Pandemic restrictions exacerbated adolescent mental health burden

Following imposed lockdowns and remote schooling in Austria, adolescents experienced significantly lower mental health and life satisfaction in 2021 compared with 2018, according to a cross-sectional study published in JAMA Network Open.

“Our results suggest a high prevalence of mental disorders 1 year after the COVID-19 pandemic began in Austria,” Christoph Pieh, MD, professor of psychotherapy and biopsychosocial health at Danube University in Austria, and colleagues wrote. “These findings highlight the need to implement health promotion and prevention strategies among adolescents.”

Pieh and colleagues assessed the impact COVID-19 restrictions in Austria had on the mental health of adolescents aged 14 to 20 years. The 3,052 students voluntarily participated experienced one semester of remote schooling and about 1 year of social distancing. The researchers asked students to answer survey questions through which they assessed the students’ well-being with the WHO-5 Well-being Index, depression with the Patient Health Questionairre-9, anxiety with the General Anxiety Disorder-7, sleep quality with the Insomnia Severity Index and disordered eating with the Eating Attitudes Test. Students completed the surveys online between February 3 and February 28.

Most (70.1%) participants were female. Overall, 55% had depressive symptoms, 47% had clinically relevant anxiety symptoms, 22.8% had moderate insomnia and 59.5% exhibited disordered eating behavior. Also, 8.9% of students reported almost daily suicidal thoughts and 7.4% reported them more than half the days during the 2 weeks prior to the survey. Increased cell phone use correlated with worsened mental health, according to the researchers. Phone use doubled overall among the students surveyed, and those used their phone the most reported a four-fold increase, greater than 8 hours of phone use a day. Moreover, mental wellbeing and life satisfaction decreased among students, with male students having worse scores.

The researchers acknowledged that since the study was voluntary, more students with a greater mental health burden could have participated, suggesting bias in the results.

“The findings of this cross-sectional study suggest that the COVID-19 pandemic was associated with impaired mental health,” Pieh and colleagues wrote. “The mental wellbeing and life satisfaction in adolescents in Austria were significantly lower in 2021 compared with in 2018.”