What is the “cage syndrome” that affected children and adolescents during the pandemic

“Cage syndrome” is similar to agoraphobia, which is the fear of staying in places that can cause symptoms of anxiety. Photo: Bigstock

An active life, with daily face-to-face classes, physical activity and going out with friends has not been more appealing to some teens who changed their behavior during the pandemic, worrying parents and health experts.

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Gabriel Lopes, a child and adolescent psychiatrist at the Brazilian Association of Psychiatry, called the “cage syndrome” the fear developed, especially by children and adolescents, of leaving home after being confined for a long time. . “This phenomenon already exists in medicine and is called agoraphobia, which is the fear of staying in places that can give symptoms of anxiety”, explains the doctor, who points out that the syndrome is not official medical terminology. and is characterized by the occurrence of agoraphobia following prolonged containment by the pandemic.

The fear of contracting Sars-CoV-2 is normal, after all we are in a pandemic and we are all afraid of being infected. However, in this “syndrome”, the individual suffers social, professional and educational losses, due to heightened fear, even though he is in a safe environment. “Aragophobia differs from the normal fear of contracting Covid-19 by the degree of impairment of the functioning and the suffering of the individual. As a person who, even vaccinated and with all the appropriate precautions, cannot leave his home, work in person, go to school or do any other activity outside, due to a crippling fear that affects normal operation, ”explains Lopes.

Alessandra Diehl, also a psychiatrist, warns that the main symptom will be the resistance to leave the house, especially if it is a child, or the excessive use of non-pharmacological means of protection, such as a mask, alcohol. and hand washing, in protected environments, such as in your own home. “Fear will cause insomnia the day before, as in the verbalization of fear. In children, it is common to find signs of somatization, such as stomach aches and diarrhea, to which are added the verbalization that they do not want to leave their home, ”explains the doctor.

If there is this fear, the best way to distinguish it from another psychiatric disorder is the psychiatric assessment. Indeed, children and adolescents are often unable to express and verbalize symptoms such as tachycardia, anticipatory anxiety, breathing difficulties and anxiety, so medical evaluation will aid in a diagnosis. early and adequate treatment.


Gabriel Lopes says there is an increase in anxiety disorders and depressive symptoms among adolescents and young people who have found it more difficult to resume face-to-face social contacts due to the long period of confinement. “In addition to the fear of contamination with Covid-19, there is a lot of shame about the changes that have taken place in the body during the period of confinement and the judgment of colleagues on body image. Because in one year, the adolescent’s body changes a lot and this can bring exacerbated shame, especially with obesity or acne, ”adds the expert.

The impact on cognitive development caused by the “syndrome” in adolescents is still unknown. However, in this age group, it is known that much of learning and development takes place through the encouragement of friends and group behavior, issues that have been limited by the pandemic. “We take away the ability for them to manage and overcome the frustrations typical of normal adolescent relationship conflicts. This can have very serious consequences in terms of self-confidence and self-esteem, ”emphasizes Lopes.

As for the cognitive and developmental impacts in the youngest, far from stimuli from the outside world, there are studies warning against a certain delay, especially in psychomotor skills and social interactions, says Alessandra. Therefore, the doctor advises parents to minimize possible harm by promoting stimuli beyond the screen, such as video games and movies, and food tips, using the creativity of the home space to make faced with these problems.

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Parents’ behavior can influence the appearance of the “syndrome” by their children. Especially if they are very anxious, worried or have a speech of despair with the news related to the pandemic, showing a lot of fear of leaving their home, warns Gabriel Lopes.

“High exposure resulting in end-to-end death is not recommended for the most vulnerable, and there needs to be assertive, non-threatening communication for children. After all, any fear-based prevention is unlikely to be successful, ”says Alessandra. She advises that in addition to offering professional help, parents should be present and attentive to the behavior of adolescents, helping them to find sources of joy and hope in the midst of their worries.

Gabriel stresses the importance of providing enjoyable opportunities for social contact for young people, albeit virtually, or in person with friends who also respect isolation, with the use of a mask, distance and use hydroalcoholic gel. “Providing a place where they can interact in complete freedom and privacy for a board game, chat, watch a movie or even do a physical activity helps improve socialization,” adds the doctor.

Additionally, Alessandra encourages gradual exposure to socialization, starting in small groups and in a sheltered manner, to make it easier to return to school in person. “It is important that parents and children work together, by making progressive exhibitions of children and adolescents in schools, in addition to dialogue and awareness,” he concludes.

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