Disease outbreaks linked to adverse mental health issues in adolescents, young people

The COVID-19 pandemic and H1N1 epidemic were associated with adverse mental health events in adolescents and youth from low- and middle-income countries, researchers reported in JAMA Psychiatry.

Previous studies indicate that during epidemics, adolescents and young people — especially in low- and middle-income countries — are at high risk for developing mental health issues, Manasi Kumar, PhD, of the department of psychiatry at the University of Nairobi in Kenya, and colleagues wrote.

Kumar and colleagues sought to identify the existing evidence regarding the association of mental health with outbreaks such as influenza A or H1N1, Zika, Ebola and SARS-CoV-2 in exposed youth and adolescents in low- and middle-income countries.

The researchers used six databases to assess the mental health outcomes of adolescents and youth aged 10 to 24 years associated with four major pandemic outbreaks from January 2009 to January 2021 in low- and middle-income countries.

Fifty-seven studies were included in the systematic scoping review. Of those, 55 were related to the SARS-CoV-2 pandemic, and two were related to the H1N1 influenza epidemic. No studies were associated with Zika or Ebola outbreaks, the authors reported.

According to Kumar and colleagues, high rates of anxiety and depressive symptoms were reported, including PTSD, general stress and health-related anxiety. Potential risk factors that were associated with poor mental health outcomes included female sex, living in an area with strict lockdown policies, reduced physical activities, poor parental or familial support, previous exposure to COVID-19 infection or being a part of a vulnerable population.

“Vulnerable youth and adolescents may be at higher risk of developing mental health–related complications, requiring more responsive interventions and further research,” Kumar and colleagues wrote.

Geographically localized disease outbreaks such as Ebola, Zika and H1N1 influenza are highly understudied, and further investigation is warranted, they wrote.

“As we found in our review, the Ebola and Zika outbreaks did not receive attention, which may have been attributable to their occurrence in economically constrained and marginalized countries,” they added.