In India, varying degrees of lockdown due to coronavirus disease 2019 (COVID-19) pandemic have been enforced in most states since late March, 2020, which has extended for more than four months now. Schools across India have closed and restrictions on public movement is in effect. Most children are forced to stay indoors because of this lockdown, which has significantly disrupted their routine and reduced social contact.

This prolonged indoor stay is likely to affect their psychological well-being in many ways. Restriction of move-ment, inability to indulge in physical outdoor sports activities, reduced social contact with peer group, monotonous daily routine and difficulty in being engaged can have a negative bearing on the child. The childhood psychological reactions to COVID-19 pandemic can be broadly classified into internalizing problems like anxiety, depression, withdrawn state and somatic complaints and externalizing problems like irritable states, aggression, disruptive and rule breaking behavioral responses. An Italian study done among children during COVID lockdown reported an increase in externalizing tendencies like irritability, intolerance to rules, whims and excessive demands [1]. A similar Spanish study showed increase in nervousness, worry, feeling of lone-liness, boredom and anger which includes both internalizing and externalizing tendencies [2]. Lockdown also impaired the quality of sleep and sleep stabilization in children [3]. Quarantined Indian children were found to experience greater psychological distress like worry, helplessness and fear [4]. On the other hand, reduction in academic pressure and more time spent with family may also contribute to reduction in stress.

Our understanding about the psychological effects of COVID-19 lockdown in children is still evolving. Most of the available data are based on unvalidated, ad hoc questionnaire- based studies with poor external validity and have to be interpreted cautiously. More studies on this aspect are needed in order to understand and prevent psychological problems in children

1. Pisano L, Galimi D, Cerniglia L. A qualitative report on exploratory data on the possible emotional/behavioral correlates of Covid-19 lockdown in 4-10 years children in Italy. [Preprint]. PsyArXiv. 2020. Available from: https://psyarxiv.com/stwbn.

2. Idoiaga Mondragon N, Berasategi Sancho N, Dosil Santamaria M, Eiguren Munitis A. Struggling to breathe: A qualitative study of children’s wellbeing during lockdown in Spain. Psychol Health. 2020; 1-16. Available from: https://www.tandfonline.com/doi/full/10.1080/08870446.2020.1804570. [Epub ahead of print].

3. Dellagiulia A, Lionetti F, Fasolo M, Verderame C, Sperati A, Alessandri G. Early impact of COVID-19 lockdown on children’s sleep: A four-week longitudinal study. J Clin Sleep Med. 2020; jcsm–8648. Available from: https://jcsm.aasm.org/doi/10.5664/jcsm.8648. Accessed July 6, 2020. [Epub ahead of print].

4. Saurabh K, Ranjan S. Compliance and psychological impact of quarantine in children and adolescents due to COVID-19 pandemic. Indian J Pediatr. 2020;87:532-6.