Mental health problems among adolescents during the COVID-19 pandemic: a repeated cross-sectional study from Sweden

Abstract

Objective: Most international studies have concluded that exposure to the COVID-19 pandemic was associated with worse mental health. Sweden implemented lighter restrictions than many other countries. We evaluated the association between changes in exposure of COVID-19 restrictions and changes in mental health problems among Swedish adolescents. Method: Repeated cross-sectional data were derived from the Stockholm school survey, mandatory for all students in municipal schools and voluntary for students in private schools. Unexposed students were assessed in the year 2020 and exposed were assessed in 2022. Mental health was assessed using items similar to the psychosomatic problem scale. All variables were dichotomised, and a non-parametric logistic regression was used to evaluate associations. Results: A significant positive association was found between exposure of COVID-19 restrictions and self-reports of five to seven mental health problems a week for girls (odds ratio (OR) 1.29, 95% confidence interval (CI) 1.18–1.41), but a non-significant association was found for boys (also after controlling for relevant covariates). Among boys and girls (shown), changes in mental health during the pandemic were moderated by social support from parents (OR 2.23, 95% CI 1.98–2.51), bullying victimisation (OR 2.24, 95% CI 2.06–2.66), a sensation-seeking temperament (OR 1.40, 95% CI 1.24–1.58) and school achievement (OR 1.34, 95% CI 1.18–1.51). Conclusions: Compared with boys, adolescent girls self-reported worse mental health following COVID-19 exposure. Girls may have been more affected by social distancing regulations in Sweden during the pandemic than boys and may require additional psychosocial support post-pandemic. Social support from parents may play an important role.

Impact of the COVID-19 Pandemic on Swedish Adolescents’ Mental Health, Psychosocial Functioning, Risk Behaviours, and Victimisation: Gender Differences and Implications

“…The conflicting findings between these Swedish studies are fascinating yet challenging to explain. One possible explanation could be that the different studies [42,43] examined only limited aspects of mental health, focusing on anxiety and various worry themes as well as depression and somatic complaints [27]. In contrast, the current study conceptualises mental health in a broader sense, encompassing symptoms of anxiety, depression, loneli-ness, anger, and involvement in conflict.…”

“…This finding is noteworthy because a previous review [41] and a study focused on the same population [28] in a multinational context showed a higher increase in mental health issues among young women. In the context of Swedish adolescents, several studies demonstrated that adolescent women reported experiencing poorer mental health outcomes such as headaches, depression, feeling fear, stomach problems, difficulty sleeping, poor appetite, and increased anxiety and worry levels after exposure to COVID-19 compared to adolescent men [27,42,43].…”

Adolescent’s health and well-being into the COVID-19 pandemic: A two-wave prospective investigation – The HUNT Study

“…In the study by Hafstad et al, somatic health complaints were shown to increase ahead of and 15 months into the pandemic whereof girls appeared to be more affected than boys [19]. Other studies also report a more adverse effect on mental health in girls compared to boys [17,21,22]. Most studies published concerning the COVID-19 pandemic's effect on adolescents have been based on cross-sectional data not being able to shed light on the longitudinal effects within the same group of individuals.…”