Symptoms of Stress Amongst Children and Adolescents During the COVID-19 Outbreak in Shiraz, Iran: A Cross-sectional Study

Because of the high daily mortality and quarantine procedures, coronavirus disease 2019 (COVID-19) can cause several psychological problems, especially in younger people.

Since most studies have mainly focused on physical problems of COVID-19 and they have neglected children in their analysis, this study aimed to evaluate the frequency and severity of stress symptoms and associated factors amongst children and adolescents aged 4 - 18 years during the COVID-19 outbreak.

Using a convenience sampling technique, this descriptive-analytic cross-sectional study was conducted in Shiraz, Iran, from March 2020 to June 2020. To collect data, the link of the online Children's Self-Reported Stress Symptoms Questionnaire was sent to eligible participants via SMS and WhatsApp. The data were analyzed using SPSS software version 21.

According to our results, 270, 77, and 16 cases had low, moderate, and severe stress, respectively. Age group, living with both parents, and birth rank had a significant relationship with the degree of stress. Furthermore, more than 50% of participants reported cognitive-emotional symptoms more than physical ones. There was a significant relationship between the age group and physical symptoms, the duration of quarantine with bad temper and sadness, and between no clear thoughts with mother’s workplace and father’s job.

Generally, almost 25% of participants reported moderate-to-severe stress. The most common symptoms of stress in children and adolescents were worrying, anger, and weakness. Furthermore, older children, those being the first child, and children living with both parents were more exposed to stress. Therefore, these items should be included in the healthcare team's training.