Mental Health Status of Adolescents after Family Confinement During the COVID-19 Outbreak (preprint)

ABSTRACT

Background: With the global spread of Coronavirus Disease 2019 (COVID-19), governments around the world have implemented strategies for closing schools and teaching online from home. However, the psychological impact of family confinement on adolescents has not been examined. Methods: From November 2019 to January 2020, just before the COVID-19 outbreak, 14,241 Chinese teenagers aged 12-17 years from 5 middle schools across North China were surveyed in the first round of the national mental health investigation of adolescents. They were assessed with paper questionnaires, including the Chinese version of the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder Scale, the short form of the Childhood Trauma Questionnaire, and the Connor-Davidson Resilience Scale. After two months of home confinement, by March 2020, 10,768 of them were re-evaluated online using the same scales. Propensity score matching analysis was performed to analyze the psychological status of adolescents who reported potential risk of exposure to COVID-19. Findings: The first survey round yielded 13,637 valid questionnaires, on which 51.51% reported depressive symptoms and 38.53% reported anxiety symptoms. The second round yielded 10,216 valid questionnaires, on which the rates decreased to 38.29% and 23.73% respectively (all P<0.0001). Of the 10,216 adolescents, 223 reported potential risk of exposure to COVID-19. Propensity score matching analysis showed that adolescents with potential exposure risks had significantly higher rates of depression (60.54% vs 45.95% P=0.002) and anxiety (41.26% vs 28.83% P=0.007) symptoms than risk-free adolescents. Multivariate logistic regression analysis showed that potential exposure risk to COVID-19 was an independent risk factor for depression symptoms (OR, 2.241; 95%CI, 1.659-3.027; PInterpretations Long-term home confinement had no adverse psychological impact on adolescents from regions with a low incidence of COVID-19. However, several adolescent groups had serious psychological complications and needed interventions in time. These adolescents included those at potential risk of exposure to COVID-19. Therefore, the strategy of closing schools should be implemented at early stage of pandemic to minimize the adverse psychological impact on adolescents.Funding Statement This work was supported by the National Natural Science Foundation of China (Grant No.81573905) and program of National Clinical/Scientific Excellence in Chinese Medicine.Declaration of Interests There are no conflicts of interest.Ethics Approval Statement Our data collection protocol followed the American Association for Public Opinion Research (AAPOR) reporting guidelines, and was approved by the Ethics in Human Research Committee of the Third Affiliated Hospital of Beijing University of Chinese Medicine (No. BZYSY-2019KYKTPJ-21). We obtained informed consents from guardians before including participants in the study. The survey was anonymous and the information from the participants was confidential.