Background COVID-19 outbreak was sudden and unexpected in most countries. It has spread globally between January and March 2020. The World Health Organization (WHO) first declared the outbreak as a global pandemic on 11 March 2020. While this lockdown has proven to be an important and successful method of social distancing to counter the growing spread of the highly contagious COVID-19 virus, it has also created a degree of psychological impact on the public. Children may be strongly exposed to pandemic-generated biopsychosocial stressors, and once the containment measures of the population are needed to minimize the spread of viruses, they may be negatively impacted by the disturbance of everyday life as a result of social isolation. During school closures, children's routines may change, and healthy behaviors, such as physical activity, adequate diet, or good sleeping habits, may be less likely to happen. Method A cross-sectional study was conducted in Saudi Arabia from 20 March 2021 to 30 March 2021, targeted at children's parents and adolescents. Our concentration was on the impact of COVID-19 on the psychiatric wellbeing of children and adolescents. The data was collected through an online self-administered questionnaire which contains 56 close-ended questions for parents of children and 46 close-ended questions for adolescents. Statistical analysis was performed using R v 3.6.3 (R Foundation, Vienna, Austria). Counts and percentages were used to summarize the distribution of categorical variables. Results The questionnaire was completed by 1141 respondents, 454 were < 18 years old. Thus, these respondents completed the questionnaire on behalf of themselves. The remaining 688 respondents were adults and completed the questionnaire on behalf of their children. Results showed that higher children's age was associated with less increase in worrying, restlessness, and a higher increase in sadness. Higher age was associated with a higher increase in the frequency of waking up, sleeping little, and uneasiness, and nervousness. Having relatives who were infected with COVID-19 was associated with higher increases in most of the negative behaviors such as anxiety, sadness, sleeping little, indecisiveness, and irritability. Punishment threats, screaming, and hitting were associated with a higher increase in negative behaviors during the pandemic compared to before the pandemic. Results showed that neither the gender of the parent nor the child was associated with any of the domains of the child's behavior. Children whose parents were divorced had higher scores on anxiety, restlessness, and sleep disorders than children whose parents were not divorced Conclusion COVID-19 has caused increased stress on families, especially children and adolescents who are vulnerable populations. Our results show that the COVID-19 pandemic can affect the mental health of children and adolescents in Saudi Arabia. We showed that parental stress is a predictor of psychiatric problems, which, if unaddressed, can cause child maltreatment and greater psychological distress.
