Changes of psychotic-like experiences and their association with anxiety/depression among young adolescents before COVID-19 and after the lockdown in China

Abstract

Objective Lockdown policies during COVID-19 pandemic have potential adverse psychological impacts on youth. However, little is known about their influence on the changes of psychotic-like experiences (PLEs) among adolescents, nor about the possible association between changes in PLEs and changes in anxiety/depression symptoms. We investigated these two questions through a longitudinal comparative study. Methods In total, 1825 adolescents were surveyed before COVID-19 and after the lockdown in China (T0, October 20th, 2019 and T1, May 18th, 2020). PLEs, anxiety, and depression were measured with paranoia, anxiety and depression subscales of the Mental Health Inventory of Middle school students (MMHI-60). Within-subjects Wilcoxon test, Spearman correlation test, and Kruskal-Wallis test were adopted. Results Significant increase in adolescent PLEs scores was observed after the lockdown (Wilcoxon's w = 9.302, p < 0.001). We also found positive correlation between changes of PLEs and changes of anxiety/depression (Spearman's rho = 0.59/0.53, both p < 0.001). Furthermore, four PLEs trajectories were identified based on the report of PLEs at two timepoints: 60.4% with no PLEs, 9.3% remitted PLEs, 16.7% new PLEs, and 13.6% persistent PLEs. Significant difference was found in changes of anxiety/depression among four groups (p < 0.001); notably, the group with new-onset PLEs had the greatest exacerbation in anxiety/depression symptoms (both p Bonferroni <0.001). Conclusions This work is the first to identify increases in adolescent PLEs across the COVID-19 pandemic and suggested a close longitudinal association between PLEs and anxiety/depression. Our findings have implications for adolescent mental health crisis interventions during the pandemic.

Increasing Trends in Mental Health Problems Among Urban Chinese Adolescents: Results From Repeated Cross-Sectional Data in Changsha 2016–2020

“…Note that all participants were new seventh-grade students when they completed the survey, and all students were from the same campus of a high school (Tianding campus of The High School All participants completed the MMHI-60 in the classroom to assess their mental health statuses. MMHI-60 is a validated and widely used self-report measure of mental health problems, which includes 10 subscales of distinct dimensions (60 items in total, and 6 items for each subscale): obsessive-compulsive tendencies, paranoid ideation, hostility, interpersonal sensitivity, depression, anxiety, academic stress, maladaptation, emotional disturbance and psychological imbalance (12)(13)(14)(15)(16). All items were scored from 1 to 5, and higher scores indicate more severe mental health problems.…”

“…In specific, a total of 2,837 different urban adolescents from a sample high school in Changsha city, Hunan province in China were surveyed in three waves from 2016 to 2020. Mental health status was assessed using a validated multi-dimensional mental health scale, Mental Health Inventory of Middle School Students (MMHI-60) ( 12 , 13 ) and compared between different years.…”

Smartphone Use Time and Total Screen Time Among Students Aged 10–19 and the Effects on Academic Stress: A Large Longitudinal Cohort Study in Shanghai, China

“…Smartphone use time and total screen time were captured by calculating average smartphone use time and total screen time in the baseline and follow-up surveys. In the follow-up survey, academic stress was evaluated using the Academic Stress Subscale of Mental Health Inventory of Middle School Students (MMHI-60) ( 25 ), whose reliability and validity had been verified. Academic Stress Subscale of MMHI-60 was developed by Professor Wang et al ( 26 ) from the Institute of Psychology of the Chinese Academy of Science based on the Symptom Checklist-90 ( 27 ), which had been widely used to measure academic stress among Chinese primary and middle school students ( 28 , 29 ).…”

Association between Parents’ Relationship, Emotion-Regulation Strategies, and Psychotic-like Experiences in Adolescents

“…Adverse social and environmental factors in childhood and adolescence, including stressful and traumatic life events such as bully victimization [ 19 ] and child abuse [ 20 ], are linked to increased susceptibility to PLEs. Especially during the COVID-19 pandemic, the stress caused by the lockdown has led to increased PLEs among adolescents [ 21 ], and positive family functioning can be protective during this crisis [ 22 ]. Among these factors, family-related factors have received much concern in the study of psychosis.…”