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.

Methods

In this longitudinal, population-based study, surveys were administered to a nationwide sample of 13–18-year-olds 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.

Translation

For the Icelandic translation of the abstract see Supplementary Materials section.

中文翻译：

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冰岛 COVID-19 大流行之前和期间青少年的抑郁症状、心理健康和物质使用：一项基于人群的纵向研究

背景

青春期是塑造心理健康轨迹的关键发展时期。在这项研究中，我们调查了 COVID-19 大流行在这个敏感的发展阶段对心理健康和物质使用的影响。

方法

在这项基于人群的纵向研究中，2016 年和 2018 年 10 月或 2 月以及 2020 年 10 月（在 COVID-19 大流行期间）对冰岛 13-18 岁的全国样本进行了调查。这些调查使用 Symptom Checklist-90 评估抑郁症状，使用 Short Warwick Edinburgh Mental Wellbeing Scale 评估心理健康，以及吸烟、电子烟使用和酒精中毒的频率。收集了人口统计数据，其中包括在家使用的语言，但不包括种族数据。我们使用混合效应模型来研究性别、年龄和调查年份对心理健康结果趋势的影响。

发现

包括 59 701 份调查回复；回应率从 63% 到 86% 不等。在所有患者中均观察到抑郁症状增加（β 0·57，95% CI 0·53 至 0·60）和心理健康状况恶化（β -0·46，95% CI -0·49 至 -0·42）大流行期间的年龄组与 COVID-19 之前的同龄人相比。与男孩相比，青春期女孩的这些结果显着更差（分别为 β 4·16，95% CI 4·05 至 4·28，以及 β -1·13，95% CI -1·23 至 -1·03） . 吸烟（OR 2·61，95% CI 2·59 至 2·66）、使用电子烟（OR 2·61，95% CI 2·59 至 2·64）和酒精中毒（OR 2·59） , 95% CI 2·56 到 2·64) 在 COVID-19 期间在 15-18 岁的人群中下降，没有类似的性别差异。

解释

我们的研究结果表明，COVID-19 严重损害了青少年的心理健康。然而，在大流行期间观察到的物质使用减少可能是隔离的意外好处，并可能成为预防未来物质使用障碍和依赖的保护因素。人群层面的预防工作，尤其是针对女孩的预防工作是有必要的。

资金

冰岛研究基金。

翻译

有关摘要的冰岛语翻译，请参阅补充材料部分。