Ulunma Natalie Umesi, MD, MBA

Objectives: The COVID-19 outbreak and infection control measures have disrupted the daily lives of children and adolescents in the United States, increasing uncertainty, fear, and social isolation. This is the first scoping review that examines the pandemic’s short- and long-term effects on mental health, systematically mapping existing research and identifying knowledge gaps. Methods: This scoping review follows Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Five databases (PubMed, APA PsycINFO, medRxiv, Web of Science, and Google Scholar) were searched. The keywords related to COVID-19, children, adolescents, mental health, and the United States. The initial search yielded a total of 6147 articles. After removing duplicates and applying the inclusion and exclusion criteria, 131 studies were included. Data extraction was conducted by 2 reviewers. Results: The review revealed reduced psychological well-being and increased mental health problems during COVID-19. The most commonly reported mental health outcomes were heightened stress, internalizing symptoms, externalizing symptoms, and traumatic symptoms. Children, adolescents, and young adults were found to be at an elevated risk of experiencing psychological distress, worry, loneliness, anxiety, depression, traumatic symptoms, other psychological disorders, suicide risk, sleep disorders, and impaired psychosocial functioning. Among high school adolescents, anxiety, depression, psychological stress, and suicidal thoughts were the most prevalent mental health issues during the COVID-19 pandemic. Several factors were identified as potential moderators of the impact of the pandemic on mental health outcomes. Conclusions: The COVID-19 pandemic and the implementation of infection control measures have significantly affected the mental health of children and adolescents in the United States. The findings of this scoping review highlight the wide-ranging and enduring psychopathological consequences of the pandemic, with heightened stress, anxiety, depression, and suicidal thoughts being particularly prevalent among high school adolescents. Future research should focus on longitudinal studies to assess the long-term effects of the pandemic on mental health outcomes and identify potential resilience factors.