{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:09:03Z","timestamp":1786115343315,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acamh.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child Adoles Ment Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mental\u2010health\u2010disorders in children\/young adults increased post\u2010pandemic; however, the absence of linkage to COVID\u201019 registries made direct attribution of psychological sequelae to acute infection challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Healthcare\u2010claims databases in Singapore were utilised to evaluate rates of new\u2010incident mental\u2010health\u2010disorders in children\/young adults aged 6\u201325\u2009years from January 1st, 2012 to 29th February, 2024. Influence on monthly observed new\u2010incident mental\u2010health\u2010disorders across various pandemic phases was modelled using negative binomial regression, accounting for seasonality and overall increasing trend (year). Separate linkage with the national COVID\u201019 database allowed construction of contemporaneous SARS\u2010CoV\u20102\u2010infected\/test\u2010negative cohorts. Cox regression, with overlap weights applied, was utilised to estimate risks of new\u2010incident medically\u2010diagnosed mental\u2010health\u2010disorders 31\u2013300\u2009days post\u2010infection versus test\u2010negatives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, there was no significant increase in risk for any new\u2010incident medically\u2010diagnosed mental\u2010health\u2010disorders (adjusted\u2010hazards\u2010ratio, aHR\u2009=\u20091.01 [95% CI\u2009=\u20090.90\u20131.12]) amongst SARS\u2010CoV\u20102\u2010infected children\/young adults (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009456,034) versus test\u2010negatives (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009482,588); with the sole exception that of stress\/anxiety disorders (aHR\u2009=\u20091.20 [95% CI\u2009=\u20091.02\u20131.40]). Only infections during the pandemic\u2010containment\u2010phase were associated with significantly increased risk of stress\/anxiety, but not during the pandemic\u2010resiliency\u2010phase when restrictions were lifted (pandemic\u2010containment: aHR\u2009=\u20091.25 [95% CI\u2009=\u20091.02\u20131.54]; pandemic\u2010resiliency: aHR\u2009=\u20091.15 [95% CI\u2009=\u20090.89\u20131.48]). Risk of stress\/anxiety was elevated amongst COVID\u201019 cases with a concurrently\u2010infected adult household contact. A 10% increase in new\u2010incident mental\u2010health\u2010disorders was observed amongst Singaporean children\/young adults during the pandemic\u2010containment\u2010phase, but this subsequently normalised in the pandemic\u2010resiliency\u2010phase.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increase in medically\u2010diagnosed mental\u2010health\u2010disorders amongst Singaporean children\/young adults at the height of pandemic restrictions did not persist into endemicity. Increased incidence of medically\u2010diagnosed stress\/anxiety post\u2010COVID\u201019 in children\/young adults at the pandemic height may be mediated by initial infection severity and concurrent household infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/camh.70112","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T01:44:11Z","timestamp":1785980651000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of new\u2010incident mental health diagnoses following\n                    <scp>SARS<\/scp>\n                    \u2010\n                    <scp>CoV<\/scp>\n                    \u20102 infection amongst children and young adults in Singapore: a retrospective cohort study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6428-9999","authenticated-orcid":false,"given":"Liang En","family":"Wee","sequence":"first","affiliation":[{"name":"Communicable Diseases Agency  Singapore Singapore"},{"name":"Duke\u2010NUS Medical School National University of Singapore  Singapore Singapore"},{"name":"Department of Infectious Diseases Singapore General Hospital  Singapore Singapore"},{"name":"National Centre for Infectious Diseases  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jue Tao","family":"Lim","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice Yu Jin","family":"Tan","sequence":"additional","affiliation":[{"name":"National Centre for Infectious Diseases  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex Jie Wei","family":"Yap","sequence":"additional","affiliation":[{"name":"National Centre for Infectious Diseases  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin","family":"Chiew","sequence":"additional","affiliation":[{"name":"Communicable Diseases Agency  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Say How","family":"Ong","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore Singapore"},{"name":"Department of Developmental Psychiatry Institute of Mental Health  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choon Guan","family":"Lim","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore Singapore"},{"name":"Department of Developmental Psychiatry Institute of Mental Health  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Shuen Sheng","family":"Fung","sequence":"additional","affiliation":[{"name":"Duke\u2010NUS Medical School National University of Singapore  Singapore Singapore"},{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore Singapore"},{"name":"Department of Developmental Psychiatry Institute of Mental Health  Singapore Singapore"},{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Chien","family":"Lye","sequence":"additional","affiliation":[{"name":"Communicable Diseases Agency  Singapore Singapore"},{"name":"National Centre for Infectious Diseases  Singapore Singapore"},{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore Singapore"},{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"Department of Infectious Diseases Tan Tock Seng Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin Bryan","family":"Tan","sequence":"additional","affiliation":[{"name":"Duke\u2010NUS Medical School National University of Singapore  Singapore Singapore"},{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore Singapore"},{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"Ministry of Health, Government of Singapore  Singapore Singapore"},{"name":"Saw Swee Hock School of Public Health National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.18204"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S1473-3099(22)00573-4","article-title":"Effectiveness of primary series and 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(2021).Chronic Disease Management Programme (CDMP). Available from:https:\/\/www.moh.gov.sg\/others\/resources\u2010and\u2010statistics\/chronic\u2010disease\u2010management\u2010programme\u2010cdmp\/[last accessed 19 February 2026]."},{"key":"e_1_2_11_19_1","unstructured":"Ministry of Health Singapore. (2022).Further easing of community and border measures. Available from:https:\/\/www.moh.gov.sg\/newsroom\/easing\u2010of\u2010community\u2010smms\u2010and\u2010border\u2010measures[last accessed 6 June 2025]"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004315"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.22189","article-title":"COVID\u201019 pandemic quarantines and mental health among adolescents in Norway","volume":"7","author":"Pettersen J.H.","year":"2024","journal-title":"JAMA Network Open"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023\u2010064658"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/camh.12426"},{"key":"e_1_2_11_24_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004122","article-title":"Post\u2010COVID\u201019\u2010associated morbidity in children, adolescents, and adults: A matched cohort study including more than 157,000 individuals with COVID\u201019 in 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age","volume":"387","author":"Tan S.H.","year":"2022","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_11_32_1","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/S2215-0366(20)30462-4","article-title":"Bidirectional associations between COVID\u201019 and psychiatric disorder: Retrospective cohort studies of 62 354 COVID\u201019 cases in the USA","volume":"8","author":"Taquet M.","year":"2020","journal-title":"The Lancet Psychiatry"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(22)00260-7"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1063203"},{"key":"e_1_2_11_35_1","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.cmi.2023.12.019","article-title":"Long\u2010term neuropsychiatric sequelae of Delta versus omicron SARS\u2010CoV\u20102 infection","volume":"30","author":"Wee L.E.","year":"2023","journal-title":"Clinical Microbiology and 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