Changes in internalizing and externalizing problems in Dutch children and adolescents receiving outpatient youth care before and during the COVID-19 pandemic
European Child & Adolescent Psychiatry, vol. 34, pp. 2521–2533
Abstract
Abstract The COVID-19 pandemic significantly impacted the mental health of children and adolescents, but its effects on treatment outcomes in youth care remain unclear. This study examines whether the pandemic influenced treatment outcomes for internalizing and externalizing problems in children receiving outpatient youth care. We analyzed data from three groups of children who received outpatient youth care (N = 1090, M age = 12.85): those treated entirely before the pandemic, those who transitioned into pandemic-related measures during treatment, and those treated entirely during the pandemic. The Child Behavior Checklist was used to assess internalizing and externalizing problems at the start and end of treatment. Repeated measures ANCOVAs and χ2 tests of independence were conducted to evaluate changes in problem severity and clinical status, and ANCOVAs were used to compare between-group differences. The results suggest that while overall treatment outcomes were not directly affected by the pandemic, fewer children treated during the pandemic recovered from externalizing problems compared to those treated before the pandemic. Additionally, children treated entirely during the pandemic exhibited higher levels of internalizing and externalizing problems at both the start and end of treatment, and those transitioning into the pandemic also had elevated externalizing problems at both time points. Although the pandemic did not affect the change in problems during treatment, the increased severity of issues at both the start and end of treatment indicates a deterioration in child mental health since the pandemic. Appropriate support, preventive interventions, and regular monitoring of mental health problems may mitigate future impacts.
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. e.m.broek@lumc.nl
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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, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam, The Netherlands
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Emma Kinderziekenhuis · Amsterdam Public Health · Amsterdam University Medical Centers · 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, Emma Children's Hospital, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam, The Netherlands
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Emma Kinderziekenhuis · Amsterdam Public Health · Amsterdam University Medical Centers · Amsterdam Reproduction Development · 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, Emma Children's Hospital, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam, The Netherlands
Amsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam, The Netherlands
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Affiliation as printed
Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Emma Kinderziekenhuis · Amsterdam Public Health · Amsterdam University Medical Centers · Levvel
Affiliation as printed
Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
Amsterdam UMC, Emma Children's Hospital, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam, The Netherlands
Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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Amsterdam Public Health · Vrije Universiteit Amsterdam
Affiliation as printed
Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, 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 · Emma Kinderziekenhuis · Accare · Amsterdam Public Health · Karakter · Amsterdam University Medical Centers · Levvel
Affiliation as printed
Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
Amsterdam UMC, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam, The Netherlands
Amsterdam UMC, Emma Children's Hospital, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam, The Netherlands
Department of Child and Adolescent Psychiatry and Accare Child Study Center, University of Groningen, University Medical Center Groningen, Groningen, 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
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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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