CoCo20 protocol: a pilot longitudinal follow-up study about the psychiatric outcomes in a paediatric population and their families during and after the stay-at-home related to coronavirus pandemic (COVID-19)

Morgane Gindt, Arnaud Fernandez, Aurelien Richez, Ophelie Nachon, Michele Battista, Florence Askenazy, Morgane Gindt, Arnaud Fernandez, Aurelien Richez, Ophelie Nachon, Michele Battista, Florence Askenazy

Abstract

Introduction: In the context of a viral outbreak and the stay-at-home measures, a significant increase in psychological distress, such as stress or fear behaviours, has previously been reported in adult and paediatric population. Children and adolescents seem to be particularly at risk of developing psychiatric disorders during and after the stay-at-home but evidences are lacking. The main objective of this article is to present the methodology of Coronavirus Confinement 2020 (CoCo20) Study, which aims to assess the impact of the coronavirus pandemic (COVID-19) and stay-at-home on the development of psychiatric disorders, including post-traumatic stress disorder (PTSD), in children and adolescents.

Methods and analysis: We describe a longitudinal and multicentre study in the paediatric population during and after stay-at-home related to COVID-19 pandemic. Inclusions started on 30 March 2020 for 6 months. This study is proposed to all consecutive paediatric outpatients consulting during and after stay-at-home related to COVID-19 pandemic in medical-psychological centres and in a paediatric psychotrauma centre and/or calling the emergency COVID-19 hotline. We perform standardised and internationally validated psychiatric assessments (Diagnosis Infant and Preschool Assessment, Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version) together with anxiety, attention deficit hyperactivity disorder, PTSD, parenting stress and somatic symptoms scales during five visits (baseline, 1 week after baseline, 1 month after baseline, 1 week after the end of the containment and 1 month after the end of the containment) in patients and their families enrolled during the containment and during three visits in case of enrolment after the containment. The inclusion period will end in 30 November 2020.

Ethics and dissemination: The protocol has been approved by the Ethics Committee of Cote d'Azur University « CERNI » (number 2020-59). All patients and their legal caregivers provide a written informed consent on enrolment in the study. We will submit the results of the study to relevant journals and offer national and international presentations. This study will enable better characterisation of the impact of the stay-at-home (related to COVID-19 pandemic) on the mental health of children and adolescents.

Trial registration number: NCT04498416.

Keywords: anxiety disorders; child & adolescent psychiatry; public health.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
'CoCo 20’ procedure and evaluation criteria for the first study times. DIPA, Diagnostic Infant preschool Assessment; KSADS, Kiddie Schedule for Affective Disorders and Schizophrenia; WFIRS, Weiss functional impairment rating scale; PSI-SF, Parental stress index—short form; YCPC, Young Child PTSD Checklist; CPC, Child PTSD Checklist; PCL, PTSD Checklist; PAS, Preschool anxiety scale; For 10 peer review only —http://bmjopen.bmj.com/site/about/guidelines.xhtml; STAIC, Situational Anxiety and Trait Inventory for Child; STAI, Situational Anxiety and Trait Inventory; PHQ-13, Patient Health Questionnaire-13.

References

    1. Hawryluck L, Gold WL, Robinson S, et al. . Sars control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis 2004;10:1206–12. 10.3201/eid1007.030703
    1. Qiu J, Shen B, Zhao M, et al. . A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatr 2020;33:e100213. 10.1136/gpsych-2020-100213
    1. Reynolds DL, Garay JR, Deamond SL, et al. . Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect 2008;136:997–1007. 10.1017/S0950268807009156
    1. Brooks SK, Webster RK, Smith LE, et al. . The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 2020;395:912–20. 10.1016/S0140-6736(20)30460-8
    1. Duan L, Shao X, Wang Y, et al. . An investigation of mental health status of children and adolescents in China during the outbreak of COVID-19. J Affect Disord 2020;275:112–8. 10.1016/j.jad.2020.06.029
    1. Zhou SJ, Zhang LG, Wang LL. Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19. Eur Child Adolesc Psychiatry 2020:1–10.
    1. Gindt M, Fernandez A, Battista M, et al. . [Psychiatric consequences of Covid 19 pandemic in the pediatric population]. Neuropsychiatr Enfance Adolesc 2021. 10.1016/j.neurenf.2021.01.001. [Epub ahead of print: 09 01 2021].
    1. Cui Y, Li Y, Zheng Y. Cs of child. mental health services for children in China during the COVID-19 pandemic: results of an expert-based national survey among child and adolescent psychiatric hospitals. Eur Child Adolesc Psychiatry 2020;1.
    1. Pierce M, Hope H, Ford T, et al. . Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. Lancet Psychiatry 2020;7:883–92. 10.1016/S2215-0366(20)30308-4
    1. Ghosh R, Dubey MJ, Chatterjee S, et al. . Impact of COVID -19 on children: special focus on the psychosocial aspect. Minerva Pediatr 2020;72:34. 10.23736/S0026-4946.20.05887-9
    1. Witt A, Ordóñez A, Martin A. Child and adolescent mental health service provision and research during the Covid-19 pandemic: challenges, opportunities, and a call for submissions, 2020.
    1. Chen I-H, Chen C-Y, Pakpour AH, et al. . Internet-related behaviors and psychological distress among schoolchildren during COVID-19 school suspension. J Am Acad Child Adolesc Psychiatry 2020;59:1099-1102.e1:1099–102. 10.1016/j.jaac.2020.06.007
    1. Imran N, Zeshan M, Pervaiz Z. Mental health considerations for children & adolescents in COVID-19 Pandemic. Pak J Med Sci 2020;36:S4. 10.12669/pjms.36.COVID19-S4.2759
    1. Wade M, Prime H, Browne DT. Why we need longitudinal mental health research with children and youth during (and after) the COVID-19 pandemic. Psychiatry Res 2020;290:113143. 10.1016/j.psychres.2020.113143
    1. Garfin DR, Silver RC, Holman EA. The novel coronavirus (COVID-2019) outbreak: amplification of public health consequences by media exposure. Health Psychol 2020;39:355–7. 10.1037/hea0000875
    1. Rapa E, Dalton L, Stein A. Talking to children about illness and death of a loved one during the COVID-19 pandemic. Lancet Child Adolesc Health 2020;4:560–2. 10.1016/S2352-4642(20)30174-7
    1. Ye J. Pediatric mental and behavioral health in the period of quarantine and social distancing with COVID-19. JMIR Pediatr Parent 2020;3:e19867. 10.2196/19867
    1. Horesh D, Brown AD. Traumatic stress in the age of COVID-19: a call to close critical gaps and adapt to new realities. Psychol Trauma 2020;12:331–5. 10.1037/tra0000592
    1. Shigemura J, Ursano RJ, Morganstein JC, et al. . Public responses to the novel 2019 coronavirus (2019-nCoV) in Japan: mental health consequences and target populations. Psychiatry Clin Neurosci 2020;74:281–2. 10.1111/pcn.12988
    1. Imran N, Aamer I, Sharif MI, et al. . Psychological burden of quarantine in children and adolescents: a rapid systematic review and proposed solutions. Pak J Med Sci 2020;36:1106. 10.12669/pjms.36.5.3088
    1. Dutheil F, Mondillon L, Navel V. PTSD as the second tsunami of the SARS-Cov-2 pandemic. Psychol Med 2020:1–2. 10.1017/S0033291720001336
    1. American Psychiatric Association . Diagnostic and statistical manual of mental Disorder-5, 2013.
    1. Dyregrov A, Yule W. A review of PTSD in children. Child Adolesc Ment Health 2006;11:176–84. 10.1111/j.1475-3588.2005.00384.x
    1. Alisic E, Zalta AK, van Wesel F, et al. . Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis. Br J Psychiatry 2014;204:335–40. 10.1192/bjp.bp.113.131227
    1. Trickey D, Siddaway AP, Meiser-Stedman R, et al. . A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents. Clin Psychol Rev 2012;32:122–38. 10.1016/j.cpr.2011.12.001
    1. Bouvard M. Échelles et Questionnaires d’évaluation Chez l’enfant et l’adolescent. Elsevier Masson, 2008.
    1. Famularo R, Fenton T, Kinscherff R, et al. . Psychiatric comorbidity in childhood post traumatic stress disorder. Child Abuse Negl 1996;20:953–61. 10.1016/0145-2134(96)00084-1
    1. Kar N, Bastia B. “Post-Traumatic Stress Disorder, Depression and Generalized Anxiety Disorder in Adolescents after a Natural Disaster: A Study of Comorbidity.”. Clin Pract Epidemiol Ment Health 2006;1:17.
    1. Cohen JA, Bukstein O, Walter H, et al. . Practice parameter for the assessment and treatment of children and adolescents with posttraumatic stress disorder. J Am Acad Child Adolesc Psychiatry 2010;49:414–30.
    1. AACAP . “Talking to Children about Coronavirus (Covid 19).”, 2020. Available:
    1. Stark AM, White AE, Rotter NS, et al. . Shifting from survival to supporting resilience in children and families in the COVID-19 pandemic: lessons for informing U.S. mental health priorities. Psychol Trauma 2020;12:S133–5. 10.1037/tra0000781
    1. Lépine J-P, Gasquet I, Kovess V, et al. . Prévalence et comorbidité des troubles psychiatriques dans la population générale française : résultats de l’étude épidémiologique ESEMeD/MHEDEA 2000/ (ESEMeD). Encephale 2005;31:182–94. 10.1016/S0013-7006(05)82385-1
    1. Scheeringa MS. Untangling psychiatric comorbidity in young children who experienced single, repeated, or Hurricane Katrina traumatic events. Child Youth Care Forum 2015;44:475–92. 10.1007/s10566-014-9293-7
    1. Thümmler S, Gindt M, Battista M. Diagnostic infant and preschool assessment (DIPA) (French version 19/07/17 of DIPA DSM-5 Scheeringa 08/08/15, 2017.
    1. Kaufman J, Birmaher B, Axelson D. The schedule for affective disorders and schizophrenia for school-age children–present and lifetime version for DSM5 (K-SADS-PL-DSM5. Child and Adolescent Research and Education (CARE) Program. Western Psychiatric Institute and Clinic: Advanced Center for Intervention and Services Research (ACISR) for Early Onset Mood and Anxiety Disorders, Yale University, 2016.
    1. Thümmler S, Askenazy F. K-SADS-PL DSM-5 French version Mai 2018 (of K-SADS-PL DSM-5 November 2016, Kaufmann J, Birmaher B, Axelson D, Perepletchikova F, Brent D, Ryan N, 2018.
    1. Egeland J, Kovalik-Gran I. Validity of the factor structure of Conners' CPT. J Atten Disord 2010;13:347–57. 10.1177/1087054709332477
    1. Thompson T, Lloyd A, Joseph A, et al. . The Weiss functional impairment rating Scale-Parent form for assessing ADHD: evaluating diagnostic accuracy and determining optimal thresholds using ROC analysis. Qual Life Res 2017;26:1879–85. 10.1007/s11136-017-1514-8
    1. Abidin R. Short Form: Professional Manual.” Parenting Stress Index. Third ed. Odessa, FL: Psychological Assessment Resources, Inc, 1995.
    1. Scheeringa M. Young child PTSD checklist, 2013.
    1. Thümmler S, Gindt M, Maria F. Young child PTSD checklist (YCPC) (French version 18/05/17 of YCPC DSM-5, Scheeringa 23/05/14), 2017. Available:
    1. Scheeringa M. Child PTSD checklist – parent version (CPC-P). Tulane University, 2014.
    1. Thümmler S, Gindt M, Maria F. Child PTSD checklist (CPC) (French version 18/05/17 of CPC DSM-5, Scheeringa), 2017. Available:
    1. Weathers FW, Litz BT, Keane TM. The ptsd checklist for dsm-5 (pcl-5). In: Scale available from the National center for PTSD, 2013.
    1. Ashbaugh AR, Houle-Johnson S, Herbert C, et al. . Psychometric validation of the English and French versions of the posttraumatic stress disorder checklist for DSM-5 (PCL-5). PLoS One 2016;11:e0161645. 10.1371/journal.pone.0161645
    1. Spence SH, Rapee R, McDonald C, et al. . The structure of anxiety symptoms among preschoolers. Behav Res Ther 2001;39:1293–316. 10.1016/S0005-7967(00)00098-X
    1. Spielberger CD. State‐Trait anxiety inventory. In: The Corsini encyclopedia of psychology, 2010
    1. Kroenke K, Spitzer RL, Williams JBW. The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med 2002;64:258–66. 10.1097/00006842-200203000-00008
    1. Bahn GH. Coronavirus disease 2019, school closures, and children's mental health. Soa Chongsonyon Chongsin Uihak 2020;31:74–9. 10.5765/jkacap.200010
    1. Courtney D, Watson P, Battaglia M, et al. . COVID-19 impacts on child and youth anxiety and depression: challenges and opportunities. Can J Psychiatry 2020;65:688–91. 10.1177/0706743720935646
    1. Cohen RIS, Bosk EA. Vulnerable youth and the COVID-19 pandemic. Pediatr 2020;146.
    1. Amstadter AB, Elwood LS, Begle AM, et al. . Predictors of physical assault victimization: findings from the National survey of adolescents. Addict Behav 2011;36:814–20. 10.1016/j.addbeh.2011.03.008
    1. Hodges M, Godbout N, Briere J, et al. . Cumulative trauma and symptom complexity in children: a path analysis. Child Abuse Negl 2013;37:891–8. 10.1016/j.chiabu.2013.04.001
    1. Bomyea J, Lang AJ. Emerging interventions for PTSD: future directions for clinical care and research. Neuropharmacology 2012;62:607–16. 10.1016/j.neuropharm.2011.05.028
    1. Salmon K, Bryant RA. Posttraumatic stress disorder in children. The influence of developmental factors. Clin Psychol Rev 2002;22:163–88. 10.1016/S0272-7358(01)00086-1
    1. Thabet AA, Vostanis P. Post traumatic stress disorder reactions in children of war: a longitudinal study. Child Abuse Negl 2000;24:291–8. 10.1016/S0145-2134(99)00127-1
    1. Cisler JM, Amstadter AB, Begle AM, et al. . PTSD symptoms, potentially traumatic event exposure, and binge drinking: a prospective study with a national sample of adolescents. J Anxiety Disord 2011;25:978–87. 10.1016/j.janxdis.2011.06.006
    1. Fegert J, Freyberger HJ. Posttraumatische Belastungsstörungen (PTBS) uPTBS und Traumafolgestörungen in der Adoleszenz [Post-traumatic stress disorders (PTSD) and trauma sequel disorders in adolescence]. Fortschr Neurol Psychiatr 2019;87:638–41.
    1. Diab M, Peltonen K, Qouta SR, et al. . Can functional emotion regulation protect children's mental health from war trauma? A Palestinian study. Int J Psychol 2019;54:42–52. 10.1002/ijop.12427
    1. Gurwitch RH, Salem H, Nelson MM, et al. . Leveraging parent-child interaction therapy and telehealth capacities to address the unique needs of young children during the COVID-19 public health crisis. Psychol Trauma 2020;12:S82–4. 10.1037/tra0000863
    1. Steele W. Trauma in schools and communities: recovery lessons from survivors and responders. Routledge, 2015.
    1. Dvorsky MR, Breaux R, Becker SP. Finding ordinary magic in extraordinary times: child and adolescent resilience during the COVID-19 pandemic. Eur Child Adolesc Psychiatry 2020:1–3.
    1. Loades ME, Chatburn E, Higson-Sweeney N, et al. . Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J Am Acad Child Adolesc Psychiatry 2020;59:1218–39. 10.1016/j.jaac.2020.05.009

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