Mental Health Impacts of the COVID-19 Pandemic on Australian Children and Adolescents with a Medical Condition: Longitudinal Findings

Round 1

Reviewer 1 Report

Dear authors, many thanks for your paper. 

I have been impressed by the high quality of your study and your manuscript. 

I will offer some minor suggestions to improve the paper. 

1. The discussion section needs to be improved. The content is now repetitive on the findings. You need to advance one step forward, extracting conclusions, at least potential, from your findings. 

2. The limitations section needs to be longer and needs to acknowledge more factors, such as attrition bias. How have you controlled which person (in fact) responded to the survey?

3. What are the suggestions for parenting, medical services, and policy-makers?

1. The discussion section needs to be improved. The content is now repetitive on the findings. You need to advance one step forward, extracting conclusions, at least potential, from your findings. 

2. The limitations section needs to be longer and needs to acknowledge more factors, such as attrition bias. How have you controlled which person (in fact) responded to the survey?

3. What are the suggestions for parenting, medical services, and policy-makers?

Author Response

Please see attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

Abstract:

While the abstract adequately covers the main objectives and findings, the addition of a brief reference to the statistical methods would enhance the scientific accuracy of the article and improve readers' understanding of the results.

Introduction:

The introduction provides a thorough background on the mental health impacts of the COVID-19 pandemic, particularly for children and adolescents with medical conditions. It effectively establishes the research gap, emphasizing the limited focus on medically vulnerable populations in prior studies.

Materials and Methods:

The Materials and Methods section is comprehensive until the sub-section on Statistical Analyses. The authors should clearly state which variables were used as dependent and independent in the models they applied. They should also clarify the target distribution and the relationship (link) with the linear models.

Results:

In Table 2, it appears that three dummy variables have been created for the variable "Time," which is incorrect. Either two dummy variables should be created, or the variable "Time" with its three levels should be entered as a categorical variable, allowing the model to produce results for two levels using the third as the reference level. Additionally, clarification is needed on what the "5" in parentheses next to "Age" in Table 2 represents.

Discussion:

The discussion appropriately contextualizes the findings within existing literature and thoroughly addresses each significant result. However, the issue is whether the results are accurate, as there are serious concerns about the statistical analyses, as mentioned above.

I've mentioned them all in the "Major comments" section

Author Response

Please see attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Dear authors, many thanks for considering my suggestions. 

The paper has been greatly improved. 

Dear authors, many thanks for considering my suggestions. 

The paper has been greatly improved. 

Author Response

Thank you for your review. 

Reviewer 2 Report

The authors should report whether the dependent variables followed a normal distribution. Did they use a General or Generalized linear mixed model? If the latter, what was the Target distribution?

The authors should report whether the dependent variables followed a normal distribution. Did they use a General or Generalized linear mixed model? If the latter, what was the Target distribution?

Author Response

Thank you for your review. We have updated the analysis section and results with the details requested. They are highlighted in red.