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Abstract
COVID-19 limitation strategies have led to widespread school closures around the world. The present study reports children’s mental health and associated factors during the COVID-19 school closure in France in the spring of 2020. We conducted a cross-sectional analysis using data from the SAPRIS project set up during the COVID-19 pandemic in France. Using multinomial logistic regression models, we estimated associations between children’s mental health, children’s health behaviors, schooling, and socioeconomic characteristics of the children’s families. The sample consisted of 5702 children aged 8–9 years, including 50.2% girls. In multivariate logistic regression models, children’s sleeping difficulties were associated with children’s abnormal symptoms of both hyperactivity-inattention (adjusted Odds Ratio (aOR) 2.05; 95% Confidence Interval 1.70–2.47) and emotional symptoms (aOR 5.34; 95% CI 4.16–6.86). Factors specifically associated with abnormal hyperactivity/inattention were: male sex (aOR 2.29; 95% CI 1.90–2.76), access to specialized care prior to the pandemic and its suspension during school closure (aOR 1.51; 95% CI 1.21–1.88), abnormal emotional symptoms (aOR 4.06; 95% CI 3.11–5.29), being unschooled or schooled with assistance before lockdown (aOR 2.13; 95% CI 1.43–3.17), and tutoring with difficulties or absence of a tutor (aOR 3.25; 95% CI 2.64–3.99; aOR 2.47; 95% CI 1.48–4.11, respectively). Factors associated with children’s emotional symptoms were the following: being born pre-term (aOR 1.34; 95% CI 1.03–1.73), COVID-19 cases among household members (aOR 1.72; 95% CI 1.08–2.73), abnormal symptoms of hyperactivity/inattention (aOR 4.18; 95% CI 3.27–5.34) and modest income (aOR 1.45; 95% CI 1.07–1.96; aOR 1.36; 95% CI 1.01–1.84). Multiple characteristics were associated with elevated levels of symptoms of hyperactivity-inattention and emotional symptoms in children during the period of school closure due to COVID-19. Further studies are needed to help policymakers to balance the pros and cons of closing schools, taking into consideration the educational and psychological consequences for children.
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1 Bordeaux Population Health Research Center, INSERM U 1219, Université de Bordeaux, Bordeaux Cedex, France (GRID:grid.412041.2) (ISNI:0000 0001 2106 639X); Centre Hospitalier Charles Perrens, Department of Child and Adolescent Psychiatry, Bordeaux, France (GRID:grid.489895.1) (ISNI:0000 0001 1554 2345)
2 Bordeaux Population Health Research Center, INSERM U 1219, Université de Bordeaux, Bordeaux Cedex, France (GRID:grid.412041.2) (ISNI:0000 0001 2106 639X)
3 French Institute for Demographic Studies (Ined), French Institute for Medical Research and Health (Inserm), ELFE Joint Unit, Paris, France (GRID:grid.77048.3c) (ISNI:0000 0001 2286 7412)
4 Université de Bordeaux, Inserm, UMR 1219, Vintage Team, Bordeaux, France (GRID:grid.412041.2) (ISNI:0000 0001 2106 639X); French National Public Health Agency, Santé Publique France, Saint-Maurice, France (GRID:grid.493975.5) (ISNI:0000 0004 5948 8741)
5 Bordeaux Population Health Research Center, INSERM U 1219, Université de Bordeaux, Bordeaux Cedex, France (GRID:grid.412041.2) (ISNI:0000 0001 2106 639X); Centre Hospitalier Charles Perrens, Department of Child and Adolescent Psychiatry, Bordeaux, France (GRID:grid.489895.1) (ISNI:0000 0001 1554 2345); University of Montreal, Department of Social and Preventive Medicine, Montreal, Canada (GRID:grid.14848.31) (ISNI:0000 0001 2292 3357); Research Unit on Children’s Psychosocial Maladjustment, Montreal, Canada (GRID:grid.459272.f) (ISNI:0000 0001 2325 5792)
6 Université Côte d’Azur, Centre National de la Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France (GRID:grid.460782.f) (ISNI:0000 0004 4910 6551)
7 Paris-Saclay University, Inserm, UVSQ, CESP, DevPsy, Paris, France (GRID:grid.460789.4) (ISNI:0000 0004 4910 6535); Paris Descartes University, Research Team (EPOPé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris, France (GRID:grid.508487.6) (ISNI:0000 0004 7885 7602); Cochin Hotel-Dieu Hospital, Unité de Recherche Clinique-Centre d’Investigations Cliniques P1419, Département Hospitalo-Universitaire Risks in Pregnancy, Paris, France (GRID:grid.411394.a) (ISNI:0000 0001 2191 1995)
8 Université de Paris, Centre for Research in Epidemiology and StatisticS (CRESS), Inserm, INRAE, Paris, France (GRID:grid.508487.6) (ISNI:0000 0004 7885 7602); Inserm Unité Mixte de Recherche 1153, Obstetrical, Perinatal, and Pediatric Epidemiology, Paris, France (GRID:grid.7429.8) (ISNI:0000000121866389)
9 ELFE Joint Unit, Paris, France (GRID:grid.7429.8)
10 EPIPAGE-2 Joint Unit, Paris, France (GRID:grid.7429.8)
11 Paris Descartes University, Research Team (EPOPé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, Département Hospitalo-Universitaire Risks in Pregnancy, Paris, France (GRID:grid.508487.6) (ISNI:0000 0004 7885 7602); Cochin Hotel-Dieu Hospital, Unité de Recherche Clinique-Centre d’Investigations Cliniques P1419, Département Hospitalo-Universitaire Risks in Pregnancy, Paris, France (GRID:grid.411394.a) (ISNI:0000 0001 2191 1995)
12 Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France (GRID:grid.462844.8) (ISNI:0000 0001 2308 1657)
13 Paris-Saclay University, Inserm, UVSQ, CESP, DevPsy, Paris, France (GRID:grid.460789.4) (ISNI:0000 0004 4910 6535); AP-HP Paris-Saclay, Bicêtre Hospital, Public Health and Epidemiology Department, Le Kremlin-Bicêtre, France (GRID:grid.413784.d) (ISNI:0000 0001 2181 7253)
14 Institut de Recherche Interdisciplinaire sur les enjeux Sociaux - Sciences Sociales, Politique, Santé, IRIS (UMR 8156 CNRS - EHESS - U997 INSERM), Aubervilliers, France (GRID:grid.503259.8) (ISNI:0000 0001 2189 6991)
15 Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Paris, France (GRID:grid.462844.8) (ISNI:0000 0001 2308 1657)
16 Paris-Dauphine University-PSL, Paris, France (GRID:grid.11024.36) (ISNI:0000000120977052)
17 French National Centre for Scientific Research, Paris, France (GRID:grid.4444.0) (ISNI:0000 0001 2112 9282)
18 University of Paris Sud, Paris, France (GRID:grid.5842.b) (ISNI:0000 0001 2171 2558)
19 National Institute for Demographic Studies, Paris, France (GRID:grid.77048.3c) (ISNI:0000 0001 2286 7412)
20 INSERM, E4N & EN3-Cohorts, Paris, France (GRID:grid.7429.8) (ISNI:0000000121866389)
21 Paris 13 University, Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Bobigny, France (GRID:grid.11318.3a) (ISNI:0000000121496883)
22 Sorbonne University, Paris, France (GRID:grid.462844.8) (ISNI:0000 0001 2308 1657)
23 Bordeaux Population Health Research Center, INSERM U 1219, Université de Bordeaux, Bordeaux Cedex, France (GRID:grid.412041.2) (ISNI:0000 0001 2106 639X); Centre Hospitalier Charles Perrens, Department of Child and Adolescent Psychiatry, Bordeaux, France (GRID:grid.489895.1) (ISNI:0000 0001 1554 2345); Research Unit on Children’s Psychosocial Maladjustment, Montreal, Canada (GRID:grid.459272.f) (ISNI:0000 0001 2325 5792)