Background: The coronavirus disease 2019 (COVID-19) pandemic and mitigation measures are likely to have a marked effect on mental health. It is important to use longitudinal data to improve inferences. Aims: To quantify the prevalence of depression, anxiety and mental wellbeing before and during the COVID-19 pandemic. To identify groups at risk of depression and/or anxiety during the pandemic. Methods: Data were from two generations of the Avon Longitudinal Study of Parents and Children (ALSPAC): the index generation (ALSPAC-young, n=2850, mean age=28), parent's generation (ALSPAC-parents, n=3720, mean age=59), and Generation Scotland (GS, n=4233, mean age=59). Depression was measured using the Short Mood and Feelings Questionnaire (SMFQ) in ALSPAC and the Patient Health Questionnaire (PHQ-9) in GS. Anxiety and mental wellbeing were measured using the Generalised Anxiety Disorder Assessment (GAD-7) and the Short Warwick Edinburgh Mental Wellbeing Scale. Results: Depression during COVID-19 was similar to pre-pandemic levels in ALSPAC-young, but those experiencing anxiety almost doubled during COVID-19: 24% (95% CI: 23%, 26%) compared to pre-pandemic levels of 13% (95% CI: 12%, 14%). In both ALSPAC and Generation Scotland, anxiety and depression during COVID-19 was greater in younger members, in women, in those with preexisting mental/physical health conditions, and in individuals in socioeconomic adversity, even when controlling for pre-pandemic anxiety and depression. Conclusions: These results provide evidence for increased anxiety in young people that is coincident with the pandemic. Specific groups are at elevated risk of depression and anxiety during COVID-19. This is important for planning mental health provisions now and for long-term impact beyond this pandemic.

Background: The impact of COVID-19 on mental health is unclear. Evidence from longitudinal studies with pre pandemic data are needed to address (1) how mental health has changed from pre-pandemic levels to during the COVID-19 pandemic and (2), whether there are groups at greater risk of poorer mental health during the pandemic? Methods: We used data from COVID-19 surveys (completed through April/May 2020), nested within two large longitudinal population cohorts with harmonised measures of mental health: two generations of the Avon Longitudinal Study of Parents and Children (ALPSAC): the index generation ALSPAC-G1 (n= 2850, mean age 28) and the parents generation ALSPAC-G0 (n= 3720, mean age = 59) and Generation Scotland: Scottish Family Health Study (GS, (n= 4233, mean age = 59), both with validated pre-pandemic measures of mental health and baseline factors. To answer question 1, we used ALSPAC-G1, which has identical mental health measures before and during the pandemic. Question 2 was addressed using both studies, using pre-pandemic and COVID-19 specific factors to explore associations with depression and anxiety in COVID-19. Findings: In ALSPAC-G1 there was evidence that anxiety and lower wellbeing, but not depression, had increased in COVID-19 from pre-pandemic assessments. The percentage of individuals with probable anxiety disorder was almost double during COVID-19: 24% (95% CI 23%, 26%) compared to pre-pandemic levels (13%, 95% CI 12%, 14%), with clinically relevant effect sizes. In both ALSPAC and GS, depression and anxiety were greater in younger populations, women, those with pre-existing mental and physical health conditions, those living alone and in socio-economic adversity. We did not detect evidence for elevated risk in key workers or health care workers. Interpretation: These results suggest increases in anxiety and lower wellbeing that may be related to the COVID-19 pandemic and/or its management, particularly in young people. This research highlights that specific groups may be disproportionally at risk of elevated levels of depression and anxiety during COVID-19 and supports recent calls for increasing funds for mental health services. Funding: The UK Medical Research Council (MRC), the Wellcome Trust and University of Bristol.

Objective To describe the prevalence of depression in children with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and investigate the relationship between depression in CFS/ME and clinical symptoms such as fatigue, disability, pain and school attendance. Design Cross-sectional survey data using the Hospital Anxiety and Depression Scale (HADS) collected at assessment. Setting Specialist paediatric CFS/ME service in the South West. Patients Children aged 12-18 years with CFS/ME. Main outcome measure Depression was defined as scoring >9 on the HADS depression scale.Results 542 subjects had complete data for the HADS and 29% (156/542) (95% CI 25% to 33%) had depression. In a univariable analysis, female sex, poorer school attendance, and higher levels of fatigue, disability, pain, and anxiety were associated with higher odds of depression. Age of child and duration of illness were not associated with depression. In a multivariable analysis, the factors most strongly associated with depression were disability, with higher scores on the physical function subscale of the 36 item Short Form (SF-36). Conclusions Depression is commonly comorbid with CFS/ME, much more common than in the general population, and is associated with markers of disease severity. It is important to screen for, identify and treat depression in this population.

rise reflects an increase in population prevalence is unclear. The apparent increase could indicate a greater willingness to discuss such issues, and a better recognition of mental health difficulties by referring clinicians, rather than increases in morbidity.One way to assess this question is to investigate rates of death by suicide. If the apparent rise in rates of emotional problems is due to increased recognition and referral of such difficulties, concurrent changes in suicide rate would not be expected. Using data from the Office for National Statistics, we did a Joinpoint regression analysis 3 to investigate changes in the rate of suicide among adolescents aged 15-19 years between 1981 and 2017 in England and Wales. The bestfitting model showed that between 2010 (95% CI 2006CI , 2015 and 2017, suicide rates per 100 000 adolescents increased by 7•9% per year (95% CI 4•8 to 11•2; figure). Trends differed by sex, although rates increased for both sexes. In men, suicides rates increased by 5•9% per year (2•9 to 9•0) between 2009 and 2017 (appendix). The absolute number of deaths by suicide is lower for women than for men between 1981 and 2017; however, intervene by raising national awareness, by funding resources for effective diagnosis, care, and treatment, and by promoting their social inclusion.We declare no competing interests.

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Background: Some people with eating disorders have difficulties with social communication. However, no longitudinal evidence regarding the direction of this association exists. We investigated trajectories of autistic social traits across childhood and adolescence in adolescents with and without disordered eating behaviours in early adolescence. Methods: We used data from the Avon Longitudinal Study of Parents and Children. Our disordered eating measure indicated presence of any, monthly and weekly disordered eating (fasting, purging, dieting, binge eating) at age 14 years. Autistic social traits were reported by mothers using the Social and Communication Disorders Checklist (SCDC) at age seven, 11, 14 and 16 years. We modelled SCDC score trajectories using multilevel negative binomial models adjusting for a number of child-and maternal-level confounders. Results: Of the 5,381 adolescents included in our sample, 421 (7.8%) experienced one or more disordered eating behaviours, and 148 (2.8%) weekly episodes. Adolescents with disordered eating had a 20% increase in SCDC scores (relative risk (RR) 1.23, 95% confidence interval (CI):1.14, 1.32) compared to those without disordered eating. This association was particularly apparent for those reporting weekly (RR 1.43, 95%CI: 1.27, 1.61) as opposed to monthly disordered eating (RR 1.12, 95%CI: 1.01, 1.22). Conclusions: Greater autistic social traits in childhood could represent a risk factor for the development of disordered eating in adolescence. Although mechanisms of this association need to be elucidated, clinicians should be aware that autistic social traits could have predated the eating disorder when managing people with these conditions.

Highlights We investigated 2000-2017 youth suicide trends in populous high-income countries. 4 of the 11 study countries are experiencing a rise in youth suicide rates. There was little evidence of an association between social media use. Evidence of an association with the 2008 economic recession was inconsistent. The rises were associated with some measures of income inequality and GDP.

Children we believe to be fasted may not be. Parents may deliberately misrepresent the actual fasting status of their child. Adherence to fasting advice may be affected by parents' recall and understanding of fasting advice.