«Anxiety disorders in children have increased due to corona»

Dr Contin-Waldvogel, a study by the Federal Office of Public Health (see box) classifies children and adolescents as a risk group due to the psychological effects of the coronavirus crisis. How do you experience this in your practice?

Registrations in our adolescent and child psychiatry department have increased significantly. We attribute this directly to the pandemic. We normally always have a larger increase in cases in November and December. But last year there were particularly high numbers, with some days seeing up to 100 per cent more registrations.

What exactly stresses the children and young people?

In general, anxiety disorders have clearly increased. We are seeing many more anxious or overanxious patients than in previous years. We have children who have developed compulsions, such as compulsive washing or the fear of infecting mum, dad or grandparents.

Is the coronavirus pandemic the only reason for the increase in cases?

Just one stress factor is usually not enough to weaken psychological stability. In other words, if a child or young person is very stable, the current situation will not necessarily be more damaging to that person. It always takes a basic disposition and usually several factors coming together for the barrel to overflow.

Are there other clinical pictures that are now becoming more common?

Yes, there is depression, feelings of powerlessness and, in extreme cases, a sense of futility. But it must also be said that every situation, including the coronavirus crisis, has two sides. Not everyone thinks the pandemic is bad.

What do you mean by that?

In paediatric psychiatry, we are always dealing with extremes. And so there are also those children and adolescents who really come to life in this crisis because they were already in social withdrawal and this is now officially legitimised. Or school phobics, i.e. children and young people who are afraid of school. Of course, they thought it was great to be able to stay at home during lockdown. Children who previously received little attention from their parents because they were away a lot also enjoyed having mum and dad around more often during lockdown.

The pandemic has been going on for a good year now. How is it affecting your work as a child and adolescent psychiatrist?

As in all hospitals, staff are stretched to the limit. When colleagues fall ill and are absent, things get tight and then we have to improvise. From a medical point of view, we have focussed even more on emergencies and acute situations. We have had to reduce routine clarifications, which means that we prioritise differently.

It is very important that parents communicate to the child: You are not alone, we stick together.

But then children who have other psychological problems almost fall through the cracks at the moment?

Yes, unfortunately that is the case. Let's take the example of an ADHD assessment. That doesn't sound like an emergency at first. But if you wait too long, it can certainly develop into one if an affected child and their parents don't get help in time. However, we do our best and try to take care of all children and young people as quickly as possible.

What do you think about school closures? What does it do with mentally vulnerable young people?

From a child psychiatry perspective, I don't think it's good. We want to educate our children to be socially competent in society instead of learning alone at home. Closing a school therefore has a restrictive effect on the child in terms of cognition, social interaction, learning and social skills. And if a child already has a predisposition for a psychological problem, then this is exacerbated. But you also have to weigh things up very clearly: It would also be a tragedy for a child's mental health if grandparents or parents were to die from coronavirus because protective measures had not been implemented. And that includes school closures.

A teenager can usually clearly express what they are missing. What is it like with younger children? The stress in younger children is probably much more difficult for parents to understand.

In younger children, this often manifests itself in physical complaints such as stomach aches, headaches, sleep disorders or regressive symptoms. This means, for example, when a child starts wetting the bed again.