Background Adolescence represents a crucial developmental period in shaping mental health trajectories. In this study, we investigated the effect of the COVID-19 pandemic on mental health and substance use during this sensitive developmental stage. MethodsIn this longitudinal, population-based study, surveys were administered to a nationwide sample of 13-18-yearolds in Iceland in October or February in 2016 and 2018, and in October, 2020 (during the COVID-19 pandemic). The surveys assessed depressive symptoms with the Symptom Checklist-90, mental wellbeing with the Short Warwick Edinburgh Mental Wellbeing Scale, and the frequency of cigarette smoking, e-cigarette use, and alcohol intoxication. Demographic data were collected, which included language spoken at home although not ethnicity data. We used mixed effects models to study the effect of gender, age, and survey year on trends in mental health outcomes. Findings 59 701 survey responses were included; response rates ranged from 63% to 86%. An increase in depressive symptoms (β 0•57, 95% CI 0•53 to 0•60) and worsened mental wellbeing (β -0•46, 95% CI -0•49 to -0•42) were observed across all age groups during the pandemic compared with same-aged peers before COVID-19. These outcomes were significantly worse in adolescent girls compared with boys (β 4•16, 95% CI 4•05 to 4•28, and β -1•13, 95% CI -1•23 to -1•03, respectively). Cigarette smoking (OR 2•61, 95% CI 2•59 to 2•66), e-cigarette use (OR 2•61, 95% CI 2•59 to 2•64), and alcohol intoxication (OR 2•59, 95% CI 2•56 to 2•64) declined among 15-18-year-olds during COVID-19, with no similar gender differences.Interpretation Our results suggest that COVID-19 has significantly impaired adolescent mental health. However, the decrease observed in substance use during the pandemic might be an unintended benefit of isolation, and might serve as a protective factor against future substance use disorders and dependence. Population-level prevention efforts, especially for girls, are warranted.Funding Icelandic Research Fund.

Adolescent use of social media platforms such as Facebook, Instagram, and Snapchat has increased dramatically over the last decade and now pervades their everyday social lives. Active and passive social media use may impact emotional health differently, but little is known about whether and to what extent either type of social media use influences emotional distress among young people. We analyzed population survey data collected from Icelandic adolescents (N = 10,563) to document the prevalence of social media use and investigate the relationship of both active and passive social media use to self-reported symptoms of anxiety and depressed mood. A hierarchical linear regression model revealed that passive social media use was related to greater symptoms of anxiety and depressed mood among adolescents and active social media use was related to decreased symptoms of anxiety and depressed mood, even after controlling for time spent on social media. When adding known risk and protective factors, self-esteem, offline peer support, poor body image and social comparison to the model, active use was not related to emotional distress; however, passive use was still related to adolescent symptoms of anxiety and depressed mood. The effect of social media on emotional distress differed by gender, as time spent on social media had a stronger relationship with emotional distress among girls. In addition, passive use was more strongly related to symptoms of depressed mood among girls. Future research should include risk and protective factors as mediators of different types of social media use and adolescent emotional distress.

The true extent of the mental health implications of the COVID-19 pandemic are unclear, but early evidence suggests poorer mental health among those exposed to the pandemic. The Internet may have differential effects, by both connecting people with resources, or reinforce the constant checking of negative information. Moreover, locus of control becomes important in an uncontrollable pandemic. The current study aimed to examine whether exposure to COVID-19 would relate to greater symptoms of depression, anxiety and stress, and to examine the role of internet use and locus of control. Adults in the United States and five European countries (N = 1723) answered an online survey through the website Mturk. Results show elevated psychological symptoms among those who have become infected with COVID-19 or perceive themselves to be at high risk if infected. Experience using the Internet relates to fewer symptoms, but information seeking is associated with more symptoms. Internet social capital relates to fewer symptoms of depression. Having an external locus of control relates to greater symptoms. These findings suggest that public health officials need to focus on the mental health effects of the pandemic, and that internet use and locus of control could be targets to improve mental health in the population.

Purpose of Review To review the literature on the trends in substance use among youth during the coronavirus SARS-CoV-2 (COVID-19) pandemic. Recent Findings The pandemic has given rise to concerns about the mental health and social well-being of youth, including its potential to increase or exacerbate substance use behaviors. This systematic review identified and included 49 studies of use across alcohol, cannabis, tobacco, e-cigarettes/vaping, and other drugs, and unspecified substances. The majority of studies across all categories of youth substance use reported reductions in prevalence, except in the case of other drugs and unspecified drug and substance use, which included three studies that reported an increase in use and three studies that reported decrease in use. Summary Overall, the results of this review suggest that the prevalence of youth substance use has largely declined during the pandemic. Youth substance use in the post-pandemic years will require monitoring and continued surveillance.