Interventions needed for adolescents with pandemic-related anxieties

Most adolescents in a cohort study conducted in Norway coped well during the COVID-19 pandemic, but intervention strategies may need to identify youth disproportionately affected by anxieties related to the pandemic, researchers noted.

“Emerging evidence suggests that there is a negative association between the pandemic and multiple domains of young people’s health and well-being, especially mental and social health (eg, depression, quality of life, loneliness) and physical activity,” Jasmina Burdzovic Andreas, PhD, ScM, of the department of alcohol, tobacco and drugs at the Norwegian Institute of Public Health, and colleagues wrote in JAMA Network Open.

“Consequently, understanding in what ways and to what extent the pandemic is associated with health and well-being outcomes among various youth subpopulations remains a public health priority, with the related need for high-quality, nuanced research,” they continued. “Such research could also help clarify what strategies may be needed to mitigate the impact of COVID-19 and accompanying policies and identify the groups in greatest need of such strategies.”

The investigators analyzed data collected from a diverse nationwide sample of students who participated in the longitudinal MyLife study in Norway. They examined two cohorts with comparable sociodemographic characteristics, with one cohort including students who entered high school in 2020, considered the COVID-19 cohort (n = 915). Those who entered high school in 2018 and 2019 (n = 1,621) composed the single pre–COVID-19 cohort. The COVID-19 pandemic and related conditions in Norway served as the exposures. Adolescents reported depression symptoms via the Patient Health Questionnaire-9 in grades 10 and 11, with high school beginning in grade 11 in Norway. Scores of 15 or higher signaled moderate/severe depression. They also reported number of close friends, physical health and participation in organized sports. Burdzovic Andreas and colleagues evaluated cohort differences using a set of nested regression models that incrementally controlled for sociodemographic covariates and grade 10 outcomes.

Results showed high pandemic anxiety among 158 (17.3%) adolescents in the COVID-19 cohort. Lower odds of participation in organized sports (adjusted OR [aOR] = 0.69; 95% CI, 0.56-0.87) was the significant difference between the two cohorts; however, subanalyses that compared adolescents with anxiety during the pandemic with adolescents in the pre-COVID-19 cohort showed an increased risk for experiencing clinical-level depression symptoms (aOR = 2.17; 95% CI, 1.39-3.37) and poor physical health (aOR = 1.53; 95% CI, 1.01-2.31) among those with high pandemic anxiety.

“Additional research is needed to identify risk factors and characteristics associated with heightened stress and anxiety during the pandemic period among adolescents,” Burdzovic Andreas and colleagues wrote. “Public health strategies cannot proceed without identifying adolescents who are worried about infection, school, and other health and social consequences of the pandemic and without understanding whether those worries are perceived or genuine (and if so, why) and what other risk factors may be associated with them. Such at-risk groups of adolescents may be disproportionately affected by the pandemic and may require specialized strategies addressing their mental and physical health needs.”