The impact of lockdown during the COVID-19 pandemic on mental and social health of children and adolescents

Michiel A.J. Luijten, Maud M. van Muilekom, Lorynn Teela, Tinca J.C. Polderman, Caroline B. Terwee, Josjan Zijlmans, Leonie Klaufus, Arne Popma, Kim J. Oostrom, Hedy A. van Oers, Lotte Haverman*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Purpose: During the COVID-19 pandemic in the Netherlands, governmental regulations resulted in a lockdown for adults as well as children/adolescents. Schools were closed and contact with other people was limited. In this cross-sectional, population-based study, we aimed to investigate the mental/social health of children/adolescents during COVID-19 lockdown. Methods: Two representative samples of Dutch children/adolescents (8–18 years) before COVID-19 (2018, N = 2401) and during lockdown (April 2020, N = 844) were compared on the Patient-Reported Outcomes Measurement Information System (PROMIS) domains: global health, peer relationships, anxiety, depressive symptoms, anger, sleep-related impairment by linear mixed models and calculating relative risks (RR (95% CI)) for the proportion of severe scores. Variables associated with worse mental/social health during COVID-19 were explored through multivariable regression models. The impact of COVID-19 regulations on the daily life of children was qualitatively analyzed. Results: Participants reported worse PROMIS T-scores on all domains during COVID-19 lockdown compared to before (absolute mean difference range 2.1–7.1 (95% CI 1.3–7.9). During lockdown, more children reported severe Anxiety (RR = 1.95 (1.55–2.46) and Sleep-Related Impairment (RR = 1.89 (1.29–2.78) and fewer children reported poor Global Health (RR = 0.36 (0.20–0.65)). Associated factors with worse mental/social health were single-parent family, ≥ three children in the family, negative change in work situation of parents due to COVID-19 regulations, and a relative/friend infected with COVID-19. A large majority (> 90%) reported a negative impact of the COVID-19 regulations on daily life. Conclusion: This study showed that governmental regulations regarding lockdown pose a serious mental/social health threat on children/adolescents that should be brought to the forefront of political decision-making and mental healthcare policy, intervention, and prevention.

Original languageEnglish
Pages (from-to)2795-2804
Number of pages10
JournalQuality of Life Research
Issue number10
Early online date15 May 2021
Publication statusPublished - Oct 2021

Bibliographical note

Funding Information:
We would like to acknowledge Stichting Steun Emma Kinderziekenhuis, the Dutch National Health Care Institute, and the Netherlands Organization for Health Research and Development for their funding. Additionally, we would like to thank all children and adolescents that completed the questionnaires and Biomedia and Panel Inzicht for their support in setting up the research website and sending out the questionnaires.

Publisher Copyright:
© 2021, The Author(s).

Copyright 2021 Elsevier B.V., All rights reserved.


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