Mental health, coping and related risk factors during the first 2 years of the COVID-19 pandemic in children: Nationally representative, multi-wave, cross-sectional results from 12 countries from the global COH-FIT study

Agorastos, Agorastos; Thompson, Trevor; Solmi, Marco; Cortese, Samuele; Estrade, Andres; Radua, Joaquim; Dragioti, Elena; Vancampfort, Davy; Thygesen, Lau Caspar; Aschauer, Harald; Schlogelhofer, Monika; Aschauer, Elena; Schneeberger, Andres; Huber, Christian G.; Hasler, Gregor; Conus, Philippe; Do Cuenod, Kim Q.; von Kanel, Roland; Arrondo, Gonzalo; Fusar-Poli, Paolo; Gorwood, Philip; Llorca, Pierre-Michel; Krebs, Marie-Odile; Scanferla, Elisabetta; Kishimoto, Taishiro; Rabbani, Golam; Skonieczna-Zydecka, Karolina; Brambilla, Paolo; Favaro, Angela; Takamiya, Akihiro; Zoccante, Leonardo; Colizzi, Marco; Bourgin, Julie; Kaminski, Karol; Moghadasin, Maryam; Seedat, Soraya; Matthews, Evan; Wells, John; Vassilopoulou, Emilia; Gadelha, Ary; Su, Kuan-Pin; Kwon, Jun Soo; Kim, Minah; Lee, Taeyoung; Papsuev, Oleg; Mankova, Denisa; Boscutti, Andrea; Gerunda, Cristiano; Saccon, Diego; Righi, Elena; Monaco, Francesco; Croatto, Giovanni; Cereda, Guido; Demurtas, Jacopo; Brondino, Natascia; Veronese, Nicola; Enrico, Paolo; Politi, Pierluigi; Ciappolino, Valentina; Pfennig, Andrea; Bechdolf, Andreas; Meyer-Lindenberg, Andreas; Kahl, Kai G.; Domschke, Katharina; Bauer, Michael; Koutsouleris, Nikolaos; Winter, Sibylle M.; Borgwardt, Stefan; Bitter, Istvan; Balazs, Judit; Czobor, Pal; Unoka, Zsolt; Mavridis, Dimitris; Tsamakis, Konstantinos; Bozikas, Vasilios P.; Tunvirachaisakul, Chavit; Maes, Michael; Rungnirundorn, Teerayuth; Supasitthumrong, Thitiporn; Haque, Ariful; Brunoni, Andre R.; Costardi, Carlos Gustavo; Schuch, Felipe Barreto; Polanczyk, Guilherme; Luiz, Jhoanne Merlyn; Fonseca, Lais; Aparicio, Luana V.; Valvassori, Samira S.; Nordentoft, Merete; Vendsborg, Per; Hoffmann, Sofie Have; Sehli, Jihed; Sartorius, Norman; Heuss, Sabina C.; Guinart, Daniel; Hamilton, Jane; Kane, John; Rubio, Jose; Sand, Michael; Koyanagi, Ai; Solanes, Aleix; Andreu-Bernabeu, Alvaro; Caceres, Antonia San Jose; Arango, Celso; Diaz-Caneja, Covadonga M.; Hidalgo-Mazzei, Diego; Vieta, Eduard; Gonzalez-Penas, Javier; Fortea, Lydia; Parellada, Mara; Fullana, Miquel A.; Verdolini, Norma; Andrlikova, Eva; Janku, Karolina; Millan, Mark J.; Honciuc, Mihaela; Moniuszko-Malinowska, Anna; Loniewski, Igor; Samochowiec, Jerzy; Kiszkiel, Lukasz; Marlicz, Maria; Sowa, Pawel; Marlicz, Wojciech; Spies, Georgina; Stubbs, Brendon; Firth, Joseph; Sullivan, Sarah; Darcin, Asli Enez; Aksu, Hatice; Dilbaz, Nesrin; Noyan, Onur; Kitazawa, Momoko; Kurokawa, Shunya; Tazawa, Yuki; Anselmi, Alejandro; Cracco, Cecilia; Machado, Ana Ines; Estrade, Natalia; De Leo, Diego; Curtis, Jackie; Berk, Michael; Carvalho, Andre F.; Ward, Philip; Teasdale, Scott; Rosenbaum, Simon; Marx, Wolfgang; Horodnic, Adrian Vasile; Oprea, Liviu; Alexinschi, Ovidiu; Ifteni, Petru; Turliuc, Serban; Ciuhodaru, Tudor; Bolos, Alexandra; Matei, Valentin; Nieman, Dorien H.; Sommer, Iris; van Os, Jim; van Amelsvoort, Therese; Sun, Ching-Fang; Guu, Ta-Wei; Jiao, Can; Zhang, Jieting; Fan, Jialin; Zou, Liye; Yu, Xin; Chi, Xinli; de Timary, Philippe; van Winkel, Ruud; Ng, Bernardo; Pena, Edilberto; Arellano, Ramon; Roman, Raquel; Sanchez, Thelma; Movina, Larisa; Morgado, Pedro; Brissos, Sofia; Aizberg, Oleg; Mosina, Anna; Krinitski, Damir; Mugisha, James; Sadeghi-Bahmani, Dena; Sheybani, Farshad; Sadeghi, Masoud; Hadi, Samira; Brand, Serge; Errazuriz, Antonia; Crossley, Nicolas; Ristic, Dragana Ignjatovic; Lopez-Jaramillo, Carlos; Efthymiou, Dimitris; Kuttichira, Praveenlal; Kallivayalil, Roy Abraham; Javed, Afzal; Afridi, Muhammad Iqbal; James, Bawo; Seb-Akahomen, Omonefe Joy; Fiedorowicz, Jess; Daskalakis, Jeff; Yatham, Lakshmi N.; Yang, Lin; Okasha, Tarek; Dahdouh, Aicha; Tiihonen, Jari; Il Shin, Jae; Lee, Jinhee; Mhalla, Ahmed; Gaha, Lotfi; Brahim, Takoua; Altynbekov, Kuanysh; Negay, Nikolay; Nurmagambetova, Saltanat; Abu Jamei, Yasser; Weiser, Mark; Correll, Christoph U.

doi:10.1016/j.euroneuro.2025.112741

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Mental health, coping and related risk factors during the first 2 years of the COVID-19 pandemic in children: Nationally representative, multi-wave, cross-sectional results from 12 countries from the global COH-FIT study

Authors: Agorastos, Agorastos ; Thompson, Trevor ; Solmi, Marco ; Cortese, Samuele ; Estrade, Andres ; Radua, Joaquim ; Dragioti, Elena ; Vancampfort, Davy ; Thygesen, Lau Caspar ; Aschauer, Harald ; Schlogelhofer, Monika ; Aschauer, Elena ; Schneeberger, Andres ; Huber, Christian G. ; Hasler, Gregor ; Conus, Philippe ; Do Cuenod, Kim Q. ; von Kanel, Roland ; Arrondo, Gonzalo ; Fusar-Poli, Paolo ; Gorwood, Philip ; Llorca, Pierre-Michel ; Krebs, Marie-Odile ; Scanferla, Elisabetta ; Kishimoto, Taishiro ; Rabbani, Golam ; Skonieczna-Zydecka, Karolina ; Brambilla, Paolo ; Favaro, Angela ; Takamiya, Akihiro ; Zoccante, Leonardo ; Colizzi, Marco ; Bourgin, Julie ; Kaminski, Karol ; Moghadasin, Maryam ; Seedat, Soraya ; Matthews, Evan ; Wells, John ; Vassilopoulou, Emilia ; Gadelha, Ary ; Su, Kuan-Pin ; Kwon, Jun Soo ; Kim, Minah ; Lee, Taeyoung ; Papsuev, Oleg ; Mankova, Denisa ; Boscutti, Andrea ; Gerunda, Cristiano ; Saccon, Diego ; Righi, Elena ; Monaco, Francesco ; Croatto, Giovanni ; Cereda, Guido ; Demurtas, Jacopo ; Brondino, Natascia ; Veronese, Nicola ; Enrico, Paolo ; Politi, Pierluigi ; Ciappolino, Valentina ; Pfennig, Andrea ; Bechdolf, Andreas ; Meyer-Lindenberg, Andreas ; Kahl, Kai G. ; Domschke, Katharina ; Bauer, Michael ; Koutsouleris, Nikolaos ; Winter, Sibylle M. ; Borgwardt, Stefan ; Bitter, Istvan ; Balazs, Judit ; Czobor, Pal ; Unoka, Zsolt ; Mavridis, Dimitris ; Tsamakis, Konstantinos ; Bozikas, Vasilios P. ; Tunvirachaisakul, Chavit ; Maes, Michael ; Rungnirundorn, Teerayuth ; Supasitthumrong, Thitiporn ; Haque, Ariful ; Brunoni, Andre R. ; Costardi, Carlos Gustavo ; Schuch, Felipe Barreto ; Polanczyk, Guilherme ; Luiz, Jhoanne Merlyn ; Fonseca, Lais ; Aparicio, Luana V. ; Valvassori, Samira S. ; Nordentoft, Merete ; Vendsborg, Per ; Hoffmann, Sofie Have ; Sehli, Jihed ; Sartorius, Norman ; Heuss, Sabina C. ; Guinart, Daniel ; Hamilton, Jane ; Kane, John ; Rubio, Jose ; Sand, Michael ; Koyanagi, Ai ; Solanes, Aleix ; Andreu-Bernabeu, Alvaro ; Caceres, Antonia San Jose ; Arango, Celso ; Diaz-Caneja, Covadonga M. ; Hidalgo-Mazzei, Diego ; Vieta, Eduard ; Gonzalez-Penas, Javier ; Fortea, Lydia ; Parellada, Mara ; Fullana, Miquel A. ; Verdolini, Norma ; Andrlikova, Eva ; Janku, Karolina ; Millan, Mark J. ; Honciuc, Mihaela ; Moniuszko-Malinowska, Anna ; Loniewski, Igor ; Samochowiec, Jerzy ; Kiszkiel, Lukasz ; Marlicz, Maria ; Sowa, Pawel ; Marlicz, Wojciech ; Spies, Georgina ; Stubbs, Brendon ; Firth, Joseph ; Sullivan, Sarah ; Darcin, Asli Enez ; Aksu, Hatice ; Dilbaz, Nesrin ; Noyan, Onur ; Kitazawa, Momoko ; Kurokawa, Shunya ; Tazawa, Yuki ; Anselmi, Alejandro ; Cracco, Cecilia ; Machado, Ana Ines ; Estrade, Natalia ; De Leo, Diego ; Curtis, Jackie ; Berk, Michael ; Carvalho, Andre F. ; Ward, Philip ; Teasdale, Scott ; Rosenbaum, Simon ; Marx, Wolfgang ; Horodnic, Adrian Vasile ; Oprea, Liviu ; Alexinschi, Ovidiu ; Ifteni, Petru ; Turliuc, Serban ; Ciuhodaru, Tudor ; Bolos, Alexandra ; Matei, Valentin ; Nieman, Dorien H. ; Sommer, Iris ; van Os, Jim ; van Amelsvoort, Therese ; Sun, Ching-Fang ; Guu, Ta-Wei ; Jiao, Can ; Zhang, Jieting ; Fan, Jialin ; Zou, Liye ; Yu, Xin ; Chi, Xinli ; de Timary, Philippe ; van Winkel, Ruud ; Ng, Bernardo ; Pena, Edilberto ; Arellano, Ramon ; Roman, Raquel ; Sanchez, Thelma ; Movina, Larisa ; Morgado, Pedro ; Brissos, Sofia ; Aizberg, Oleg ; Mosina, Anna ; Krinitski, Damir ; Mugisha, James ; Sadeghi-Bahmani, Dena ; Sheybani, Farshad ; Sadeghi, Masoud ; Hadi, Samira ; Brand, Serge ; Errazuriz, Antonia ; Crossley, Nicolas ; Ristic, Dragana Ignjatovic ; Lopez-Jaramillo, Carlos ; Efthymiou, Dimitris ; Kuttichira, Praveenlal ; Kallivayalil, Roy Abraham ; Javed, Afzal ; Afridi, Muhammad Iqbal ; James, Bawo ; Seb-Akahomen, Omonefe Joy ; Fiedorowicz, Jess ; Daskalakis, Jeff ; Yatham, Lakshmi N. ; Yang, Lin ; Okasha, Tarek ; Dahdouh, Aicha ; Tiihonen, Jari ; Il Shin, Jae ; Lee, Jinhee ; Mhalla, Ahmed ; Gaha, Lotfi ; Brahim, Takoua ; Altynbekov, Kuanysh ; Negay, Nikolay ; Nurmagambetova, Saltanat ; Abu Jamei, Yasser ; Weiser, Mark ; Correll, Christoph U.

Citation: EUROPEAN NEUROPSYCHOPHARMACOLOGY, Vol.104, 2026-03

Article Number: 112741

Journal Title: EUROPEAN NEUROPSYCHOPHARMACOLOGY

ISSN: 0924-977X

Issue Date: 2026-03

MeSH: Adaptation, Psychological* ; Adolescent ; COVID-19* / epidemiology ; COVID-19* / psychology ; Child ; Cross-Sectional Studies ; Female ; Humans ; Male ; Mental Health* ; Retrospective Studies ; Risk Factors

Keywords: COVID-19 ; WHO-5 ; Children ; Mental health ; Pandemic ; Psychiatry ; Survey ; Well-being

Abstract: Few multinational studies have assessed risk factors and coping strategies associated with the impact of the COVID-19 pandemic on children's mental health over time. The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is the largest transcontinental, multi-wave, cross-sectional survey collecting multi-nation data on well-being and psychopathology during the pandemic. We analyzed country-specific, general-population-based, representative COH-FIT data of 6067 children aged 6-13 years from 12 countries across repeated cross-sectional waves over a period of >2 years (Apr/2020-May/2022), addressing through current and retrospective assessment pre- to intra-pandemic changes in well-being (WHO-5) and general psychopathology scores (P-c) (0-100) in relation to COVID-related deaths, stringency index, eight a priori risk factors, and 16 coping strategies in different responders at each wave. From pre- to intra-pandemic, WHO-5 scores decreased (4.59, 95 %CI= -6.18 to -2.99, p < 0.001), while PC-scores increased (+6.68, 95 % CI=4.48-8.88, p < 0.001) significantly, following distinct time patterns but both returning to near pre-pandemic levels. Changes in both scores varied by country. WHO-5 scores correlated strongly with P-C and subdomain scores. Both score changes were significantly but minimally associated to COVID-19 deaths/stringency index. The proportion of children screening positive for depression increased from 3.9 % to 8.3 % (chi(2) =145.70, p < 0.001) and for major depression from 0.6 % to 2.2 % (chi(2)=68.64, p < 0.001) intrapandemic. WHO-5 and P-C-score changes were significantly associated with female gender, school closure, and pre-existing physical and mental conditions, with cumulative effects. The five most frequently endorsed coping strategies were family contact (85.2 %), friends (67.3 %), outdoor play (54.0 %), pet interaction (51.5 %), and internet use (50.9 %). Identified risk groups and coping strategies can inform targeted interventions and global public health policy.