Pedrini Laura, Meloni Serena, Lanfredi Mariangela, Ferrari Clarissa, Geviti Andrea, Cattaneo Annamaria, Rossi Roberta
Unit of Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni, 4, Brescia, Italy.
Statistics Service, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni, 4, Brescia, Italy.
Child Adolesc Psychiatry Ment Health. 2022 Jun 10;16(1):42. doi: 10.1186/s13034-022-00474-x.
Adolescents have been deeply exposed to negative consequences of social distancing imposed by Covid-19. There is a lack of longitudinal studies regarding the impact on adolescents of this unfavorable condition, and their results are controversial. The aim of the present prospective study is to assess psychopathological symptoms in adolescent students over time and to evaluate what type of impact the Covid-19 pandemic had on adolescents. Moreover, the association between mental health indexes, potential risk and resilience factors is explored.
Psychopathological symptoms (i.e., anxiety, depression, stress, emotional dysregulation, maladaptive behaviours), and potential risk and resilience factors (i.e., childhood trauma, emotional regulation skills, family function, personality traits) were assessed among a sample of 153 students (72% female; mean age 16.1 ± 0.49), living in a medium-size city in the north of Italy, at two time points: before the outbreak of the Covid-19 pandemic (November 2019-January 2020) and 1 year later (April-May 2021).
After 1 year, we found an increase in mean scores on anxiety, stress for future uncertainty, and higher frequency of maladaptive behaviours. By contrast, the level of stress related to social domains (i.e., school attendance, romantic relationships, peer pressure) decreased. Dysfunctional emotional regulation skills, childhood trauma, low family functioning, and specific personality traits were associated to higher psychopathological symptoms. Cluster analysis detected three groups of youths based on their change over time in psychopathological symptoms: those who worsened (N = 23; 15%), improved (N = 55; 34%), or remained stable (N = 75; 46%). After controlling for baseline mental health status, those adolescents reporting increase in self-harm (OR = 2.61; p < 0.001), binge-drinking (OR = 3.0; p = 0.007), aggressiveness (OR 1.92; p = 0.004), and binge-eating (OR 2.55; p = 0.003) were more likely to present a worsened mental health condition.
The present results suggest that the Covid-19 pandemic seems to have had a different impact on subgroups of students. Indeed, we found a global worsening of psychological well-being only in a subgroup of adolescents, otherwise other students remained stable or improved. Increased frequency of maladaptive behaviors was found as a predictor of worsened mental health, therefore interventions to strengthen emotional regulation strategies are warranted. Finally, the decrease of stress in social domains could be due to reduction of potential triggering situations, thus indicating only a temporary beneficial effect that requires careful monitoring.
青少年深受新冠疫情实施社交距离措施带来的负面影响。关于这种不利状况对青少年的影响，缺乏纵向研究，且研究结果存在争议。本前瞻性研究的目的是评估青少年学生一段时间内的心理病理症状，并评估新冠疫情对青少年产生了何种影响。此外，还探讨了心理健康指标、潜在风险和复原力因素之间的关联。
在意大利北部一个中等规模城市的153名学生（72%为女性；平均年龄16.1±0.49岁）样本中，于两个时间点评估心理病理症状（即焦虑、抑郁、压力、情绪失调、适应不良行为）以及潜在风险和复原力因素（即童年创伤、情绪调节技能、家庭功能、人格特质）：新冠疫情爆发前（2019年11月至2020年1月）和1年后（2021年4月至5月）。
1年后，我们发现焦虑、对未来不确定性的压力的平均得分有所增加，适应不良行为的频率更高。相比之下，与社交领域（即上学、恋爱关系、同伴压力）相关的压力水平有所下降。功能失调的情绪调节技能、童年创伤、家庭功能低下和特定人格特质与较高的心理病理症状相关。聚类分析根据心理病理症状随时间的变化将青少年分为三组：症状恶化组（N = 23；15%）、改善组（N = 55；34%）或保持稳定组（N = 75；46%）。在控制基线心理健康状况后，那些报告自我伤害增加（OR = 2.61；p < 0.001）、暴饮（OR = 3.0；p = 0.007）、攻击性增加（OR = 1.92；p = 0.004）和暴饮暴食增加（OR = 2.55；p = 0.003）的青少年更有可能出现心理健康状况恶化。
目前的结果表明，新冠疫情似乎对不同的学生亚组产生了不同的影响。事实上，我们发现只有一部分青少年的心理健康状况总体恶化，而其他学生则保持稳定或有所改善。适应不良行为频率增加是心理健康状况恶化的一个预测因素，因此有必要采取干预措施加强情绪调节策略。最后，社交领域压力的降低可能是由于潜在触发情况的减少，因此仅表明是一种需要密切监测的暂时有益效果。
