Longitudinal trajectories of depression and anxiety among adolescents during COVID-19 lockdown in China

• Published in: Journal of affective disorders 2022-02, Vol.299, p.628-635
• Main Authors: Wang, Dongfang, Zhao, Jingbo, Ross, Brendan, Ma, Zijuan, Zhang, Jinfang, Fan, Fang, Liu, Xianchen
• Format: Article
• Language: English
• Subjects: Adolescent; Anxiety; Anxiety - epidemiology; China - epidemiology; Communicable Disease Control; COVID-19; Depression; Depression - epidemiology; Humans; Longitudinal studies; SARS-CoV-2; Trajectories
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2021.12.086

•This was the large-scale longitudinal study to examine the psychological symptoms among adolescents.•This was the first study to explore trajectories of depression and anxiety across different stages of the COVID-19 pandemic.•The influences of demographic characteristics, pandemic related factors, and psychological factors was both considered. This study examines the patterns and predictors of depression and anxiety trajectories among adolescents during COVID-19 lockdown in China. A total of 35,516 college students were followed from the pandemic outbreak period, initial remission period, and control period. Participants completed the Patient Heath Questionnaire, Generalized Anxiety Disorder Scale, Perceived Social Support Scale, the Simplified Coping Style Questionnaire, and APGAR-family scale. Distinct patterns of depression and anxiety trajectories were established through grouping participants based on time-varying changes of the cut-off score. Multivariate logistic regressions were used to examine predictors for trajectory membership. Depression and anxiety prevalence during the COVID-19 outbreak were 21.3% and 11.5% respectively, and symptoms worsened as the lockdown time increased. Five depression/anxiety trajectories were observed: resistance, recovery, relapsing/remitting, delayed-dysfunction and chronic-dysfunction. Gender, academic year, residence location, history of mental health, and COVID-19 community exposure were significant predictors of distinct trajectories for depression or anxiety. Less social support or positive coping, more negative coping, and poorer family function were also risk predictors for not developing delayed or chronic dysfunction. Although most adolescents remain euthymic or recover over time, some adolescents, especially those with the risk factors noted above, exhibit delayed or chronic symptoms. Thus, the need for individualized intervention with these adolescents is indicated.