The true impact of the COVID-19 pandemic on the younger population with pre-existing psychiatric disorders

Dear Editor,

Having read the article by Palacio-Ortiz et al. with great interest, I appreciate that there are a number of changes relating to lockdown that threaten to exacerbate symptoms, involving factors such as family dynamics, drug treatment and monitoring by telepsychiatry. However, we were struck by the fact that, with the objective cited as being the effects in children with an underlying psychiatric disorder, the approach taken was at the level of recommendations and indications of help for both patients and caregivers, and the main focus of the review was left aside.

The role of each family in the mental health of their children needs to be clearly established. Situations such as quarantine, loss, estrangement or separation from loved ones, poverty, overcrowding, abuse of new technologies¹ and distancing from groups they belong to can have a long-term impact, and psychopathological complications can be all the greater.²

As an indicator that the psychological impact on the population is sizeable and is causing great stress, there has been a marked increase in the search for the symptoms “anxiety” and “insomnia” on Google during this pandemic compared to previous years.³

Jinsong Shang et al. conducted a study of 241 parents of school-age children with an established diagnosis of attention deficit hyperactivity disorder (ADHD). They determined that, although the children’s negative mood was partly associated with the symptoms of ADHD, the mood transmitted by the parents was also going to have an important impact on them. The mere fact of being in a stressful situation such as the pandemic in itself considerably alters children’s mental state, so the symptoms of children with ADHD are exacerbated yet further.⁴

The information search is aimed at a vulnerable child-adolescent population such as children with a diagnosis of psychiatric illness, and it has been observed that these children are the most likely to suffer the effects of the pandemic.² It has also been reported that having a history of psychiatric illness can trigger anxiety and anger four to six months after the end of quarantine.⁵ Healthcare planning would therefore have to consider a different approach for the treatment of these patients.⁶

Last of all, we would like to highlight the importance of the early gathering of data about the effects the pandemic will have on mental health, with greater focus on the paediatric population, as children are the most susceptible to psychological problems.⁷ This will help provide quality information that may be useful in the event of a new pandemic, and better tools to enable effective interventions in this type of population.