Collaborative Outcomes Study on Health and Functioning During Infection Times (COH-FIT): Global and Risk-Group Stratified Course of Well-Being and Mental Health During the COVID-19 Pandemic in Adolescents.
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Solmi Marco, Thompson Trevor, Cortese Samuele, Estradé Andrés, Agorastos Agorastos, Radua Joaquim, Dragioti Elena, Vancampfort Davy, Thygesen Lau Caspar, Aschauer Harald, Schlögelhofer Monika, Aschauer Elena, Schneeberger Andres Andres, Huber Christian G, Hasler Gregor, Conus Philippe, Do Cuénod Kim Q, von Känel Roland, Arrondo Gonzalo, Fusar-Poli Paolo, Gorwood Philip, Llorca Pierre-Michel, Krebs Marie-Odile, Scanferla Elisabetta, Kishimoto Taishiro, Rabbani Golam, Skonieczna-Żydecka Karolina, Brambilla Paolo, Favaro Angela, Takamiya Akihiro, Zoccante Leonardo, Colizzi Marco, Bourgin Julie, Kamiński Karol, Moghadasin Maryam, Seedat Soraya, Matthews Evan, Wells John, Vassilopoulou Emilia, Gadelha Ary, Su Kuan-Pin, Kwon Jun Soo, Kim Minah, Lee Tae Young, Papsuev Oleg, Manková Denisa, Boscutti Andrea, Gerunda Cristiano, Saccon Diego, Righi Elena, Monaco Francesco, Croatto Giovanni, Cereda Guido, Demurtas Jacopo, Brondino Natascia, Veronese Nicola, Enrico Paolo, Politi Pierluigi, Ciappolino Valentina, Pfennig Andrea, Bechdolf Andreas, Meyer-Lindenberg Andreas, Kahl Kai G, Domschke Katharina, Bauer Michael, Koutsouleris Nikolaos, Winter Sibylle, Borgwardt Stefan, Bitter Istvan, Balazs Judit, Czobor Pál, Unoka Zsolt, Mavridis Dimitris, Tsamakis Konstantinos, Bozikas Vasilios P, Tunvirachaisakul Chavit, Maes Michael, Rungnirundorn Teerayuth, Supasitthumrong Thitiporn, Haque Ariful, Brunoni Andre R, Costardi Carlos Gustavo, Schuch Felipe Barreto, Polanczyk Guilherme, Luiz Jhoanne Merlyn, Fonseca Lais, Aparicio Luana V, Valvassori Samira S, Nordentoft Merete, Vendsborg Per, Hoffmann Sofie Have, Sehli Jihed, Sartorius Norman, Heuss Sabina, Guinart Daniel, Hamilton Jane, Kane John, Rubio Jose, Sand Michael, Koyanagi Ai, Solanes Aleix, Andreu-Bernabeu Alvaro, San José Cáceres Antonia, Arango Celso, Díaz-Caneja Covadonga M, Hidalgo-Mazzei Diego, Vieta Eduard, Gonzalez-Peñas Javier, Fortea Lydia, Parellada Mara, Fullana Miquel A, Verdolini Norma, Andrlíková Eva, Janků Karolina, Millan Mark J, Honciuc Mihaela, Moniuszko-Malinowska Anna, Łoniewski Igor, Samochowiec Jerzy, Kiszkiel Łukasz, Marlicz Maria, Sowa Paweł, Marlicz Wojciech, Spies Georgina, Stubbs Brendon, Firth Joseph, Sullivan Sarah, Darcin Asli Enez, Aksu Hatice, Dilbaz Nesrin, Noyan Onur, Kitazawa Momoko, Kurokawa Shunya, Tazawa Yuki, Anselmi Alejandro, Cracco Cecilia, Machado Ana Inés, Estrade Natalia, De Leo Diego, Curtis Jackie, Berk Michael, Carvalho Andre F, Ward Philip, Teasdale Scott, Rosenbaum Simon, Marx Wolfgang, Horodnic Adrian Vasile, Oprea Liviu, Alexinschi Ovidiu, Ifteni Petru, Turliuc Serban, Ciuhodaru Tudor, Bolos Alexandra, Matei Valentin, Nieman Dorien H, Sommer Iris, van Os Jim, van Amelsvoort Therese, Sun Ching-Fang, Guu Ta-Wei, Jiao Can, Zhang Jieting, Fan Jialin, Zou Liye, Yu Xin, Chi Xinli, de Timary Philippe, van Winkel Ruud, Ng Bernardo, Pena Edilberto, Arellano Ramon, Roman Raquel, Sanchez Thelma, Movina Larisa, Morgado Pedro, Brissos Sofia, Aizberg Oleg, Mosina Anna, Krinitski Damir, Mugisha James, Sadeghi-Bahmani Dena, Sheybani Farshad, Sadeghi Masoud, Hadi Samira, Brand Serge, Errazuriz Antonia, Crossley Nicolas, Ristic Dragana Ignjatovic, López-Jaramillo Carlos, Efthymiou Dimitris, Kuttichira Praveenlal, Kallivayalil Roy Abraham, Javed Afzal, Afridi Muhammad Iqbal, James Bawo, Seb-Akahomen Omonefe Joy, Fiedorowicz Jess, Daskalakis Jeff, Yatham Lakshmi N, Yang Lin, Okasha Tarek, Dahdouh Aïcha, Tiihonen Jari, Shin Jae Il, Lee Jinhee, Mhalla Ahmed, Gaha Lotfi, Brahim Takoua, Altynbekov Kuanysh, Negay Nikolay, Nurmagambetova Saltanat, Jamei Yasser Abu, Weiser Mark, Correll Christoph U
Аннотация
METHOD: This study was based on an anonymous online multi-national/multi-language survey in the general population (representative/weighted non-representative samples, 14-17 years of age), measuring change in well-being (World Health Organization-Five Well-Being Index [WHO-5]/range = 0-100) and psychopathology (validated composite P-score/range = 0-100), WHO-5 <50 and <29, pre- vs during COVID-19 pandemic (April 26, 2020-June 26, 2022). Coping strategies and 9 a priori- defined individual/cumulative risk factors were measured. A χ2, penalized cubic splines, linear regression, and correlation analyses were conducted.
RESULTS: Analyzing 8,115 of 8,762 initiated surveys (representative = 75.1%), the pre-pandemic WHO-5 and P-score remained stable during the study (excluding relevant recall bias/drift), but worsened during the pandemic by 5.55 ± 17.13 (SD) and 6.74 ± 16.06 points, respectively (effect size d = 0.27 and d = 0.28). The proportion of adolescents with WHO-5 scores suggesting depression screening (<50) and major depression (<29) increased from 9% to 17% and 2% to 6%. WHO-5 worsened (descending magnitude, with cumulative effect) in adolescents with a mental or physical disorder, female gender, and with school closure. Results were similar for the P-score, with the exception of school closure (not significant) and living in a low-income country, as well as not living in a large city (significant). Changes were significantly but minimally related to COVID-19 deaths/restrictions, returning to near-pre-pandemic values after >2 years. The 3 most subjectively effective coping strategies were Internet use, exercise/walking, and social contacts.
CONCLUSION: Overall, well-being/mental health worsened (small effect sizes) during the early stages of the COVID-19 pandemic, especially in vulnerable subpopulations. Identified at-risk groups, association with pandemic-related measures, and coping strategies can inform individual behaviors and global public health strategies.
PLAIN LANGUAGE SUMMARY: The impact of COVID-19 and related restrictions on the mental health of children and adolescents remains unclear. This study conducted an anonymous online survey with over 8,100 adolescents aged 14 to 17 years worldwide. Results showed a significant decline in wellbeing, with depression rates increasing from 9% to 17% returning to near- pre-pandemic values after about 2 years. Adolescents with preexisting mental health conditions, female youth, and those affected by school closures were particularly vulnerable. Effective coping strategies included internet use, exercise, and social contacts, highlighting areas for public health focus to support youth during pandemics.
STUDY PREREGISTRATION INFORMATION: Physical and mental health impact of COVID-19 on children, adolescents, and their families: The Collaborative Outcomes study on Health and Functioning during Infection Times - Children and Adolescents (COH-FIT-C&A); https://doi.org/10.1016/j.jad.2021.09.090 DIVERSITY & INCLUSION STATEMENT: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. We actively worked to promote sex and gender balance in our author group. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science.