Three years after the pandemic: how has the mental health of children and adolescents evolved? A longitudinal study in Italy, Spain and Portugal

The COVID-19 pandemic significantly challenged the mental health of children and adolescents, with existing research highlighting the negative effects of restrictive measures to control the virus’s spread. However, in the specific context of this pandemic, there is limited understanding of how these difficulties have persisted over time after the situation was fully restored. This study sought to evaluate the pandemic’s impact on psychological symptoms in children from Italy, Spain, and Portugal across five-time points (2, 5, and 8 weeks, 6 months, and three and a half years after the pandemic’s onset). A total of 1613 parents completed the Psychological Impact of COVID-19 and Confinement on Children and Adolescents Scale, reporting symptoms in their children aged 3–17 years (39.2% female). The findings reveal an initial surge in psychological difficulties—anxiety, mood, sleep, behavioral, eating, and cognitive disturbances—followed by improvements in these domains three and a half years later. By September 2023, Spanish children experienced more significant reductions in symptoms compared to their Italian and Portuguese peers. While the COVID-19 pandemic has been a prolonged crisis, with varying impacts over time and across regions depending on the strictness of restrictions, the trends suggest a gradual improvement in the psychological well-being of children and adolescents.