A rapid review does warn: Impact of children’s loneliness today could manifest in depression for years to come

This review didn’t examine the effects of Corona and the different lockdowns around the globe, but did examine what we know about the relation between spanning isolation, loneliness and mental health for young people aged 4 – 21 and it does cause for alarm with effects that can sometimes be lagged. This all can mean that it can take up to 10 years to really understand the scale of the mental health impact the covid-19 crisis has created

From the press release:

Children and adolescents are likely to experience high rates of depression and anxiety long after current lockdown and social isolation ends and clinical services need to be prepared for a future spike in demand, according to the authors of a new rapid review into the long-term mental health effects of lockdown.

The research, which draws on over 60 pre-existing, peer-reviewed studies into topics spanning isolation, loneliness and mental health for young people aged 4 – 21, is published today (Monday 1 June 2020) in the Journal of the American Academy of Child and Adolescent Psychiatry.

According to the review, young people who are lonely might be as much as three times more likely to develop depression in the future, and that the impact of loneliness on mental health could last for at least 9 years.

The studies highlight an association between loneliness and an increased risk of mental health problems for young people. There is also evidence that duration of loneliness may be more important than the intensity of loneliness in increasing the risk of future depression among young people.

This, say the authors, should act as a warning to policymakers of the expected rise in demand for mental health services from young people and young adults in the years to come – both here in the UK and around the world.

Dr Maria Loades, clinical psychologist from the Department of Psychology at the University of Bath who led the work, explained: “From our analysis, it is clear there are strong associations between loneliness and depression in young people, both in the immediate and the longer-term. We know this effect can sometimes be lagged, meaning it can take up to 10 years to really understand the scale of the mental health impact the covid-19 crisis has created.”

For teachers and policymakers currently preparing for a phased re-start of schools in the UK, scheduled from today, Monday 1 June, Dr Loades suggests the research could have important implications for how this process is managed too.

She adds: “There is evidence that it’s the duration of loneliness as opposed to the intensity which seems to have the biggest impact on depression rates in young people. This means that returning to some degree of normality as soon as possible is of course important. However, how this process is managed matters when it comes to shaping young people’s feelings and experiences about this period.

“For our youngest and their return to school from this week, we need to prioritise the importance of play in helping them to reconnect with friends and adjust following this intense period of isolation.”

Members of the review team were also involved in a recent open letter to UK Education Secretary, Gavin Williamson MP, focusing on support for children’s social and emotional wellbeing during and after lockdown. In their letter they suggested that:

– The easing of lockdown restrictions should be done in a way that provides all children with the time and opportunity to play with peers, in and outside of school, and even while social distancing measures remain in place;

– Schools should be appropriately resourced and given clear guidance on how to support children’s emotional wellbeing during the transition period as schools reopen and that play – rather than academic progress – should be the priority during this time;

– The social and emotional benefits of play and interaction with peers must be clearly communicated, alongside guidance on the objective risks to children.

Acknowledging the trade-offs that need to be struck in terms of restarting the economy and reducing educational disparities, their letter to the Education Secretary concludes: ‘Poor emotional health in children leads to long term mental health problems, poorer educational attainment and has a considerable economic burden.’

Abstract of the review:

Objective: Disease containment of COVID-19 has necessitated widespread social isolation.  We aimed to establish what is known about how loneliness and disease containment measures impact on the mental health in children and adolescents. Method: For this rapid review, we searched MEDLINE, PSYCHINFO, and Web of Science for articles published between 01/01/1946 and 03/29/2020. 20% of articles were double screened using pre-defined criteria and 20% of data was double extracted for quality assurance.
Results: 83 articles (80 studies) met inclusion criteria. Of these, 63 studies reported on the impact of social isolation and loneliness on the mental health of previously healthy children and adolescents (n=51,576; mean age 15.3) 61 studies were observational; 18 were longitudinal and 43 cross sectional studies assessing self-reported loneliness in healthy children and adolescents. One of these studies was a retrospective investigation after a pandemic. Two studies evaluated interventions. Studies had a high risk of bias although longitudinal studies were of better methodological quality. Social isolation and loneliness increased the risk of depression, and possibly anxiety at the time loneliness was measured and between 0.25 to 9 years later. Duration of loneliness was more strongly correlated with mental health symptoms than intensity of loneliness.
Conclusions: Children and adolescents are probably more likely to experience high rates of depression and probably anxiety during and after enforced isolation ends. This may increase as enforced isolation continues. Clinical services should offer preventative support and early intervention where possible and be prepared for an increase in mental health problems.

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