Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany

TLDR

The COVID‑19 pandemic has dramatically altered the lives of 1.6 billion children worldwide, and early non‑representative studies from several countries reported a negative mental‑health impact. This study is the first nationwide representative survey in Germany to assess how the pandemic has affected children’s and adolescents’ health‑related quality of life and mental health from their own perspective. An online survey of 1,586 families with 7‑ to 17‑year‑olds, conducted May 26–June 10, used validated instruments (KIDSCREEN‑10, SDQ, SCARED, CES‑DC) and compared results to the pre‑pandemic BELLA cohort of 1,556 participants. Two‑thirds of participants reported high pandemic burden, with significantly lower HRQoL, more mental‑health problems, and higher anxiety than pre‑pandemic levels; children with low socioeconomic status, migration background, or limited living space were disproportionately affected, underscoring the need for targeted health‑promotion and prevention strategies.

Abstract

The COVID-19 pandemic has caused unprecedented changes in the lives of 1.6 billion children and adolescents. First non-representative studies from China, India, Brazil, the US, Spain, Italy, and Germany pointed to a negative mental health impact. The current study is the first nationwide representative study to investigate the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) and mental health of children and adolescents in Germany from the perspective of children themselves. A representative online survey was conducted among n = 1586 families with 7- to 17-year-old children and adolescents between May 26 and June 10. The survey included internationally established and validated instruments for measuring HRQoL (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), and depression (CES-DC). Results were compared with data from the nationwide, longitudinal, representative BELLA cohort study (n = 1556) conducted in Germany before the pandemic. Two-thirds of the children and adolescents reported being highly burdened by the COVID-19 pandemic. They experienced significantly lower HRQoL (40.2% vs. 15.3%), more mental health problems (17.8% vs. 9.9%) and higher anxiety levels (24.1% vs. 14.9%) than before the pandemic. Children with low socioeconomic status, migration background and limited living space were affected significantly more. Health promotion and prevention strategies need to be implemented to maintain children's and adolescents' mental health, improve their HRQoL, and mitigate the burden caused by COVID-19, particularly for children who are most at risk.