A longitudinal study of mental health in at-risk adolescents before and during the COVID-19 pandemic

Abstract

Although cross-sectional studies have shown that the COVID-19 pandemic has negatively affected the mental health of adolescents, the effect of the pandemic on adolescents with pre-pandemic symptoms is unclear. We, therefore, tested the hypothesis that adolescents had increased emotional and behavioral problems during the lockdowns imposed during the pandemic.This study included three measurements in a prospective cohort of 1022 adolescents who were oversampled based on their high risk of developing psychopathology. Before the pandemic, we assessed depressive, anxiety, stress, oppositional defiant problems, psychotic experiences and suicidality, using the Youth Self-Report; 445 and 333 of these 1,022 adolescents subsequently completed the online questionnaire in the first lockdown (in April 2020) and in the second lockdown (in January 2021), respectively. Multilevel random intercept regression models were used to determine the change in psychiatric symptoms, including an interaction term to assess whether these changes differed based on the severity of symptoms prior to the pandemic. Throughout the pandemic, the majority of the participating adolescents reported having emotional and behavioral symptoms that were within the normal range. Moreover, the mean symptom scores for all six outcomes decreased significantly among adolescents with high clinical severity prior to the pandemic.In contrast to our original hypothesis, the effects of the COVID-19 pandemic may not necessarily be detrimental, at least among a specific subgroup of adolescents with pre-existing mental health problems. Moreover, our finding that most adolescents in this at-risk sample did not report experiencing clinically relevant symptoms during the pandemic reflects their resilience during the pandemic.

Factors associated with resilience among children and youths with disability during the COVID-19 pandemic

“…At the same time, some studies have not found a differential impact of the COVID-19 pandemic among some children and youths with disability [10][11][12][13][14]. One longitudinal study did not find significant differences compared to pre-pandemic levels in caregiver distress, caregiver life satisfaction, nor internalising or externalising problems in children with intellectual disability [15].…”

Changes in Canadian Adolescent Well-Being since the COVID-19 Pandemic: The Role of Prior Child Maltreatment

“…For example, the results of a study by Hamza et al (2021) revealed that although postsecondary students with pre-existing mental health concerns continued to present mental health concerns during the pandemic, they showed similar or improving mental health during the pandemic compared with the previous (pre-pandemic) year [ 50 ]. Another study conducted in the Netherlands also reported decreases in adolescent mental health symptoms among those who had the highest clinical severity of symptoms pre-pandemic [ 51 ]. Taken together, these results may suggest that more vulnerable adolescents develop resilience in the face of other adversities, such as the COVID-19 pandemic.…”

Santé mentale et Covid : toutes et tous concernés. Une revue narrative

“…Il y a peu de données longitudinales et, tout comme chez l’adulte, il est intéressant d’étudier les données issues de cohortes déjà suivies avant la pandémie. Les données issues d’une cohorte sur 1 222 adolescents déjà suivis et identifiés « à risque » [7] ont permis une mesure avant la pandémie, au début (avril 2020, premier confinement) et en janvier 2021 (deuxième confinement). De façon similaire à ce qui a pu être observé chez l’adulte [24] , la santé mentale des participants antérieurement les plus fragiles sur le plan émotionnel et comportemental s’est moins dégradée pendant la pandémie.…”