Mental health of children and adolescents with pre-existing psychiatric and developmental disorders during the first pandemic-related lockdown: A cross-sectional study in Greece

Since the onset of COVID-19 pandemic, concerns have been raised about the effects of the pandemic on youth with pre-existing mental health disorders. The present study aimed to explore change in emotional and behavioral symptoms (mood states) and daily behaviors during the lockdown in a clinical sample of children and adolescents in Greece. A cross-sectional survey, using the CoRonavIrus Health Impact Survey (CRISIS) Questionnaire, was completed by 738 parents of children and adolescents aged 2–18 years attending 12 outpatient child and adolescent mental health services (CAMHS) across four geographical regions in Greece. Participants reported at a single time-point on their children's mood states and daily behaviors 3 months prior to the pandemic and during the past two weeks, as well as on life changes during the spring 2020 lockdown. Using paired samples t-tests no change was found in mean mood states scores pre- and post-pandemic onset in all subgroups investigated. Using McNemar's test, we found that among individual mood states, some symptoms increased, and others decreased or remained stable. Additionally, participants did rate several of their daily behaviours as having overall worsened, e.g., reduced sleep or time spent outdoors during the lockdown, as compared to 3 months prior the pandemic. Longitudinal studies are needed to ascertain which factors buffer against deterioration of mental health among children with pre-pandemic psychiatric or developmental disorders, in order to inform public mental health and educational policy. •Lockdown did not worsen mood states in a clinical sample of Greek youth.•Mood states remained stable across age, sex and diagnosis groups.•Daily behaviors worsened significantly during lockdown compared to three months prior.•Children were reported to experience increased sadness and less enjoyment in activities. Other mental health symptoms decreased or remained stable.•Possible heterogeneity in symptoms' change should be considered when designing policies responding to the pandemic.