Pandemic has led to increased prevalence of high depressive symptoms in adolescents

The COVID pandemic has increased depressive illnesses and led to a decrease in life satisfaction among adolescents, Government research has concluded.

The study also suggested that the mental health of girls was more affected by the pandemic than boys. However, overall, these effects have not led to an increase in externalising disorders.

The project is one of the largest school-based trials of mental health interventions conducted in the UK. The investigating team comprised researchers from universities across England and Scotland, and from the Evidence Based Practice Unit (EBPU) at the Anna Freud National Centre for Children and Families.

A total of 11,450 pupils from 178 schools took part in the study. The pre-COVID-19 (phase one) group comprised 6,419 pupils from 90 schools; phase two – the COVID-19 group -- involved 5,031 pupils from 88 schools.

The pupils were in Years 7, 8, and 9 during both phases, with approximately equal numbers of boys and girls. Phase 1 schools completed their baseline surveys in September - October 2018 and the 1-year follow-up between January - March 2020, so had not experienced the COVID-19 pandemic.

Those in Phase 2 schools completed their baseline surveys after the start of the pandemic, in September to October 2019, with the one- year follow-up between February-April 2021.

“The groups were compared on a range of school and individual-level characteristics such as free school meal (FSM) eligibility, and were found to be similar.”

Depressive symptoms were assessed using the Short Mood and Feelings Questionnaire, which included 13 self-report items, capturing experiences of symptoms in the previous two weeks.

The report says that externalising difficulties were measured using the behavioural difficulties sub-scale in the Me and My Feelings Questionnaire, a widely used measure developed by the EBPU. Examples include ‘I lose my temper’ and ‘I hit out when I am angry’.

“Life satisfaction was captured using the Huebner Life Satisfaction Scale. The 7-item adapted version was used in the current study and items recoded so that high scores indicated greater life satisfaction. Only a continuous measure of life satisfaction was included,” the report says.

“If the COVID-19 pandemic had not occurred, estimates suggest that we would observe 6% fewer adolescents with high depressive symptoms. This equates to a difference of 1.6% prevalence. Given that the prevalence of high depressive symptoms in the data was 27.1%, it can be estimated that in a scenario where the COVID-19 pandemic did not happen, the prevalence would be 25.5%.”

Adolescents eligible for free school meals showed lower life satisfaction than those not eligible, across both the control and the COVID-19 groups.

“However, those in higher socio-economic position showed a greater difference between life satisfaction scores in the control group and the COVID-19 group, with life satisfaction scores decreasing closer to levels of the FSM eligible group. No clear subgroup effects were observed for ethnicity and special educational needs (SEN) status.”

The report points out that prior to the COVID-19 pandemic, rates of adolescent mental health difficulties in England were already of increasing concern.

It adds: “This current study suggests that many young people were experiencing high depressive symptoms during the early stages of the pandemic while schools and Child and Adolescent Mental Health Services (CAMHS) were trying to adapt to the challenging circumstances.”

“The large proportion of adolescents with high depressive symptom scores during the pandemic demonstrates a high level of need for professional support.”

In the future, the report concludes, “given the potential long-term nature of impacts, it is important to prioritise mental health support for school-aged children and young people. This will require significant focus of resources and activity through a comprehensive public health approach that builds capacity within and between sectors to promote this populations’ mental health and provide both early help in school and community settings alongside targeted support.”