Changes in internalizing and externalizing problems in Dutch children and adolescents receiving youth care before and during the COVID-19 pandemic
Abstract
Abstract Background The COVID-19 pandemic had serious effects on the mental health of children and adolescents. However, it is unclear how the pandemic may have affected treatment effects and outcomes in youth care. We investigated if treatment effects and externalizing and internalizing problems of children and adolescents receiving youth care were affected by the COVID-19 pandemic. Methods We used data from children and adolescents in youth care ( N = 1,090, M age = 12.85 ( SD = 2.83; range = 8-18 years)). Internalizing and externalizing problems were assessed at the start and end of treatment using the Child Behavior Checklist. We inspected change in internalizing and externalizing problems and clinical status at the end of treatment to investigate treatment effects, and the level of problems at the start and end of treatment. Outcomes were compared between three groups: children treated entirely before the COVID-19 pandemic, children who experienced the transition into COVID-19 measures during treatment, and children treated entirely during the pandemic. Results We did not find evidence that the pandemic affected treatment effectiveness. However, fewer children who were treated during the pandemic recovered from externalizing problems compared to children treated before the pandemic. Children who received treatment entirely during the pandemic also showed more internalizing and externalizing problems at both the start and end of their treatment, and children who experienced the transition into the pandemic showed elevated externalizing problems at both timepoints. Conclusions Although the change in internalizing and externalizing problems from start to end of treatment was not affected by the pandemic, our findings that children are entering and leaving care with more problems suggest that child mental health has deteriorated since the pandemic.
Authors 11
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Leiden University Medical Center
Affiliation as printed
LUMC Curium - Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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Affiliation as printed
Praktikon, Nijmegen, The Netherlands
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Amsterdam Public Health · Amsterdam University Medical Centers
Affiliation as printed
Amsterdam Public Health, Mental health, Amsterdam, The Netherlands
Amsterdam UMC location VU University, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Emma Kinderziekenhuis · Amsterdam Public Health · Amsterdam Reproduction Development
Affiliation as printed
Amsterdam Public Health, Mental health, Amsterdam, The Netherlands
Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
Amsterdam Reproduction and Development, Child Development, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Emma Kinderziekenhuis · Amsterdam Public Health · Amsterdam University Medical Centers · Amsterdam Reproduction Development · Vrije Universiteit Amsterdam · Amsterdam UMC Location Vrije Universiteit Amsterdam
Affiliation as printed
Amsterdam Public Health, Methodology and Mental Health, Amsterdam, The Netherlands
Amsterdam Reproduction and Development, Child Development, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
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Affiliation as printed
Vrije Universiteit Amsterdam, Department of Biological Psychology, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Emma Kinderziekenhuis · Amsterdam Public Health · Levvel
Affiliation as printed
Amsterdam Public Health, Mental health, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
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Amsterdam Public Health · Vrije Universiteit Amsterdam
Affiliation as printed
Amsterdam Public Health, Mental health, Amsterdam, The Netherlands
Vrije Universiteit Amsterdam, Department of Biological Psychology, The Netherlands
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Leiden University Medical Center · Parnassia Groep
Affiliation as printed
LUMC Curium - Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
Youz, Parnassia Psychiatric Institute, The Hague, The Netherlands
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University Medical Center Groningen · University of Groningen · Leiden University Medical Center · Amsterdam UMC Location University of Amsterdam · Emma Kinderziekenhuis · Accare · Amsterdam Public Health · Karakter · Levvel
Affiliation as printed
Amsterdam Public Health, Mental health, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
LUMC Curium - Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry & Accare Child Study Center, Groningen, The Netherlands
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Leiden University Medical Center
Affiliation as printed
LUMC Curium - Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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