Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: a longitudinal, population-based study

Abstract

Background Adolescence represents a crucial developmental period in shaping mental health trajectories. In this study, we investigated the effect of the COVID-19 pandemic on mental health and substance use during this sensitive developmental stage. MethodsIn this longitudinal, population-based study, surveys were administered to a nationwide sample of 13-18-yearolds in Iceland in October or February in 2016 and 2018, and in October, 2020 (during the COVID-19 pandemic). The surveys assessed depressive symptoms with the Symptom Checklist-90, mental wellbeing with the Short Warwick Edinburgh Mental Wellbeing Scale, and the frequency of cigarette smoking, e-cigarette use, and alcohol intoxication. Demographic data were collected, which included language spoken at home although not ethnicity data. We used mixed effects models to study the effect of gender, age, and survey year on trends in mental health outcomes. Findings 59 701 survey responses were included; response rates ranged from 63% to 86%. An increase in depressive symptoms (β 0•57, 95% CI 0•53 to 0•60) and worsened mental wellbeing (β -0•46, 95% CI -0•49 to -0•42) were observed across all age groups during the pandemic compared with same-aged peers before COVID-19. These outcomes were significantly worse in adolescent girls compared with boys (β 4•16, 95% CI 4•05 to 4•28, and β -1•13, 95% CI -1•23 to -1•03, respectively). Cigarette smoking (OR 2•61, 95% CI 2•59 to 2•66), e-cigarette use (OR 2•61, 95% CI 2•59 to 2•64), and alcohol intoxication (OR 2•59, 95% CI 2•56 to 2•64) declined among 15-18-year-olds during COVID-19, with no similar gender differences.Interpretation Our results suggest that COVID-19 has significantly impaired adolescent mental health. However, the decrease observed in substance use during the pandemic might be an unintended benefit of isolation, and might serve as a protective factor against future substance use disorders and dependence. Population-level prevention efforts, especially for girls, are warranted.Funding Icelandic Research Fund.

Temporal trends in primary care-recorded self-harm during and beyond the first year of the COVID-19 pandemic: Time series analysis of electronic healthcare records for 2.8 million patients in the Greater Manchester Care Record

“…These complex social mechanisms will have likely impacted the mental health of many children and adolescents [40] . While the pandemic is likely to have affected adolescents’ mental health [41] , it is not known to what extent the increase we found reflects the existing trajectory of worsening mental health among adolescents prior to the pandemic [42] . In any case, self-harm is the strongest risk factor for suicide in adolescents and young people [43] and early intervention for young people who have self-harmed is recommended [44] .…”

The Impact of the COVID‐19 Pandemic on Adolescent Emotional, Social, and Academic Adjustment

“…Also, studies on other outcomes such as substance use are needed. Although findings so far suggest that e‐cigarette use declined and use of other tobacco, cannabis, and alcohol and alcohol intoxication declined or remained stable among 15‐ to 18‐year‐olds during COVID‐19 (Chaffee, Cheng, Couch, Hoeft, & Halpern‐Felsher, 2021 ; Thorisdottir et al., 2021 ), there are concerns regarding increases particularly for young adults. Together, these kind of studies will increase our understanding of the impact of the COVID‐19 pandemic on adolescent development, and will shed light on which adolescents are in most need of intervention and how policy and practice can best support them.…”

COVID-19 Infection in Children, Infants and Pregnant Subjects: An Overview of Recent Insights and Therapies

“…At the same time, there was a decrease in the use of drugs, a benefit derived from isolation [17]. The vulnerability linked to emotional-behavioural symptoms (for example, anxiety) of "pandemic adolescents" has led this population to less internalisation, but they engage in behaviours such as binge drinking, self-destructive behaviours, and obsessive use of social media related to uncontrolled eating attitudes [18].…”