COVID-19 related posttraumatic stress disorder in children and adolescents in Saudi Arabia.

Mohamed H Sayed,Mohamed S El-Baz,Mohammad A Altuwiriqi,Moustafa A Hegazi,Saleh H Almurashi,Ali F Atwah,Fajr A Saeedi,Nadeem A Zubairi,Nada M Abdulhaq,Turki S Alahmadi,Vedat Sar

doi:10.1371/journal.pone.0255440

Abstract

The COVID-19 pandemic resulted in quarantine/lockdown measures in most countries. Quarantine may create intense psychological problems including post-traumatic stress disorder (PTSD) especially for the vulnerable critically developing children/adolescents. Few studies evaluated PTSD associated with infectious disasters but no Saudi study investigated PTSD associated with COVID-19 in children/adolescents. This study was undertaken to screen for PTSD in children/adolescent in Saudi Arabia to identify its prevalence/risk factors during COVID-19 pandemic and its quarantine. A cross-sectional survey was conducted after 2 months form start of quarantine for COVID-19 pandemic utilizing the original English version and an Arabic translated version for the University of California at Los Angeles Brief COVID-19 Screen for Child/Adolescent PTSD that can be parent-reported or self-completed by older children/adolescents. Participants (Saudi citizens/non-Saudi residents) were approached online via social media. Five hundred and thirty seven participants were enrolled. The participants were 262 boys and 275 girls with a mean age of 12.25±3.77 years. Symptoms of no, minimal, mild and potential PTSD were identified in 15.5%, 44.1%, 27.4% and 13.0% of children/adolescents, respectively. The age, gender, school grade, and residence were not predictive of PTSD symptoms. Univariate analysis of risk factors for PTSD revealed that work of a close relative around people who might be infected was significantly different between groups of PTSD symptoms, but this difference disappeared during multivariate analysis. Children/adolescents of Saudi citizens had significantly lower median total PTSD score than children/adolescents of expatriate families (p = 0.002). PTSD associated with the COVID-19 and its resultant quarantine shouldn't be overlooked in different populations as it is expected in a considerable proportion of children/adolescents with variable prevalence, risk factors and severity. Parents/healthcare providers must be aware of PTSD associated with COVID-19 or similar disasters, so, they can provide children/adolescent with effective coping mechanisms.

Highlights

The COVID-19 pandemic resulted in quarantine/lockdown measures in most countries
Univariate analysis of risk factors for post-traumatic stress disorder (PTSD) revealed that work of a close relative around people who might be infected was significantly different between groups of PTSD
Univariate analysis with comparisons of the studied variables and risk factors for PTSD in the initial set of COVID-19 exposure questions revealed that work of a close relative around people who might have COVID-19 and upsetting issues that happened to children/adolescents or their families because of SARS-CoV-2 were significantly different between the groups of no, minimal, mild and potential PTSD symptoms (X2 = 14.7, p = 0.002 and X2 = 12.2, p = 0.007 respectively) but these significant differences disappeared during multivariate regression analysis comparing potential PTSD group to the other 3 groups with no, minimal and mild PTSD symptoms (S7 and S8 Tables)