Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China.
The High School Attached to Hunan Normal University and Bocai Experimental School, Changsha, Hunan, China.
Schizophr Res. 2021 Nov;237:40-46. doi: 10.1016/j.schres.2021.08.020. Epub 2021 Sep 1.
Lockdown policies during COVID-19 pandemic have potential adverse psychological impacts on youth. However, little is known about their influence on the changes of psychotic-like experiences (PLEs) among adolescents, nor about the possible association between changes in PLEs and changes in anxiety/depression symptoms. We investigated these two questions through a longitudinal comparative study.
In total, 1825 adolescents were surveyed before COVID-19 and after the lockdown in China (T0, October 20th, 2019 and T1, May 18th, 2020). PLEs, anxiety, and depression were measured with paranoia, anxiety and depression subscales of the Mental Health Inventory of Middle school students (MMHI-60). Within-subjects Wilcoxon test, Spearman correlation test, and Kruskal-Wallis test were adopted.
Significant increase in adolescent PLEs scores was observed after the lockdown (Wilcoxon's w = 9.302, p < 0.001). We also found positive correlation between changes of PLEs and changes of anxiety/depression (Spearman's rho = 0.59/0.53, both p < 0.001). Furthermore, four PLEs trajectories were identified based on the report of PLEs at two timepoints: 60.4% with no PLEs, 9.3% remitted PLEs, 16.7% new PLEs, and 13.6% persistent PLEs. Significant difference was found in changes of anxiety/depression among four groups (p < 0.001); notably, the group with new-onset PLEs had the greatest exacerbation in anxiety/depression symptoms (both p Bonferroni <0.001).
This work is the first to identify increases in adolescent PLEs across the COVID-19 pandemic and suggested a close longitudinal association between PLEs and anxiety/depression. Our findings have implications for adolescent mental health crisis interventions during the pandemic.
新冠疫情期间的封锁政策对年轻人可能产生潜在的不良心理影响。然而，人们对封锁政策对青少年类精神病体验（PLE）变化的影响知之甚少，也不知道 PLE 变化与焦虑/抑郁症状变化之间可能存在的关联。我们通过一项纵向比较研究调查了这两个问题。
共对 1825 名青少年进行了调查，分别在新冠疫情前（T0，2019 年 10 月 20 日）和中国封锁后（T1，2020 年 5 月 18 日）进行了调查。使用中学生心理健康量表（MMHI-60）的妄想、焦虑和抑郁分量表测量 PLE、焦虑和抑郁。采用组内 Wilcoxon 检验、Spearman 相关检验和 Kruskal-Wallis 检验。
封锁后青少年 PLE 评分显著增加（Wilcoxon 的 w=9.302，p<0.001）。我们还发现 PLE 变化与焦虑/抑郁变化之间存在正相关（Spearman 的 rho=0.59/0.53，均 p<0.001）。此外，根据两次 PLE 报告，确定了 4 种 PLE 轨迹：60.4%无 PLE，9.3% PLE 缓解，16.7%新 PLE，13.6%持续 PLE。四组焦虑/抑郁变化差异有统计学意义（p<0.001）；值得注意的是，出现新发作 PLE 的组焦虑/抑郁症状恶化最严重（均 p Bonferroni <0.001）。
这项工作首次确定了新冠疫情期间青少年 PLE 增加，并提示 PLE 与焦虑/抑郁之间存在密切的纵向关联。我们的研究结果为疫情期间青少年心理健康危机干预提供了依据。
