Although the exact rate of pediatric patients affected by COVID-19 worldwide is not available thus far, children and adolescents seem to be less infected . According to COVID-19 integrated surveillance data in Italy, only 3.1% of patients diagnosed with SARS-CoV-2 infection were aged 0–18 years . However, it is well known that children and adolescents who are quarantined during pandemic diseases had a high risk of acute stress disorder. A preliminary study conducted in the Shaanxi province during the COVID-19 epidemic showed that clinging, inattention, and irritability were the most severe psychological conditions demonstrated by children and adolescents . Our survey confirmed that the majority of adolescents experienced feelings of fear, discouragement, and anxiety due to the lock-down, which strongly affected the approach to their daily lifestyles.
Technology has played a crucial role during the quarantine for young subjects who have increased the daily use of technological devices to stay connected with the rest of the world. Particularly, social media platforms have become fundamental for maintaining and enhancing socialization. These interactive media platforms have been constantly used to maintain friendship and emotional connection. Nowadays, the real-life of adolescents is closely related to their “online environments”, and social media have become an integral part of critical adolescent developmental tasks . These online environments reflect, complement, and reinforce well-understood psychological mechanisms, such as social comparison, self-disclosure, and impression management . Social media tools also allow adolescents to enhance individual and collective creativity through the sharing of artistic and musical activities, the creation of blogs, podcasts, and videos . In some cases, the frequent use of social networks can mitigate negative experiences such as psychosocial maladjustment and relationship difficulties and allows them to remove fears and insecurities . The use of social media tools can also facilitate self-esteem increase, identity exploration, aspirational development, and it provides adolescents the opportunity to explore knowledge and establish new friendships . Our survey showed the crucial role of friendship during the adolescence age. Face-to-face contact with close friends has been the main lack due to restrictive laws among the surveyed adolescents. To obviate this lack, text messages, video-chats, and online contacts have become more frequent during the lock-down period. Therefore, face-to-face communication has been well replaced by virtual and interactive contact characterized by close friendships and emotional relationships .
Despite the strong psychological impact of the quarantine, adolescents have shown good levels of resilience. Most of the surveyed subjects reported having used this period to acquire new skills. This positive response to the social emergency is related to the development of functional empowerment which allows reaching a satisfactory level of interior maturity. Interestingly, most of the subjects spent at least 1–3 h a week for indoor physical activity. This finding is accordingly with another Italian survey that demonstrated an increase in training frequency .
Sleep-wake habits were radically changed during the lock-down, as demonstrated by the majority of the surveyed adolescents who declared modification in their sleep/weak rhythm. This finding is in agreement with a French cross-sectional study that reported a high rate of trouble sleeping, particularly among young people . However, it should not be overlooked that sleep disturbances could also be related to the exaggerated use of technological devices at night. “Vamping” is a term that refers to some young people’s practice to stay online all night during which they text, share videos, and post selfies on social media. Previous studies have already demonstrated that alterations in neurophysiological mechanisms of sleep and circadian rhythm affect tech-addicted adolescents who are at greater risk for bad school performance and loss of self-control . Use of social media out of all proportion may also have other negative effects. It is widely accepted that virtual socialization could cause cyberbullying, sexting, and various psychological disorders such as depression and anxiety that adversely affect the development of the adolescent’s identity .
Regarding the dietary habits, almost half of adolescents have not reported any modifications. Otherwise, 25.6% of those interviewed declared a more balanced diet. We suppose that abstention from school and peer relationships out of school, has helped to maintain a healthy diet since the consumption of savory snacks, snacks, processed meat, carbonated and sugary drinks decreased . On the contrary, the consumption of healthy homemade food prevailed.
Finally, the lockdown period allowed to strengthen the relationship between adolescents and their parents at home in most cases. The critical role of the family in adolescent neuropsychological development is well documented. The relationship between adolescents and their families is based on two opposite aspects: preserving a close bond with their family and the need to achieve autonomy. The quality of family relationships is related to the way how adolescents cope with core developmental tasks and the transition to adulthood . Consequently, dialogue and mutual listening are crucial in the parent-child relationship as they allow to create emotional sharing and ensure the adolescent’s growth . Spending a lot of time at home has undoubtedly encouraged adolescents to have daily, constructive interactions with their parents which allowed them to gain awareness of their maturity process.