JMIR Publications

ABSTRACT

Background:

Adolescents are vulnerable to mental illness and have experienced significant disruption due to the COVID-19 pandemic. Digital environment is increasingly important in the context of pandemic when in-person social connection is restricted.

Objective:

We aimed to estimate whether depression and anxiety had worsened compared to pre-pandemic and examine potential associations with sociodemographic characteristics and behavioural factors, particularly digital behaviours.

Methods:

We analysed cross-sectional and longitudinal data from the large, representative adolescent cohort across Greater London in the Study of Cognition, Adolescents and Mobile Phones (SCAMP). Participants completed surveys between November 2016 and July 2018 (n=4978, ages 13-15, T1) and between July 2020 and June 2021 (n=1328, ages 16-18, T2). Depression and anxiety were measured by the Patient Health Questionnaire and Generalized Anxiety Disorder scale, respectively. Information on durations of total mobile phone use, social network site (SNS) use, and video gaming was also collected by questionnaires.

Results:

The proportion of adolescents for clinical depression and anxiety significantly increased at T2 (depression: 30.9%; anxiety: 25.9%) compared to T1 (depression: 15.3%; anxiety: 13.2%) (P for two-proportion z-test <0.001 for both depression and anxiety). Depression and anxiety levels were similar between summer holiday, school opening, and school closures. Females had higher odds of new incident depression (OR=2.5, 95% CI 1.5-4.18) and anxiety (OR=2.11, 95% CI 1.23-3.61) at T2. High level of total mobile phone use at T1 was associated with developing depression at T2 (OR: 1.89, 95% CI 1.02-3.49). SNS use was associated with depression and anxiety cross-sectionally at T1 and T2 but did not appear to be associated with developing depression or anxiety longitudinally. Insufficient sleep at T1 was associated with developing depression at T2 (OR: 2.26, 95% CI 1.31-3.91).

Conclusions:

The mental health of this large sample of London adolescents deteriorated during the pandemic without noticeable variations relating to public health measures. The deterioration was exacerbated in girls, those with pre-existing high total mobile phone use, and those with pre-existing disrupted sleep. However, SNS use appeared to offer some protection against developing depression during the pandemic. Our findings indicate that resources to target these modifiable factors and high-risk groups are needed.