The Association of Cyberspace and Attention-Deficit Hyperactivity Disorder Symptoms in Children During the COVID-19 Pandemic: A Systematic Review.

Background: The negative impact of the COVID-19 pandemic on the mental health of children has been considered. Children with attention-deficit and hyperactivity disorder (ADHD) are likely to be more vulnerable too. This study aimed to provide a systematic review of evidence regarding the association between screen usage and symptoms of ADHD during the COVID-19 pandemic.

Methods: This review adhered to PRISMA guidelines. Systematic searches were conducted in PubMed, Scopus, Web of Sciences and Cochrane Library.

Results: Of 130 identified reports, 8 papers covering 1587 subjects were included. The spent time on different types of screen time from TV to video games among children and adolescents with ADHD increased. The majority of studies showed that a surge in screen time was associated with the worsening of ADHD symptoms such as irritation, inattention, hyperactivity and oppositional defiant disorders (ODDs). The finding confirmed the severity of ADHD symptoms in individuals with a history of addictive or problematic usage of media was higher in comparison with others. One study found that educational screen time was not associated with disturbances in ADHD symptoms. In addition, ADHD symptoms during the COVID-19 pandemic were influenced by prior mental health situations.

Conclusions: The current findings suggest considering the negative association of excess screen time with ADHD symptoms, monitoring of screen time particularly for recreational purposes should be monitored to prevent negative consequences in children and adolescents with ADHD. On the other hand, designing educational and treatment interventions based on digital technology could not be ignored.