Javed A
  194. Afridi MI
  195. James B
  196. Sebakahomen OJ
  197. Fiedorowicz J
  198. Daskalakis J
  199. Yatham LN
  200. Yang L
  201. Okasha T
  202. Dahdouh A
  203. Tiihonen J
  204. Shin JI
  205. Lee J
  206. Mhalla A
  207. Gaha L
  208. Brahim T
  209. Altynbekov K
  210. Negay N
  211. Nurmagambetova S
  212. Jamei YA
  213. Weiser M
  214. Correll CU

Source: European Neuropsychopharmacology Published:2026


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 (Pc) (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 PC 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 PC-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 © 2025 The Author(s).
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