Letters to the Editor.

Abstract

It is with great interest we read the article titled ‘Parenting stress, maternal depression and child mental health in a Melbourne cohort before and during the COVID-19 pandemic’ by Galbally et al.1 While the study has many strengths, including the robust measurement, the study was unable to report on mental health outcomes for those exposed to COVID-19 infection. A similar study was done in India, considering the mental health outcomes of health-care workers (HCW) exposed to the pandemic frontline. India, the second-largest population globally, has a rural-based and growing-urban developing economy and has suffered COVID-19 since January 2020. India reached its first peak with 100,000 infective cases on 18 May 2020, and as of 13 October 2021, the overall cases in India has exceeded 34 million. A four-phased lockdown from 24 March 2020 to 31 May 2020 was enforced to deal with COVID-19. During the pandemic, a few issues significantly attributed to psychological distress among people, especially children, include isolation, fear and uncertainty. It was possible to analyse the psychological impact on parents and their children in a developing country like India during the pandemic. The psychological impact of COVID-19 among the parents was assessed by a questionnaire with the IES-R scale, while the CRIES-13 scale was used to assess the psychological impact on their children among the 8- to 16-year-old age group.2 The parents of children with special health care needs were excluded from the study. It was observed that 75th percentile participants had a minimal psychological impact while most displayed average range values. The non-parametric Mann-Whitney statistical analysis found significant differences in IES-R of hyperarousal and intrusion scores between HCW and non-health-care workers (NHCW). In children, the CRIES-13 median score was 9, which indicates no risk of post-traumatic stress disorder. No significant differences were found between children of HCW and NHCW (P > 0.05). We looked for factors associated with psychological distress in parents, females and HCW associated with higher IES-R scores P < 0.05 (Pearson Chi-square test). CRIES-13 scores of children were related to parents′ IES scoring. Additionally, siblings′ CRIES-13 scores were correlated, suggesting a possible family effect for distress. A correlation between parent and child ratings was expected, reflecting a commonality of contextual factors related to COVID-19 and a similarity in temperamental traits and emotional communication capacity that are likely to be genetically and environmentally influenced. It was observed that many parents and their children had a psychological impact due to COVID-19. Though concerns have been raised that children might be susceptible to the psychological effects of COVID-19, the role of parents becomes essential for attenuating the detrimental psychological effects of confinement. Fear of infection and home confinement could be particularly stressful for young people. The close link between parent and child-reported distress suggests that interventions to prevent and manage COVID-19-related anxiety in children should consider parental distress.