Purpose

The impact of the COVID-19 pandemic on adolescent mental health is a global concern; however, most research is cross-sectional or started after the pandemic response began and thus unable to evaluate within-individual change. The purpose of this prospective study was to evaluate the effect of the initial COVID-19 response on adolescent mental health and ill-health as a natural experiment.

Methods

We used 3-year linked data from the COMPASS study, including 7,653 Canadian (Quebec, Ontario) adolescents from which 2,099 completed surveys in all three waves (pre-COVID-19 [2018 and 2019] and online [May–July 2020], 2–3 months into the pandemic). A structural equation modeling approach to fixed effects and a difference-in-differences design were used to estimate pre-COVID-19–to–early lockdown change in mental health (psychosocial well-being [flourishing—reverse scored]) and ill-health (depression and anxiety symptoms), compared with 2018-to-2019 change. Models were adjusted for self-selection, age of entry into the cohort, and sociodemographics.

Results

Depression, anxiety, and reverse-flourishing scores increased across all waves; however, the mental health changes from the pre-COVID-19 wave (2019) to 2020 were not greater relative to the changes seen across the 2018-to-2019 waves.

Conclusions

Our results do not support a detrimental effect of the initial stages of the COVID-19 lockdown measures on adolescent mental health. The deterioration in mental health in the early COVID-19 response was less than the decline found over a prepandemic period. Further prospective research is needed to explore the impact of the prolonged pandemic and related measures on adolescents and inequitable effects in population subgroups.

中文翻译：

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COVID-19 大流行的最初几个月对加拿大青少年未来群体心理健康的影响分析

目的

COVID-19 大流行对青少年心理健康的影响是全球关注的问题；然而，大多数研究都是横向的，或者是在大流行应对措施开始后开始的，因此无法评估个体内部的变化。这项前瞻性研究的目的是作为自然实验来评估最初的 COVID-19 反应对青少年心理健康和疾病的影响。

方法

我们使用了 COMPASS 研究的 3 年关联数据，包括 7,653 名加拿大（魁北克省、安大略省）青少年，其中 2,099 名青少年完成了所有三轮调查（COVID-19 之前的调查[2018 年和 2019 年]以及在线调查[2020 年 5 月至 7 月]，疫情爆发后 2-3 个月）。使用固定效应的结构方程建模方法和双重差分设计来估计 COVID-19 之前到封锁早期的心理健康（心理社会福祉 [蓬勃发展 - 反向评分]）和健康状况不佳的变化（抑郁和焦虑症状）与 2018 年至 2019 年的变化相比。模型根据自我选择、进入队列的年龄和社会人口统计学进行了调整。

结果

抑郁、焦虑和逆向繁荣得分在所有波浪中均有所增加；然而，与 2018 年至 2019 年期间的变化相比，从 COVID-19 之前的浪潮（2019 年）到 2020 年的心理健康变化并没有更大。

结论

我们的结果并不支持 COVID-19 封锁措施的初始阶段对青少年心理健康产生不利影响。COVID-19 早期应对措施中心理健康状况的恶化程度低于大流行前时期的下降程度。需要进一步的前瞻性研究来探讨长期流行病和相关措施对青少年的影响以及对人口亚群体的不公平影响。