PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway.
JAMA Netw Open. 2024 Jul 1;7(7):e2422189. doi: 10.1001/jamanetworkopen.2024.22189.
Adolescence is a critical developmental phase when mental health disorders, such as anxiety and depression, often emerge. Stringent public health measures and quarantine mandates during the COVID-19 pandemic could threaten adolescent mental health.
To investigate the associations of public health measures and quarantine experiences with mental distress among Norwegian adolescents and to explore if certain vulnerability factors moderate these associations.
DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study used repeated measures to capture variations in mental distress explained by the stringency of public health measures and quarantine experiences. Data from the Norwegian Mother, Father, and Child cohort study were linked to national health registries and a national stringency index from April 1, 2020, to February 17, 2021. Participant included 7787 Norwegian adolescents aged 16 to 18 years. Data were analyzed from October 2022 to October 2023.
Stringency index of public health measures and quarantine experiences including recent quarantine (within the last 2 weeks) and quarantine frequency (cumulative number of quarantine episodes).
Mental distress was measured using the Hopkins Symptom Checklist across 6 data collection waves.
In this study, 7787 participants were included in the analysis (4473 female [57%]; mean [SD] age, 17.0 [0.6] years). Stringent public health measures (β = 0.18; SE, 0.02; P < .001), recent quarantine (β = 0.11; SE, 0.02; P < .001), and frequent quarantine (β = 0.08; SE, 0.01; P < .001) were associated with higher levels of mental distress. The associations between public health measures and mental distress were not moderated by sex, age, prepandemic anxiety or depression, or genetic liability for mental health conditions. Frequency of quarantine appeared to be more strongly associated with mental distress among younger adolescents (β = -0.04; SE, 0.01; P = .008), those with parents with lower education (β = -0.04; SE, 0.01; P = .007), and those with lower genetic risk for depression (β = -0.03; SE, 0.01; P = .006).
In this study, younger adolescents, those with parents with lower education, or those with low genetic liability for depression appeared more vulnerable when being quarantined several times. These findings emphasize the need for targeted support strategies to better protect adolescent well-being during future crises. Adolescents who experienced increased mental distress during the COVID-19 pandemic may be at risk of continued mental health problems and in need of ongoing support.
青春期是心理健康障碍（如焦虑和抑郁）经常出现的关键发育阶段。在 COVID-19 大流行期间，严格的公共卫生措施和隔离命令可能会威胁青少年的心理健康。
调查挪威青少年的公共卫生措施和隔离经历与精神困扰之间的关联，并探讨某些脆弱性因素是否会调节这些关联。
设计、地点和参与者：这项纵向队列研究使用重复测量来捕捉公共卫生措施的严格程度和隔离经历所解释的精神困扰的变化。数据来自挪威母婴儿童队列研究，并与国家健康登记处和 2020 年 4 月 1 日至 2021 年 2 月 17 日期间的国家严格指数相关联。参与者包括 7787 名年龄在 16 至 18 岁的挪威青少年。数据于 2022 年 10 月至 2023 年 10 月进行分析。
公共卫生措施和隔离经历的严格程度指数，包括最近的隔离（在过去 2 周内）和隔离频率（累积的隔离事件数）。
使用 Hopkins 症状清单在 6 个数据收集波次中测量精神困扰。
在这项研究中，共有 7787 名参与者纳入分析（4473 名女性[57%]；平均[标准差]年龄为 17.0[0.6]岁）。严格的公共卫生措施（β=0.18；SE，0.02；P<0.001）、最近的隔离（β=0.11；SE，0.02；P<0.001）和频繁的隔离（β=0.08；SE，0.01；P<0.001）与更高水平的精神困扰相关。公共卫生措施与精神困扰之间的关联不受性别、年龄、大流行前焦虑或抑郁或精神健康状况遗传易感性的调节。与年轻人相比，隔离频率与精神困扰的关联似乎更强（β=-0.04；SE，0.01；P=0.008），与受教育程度较低的父母（β=-0.04；SE，0.01；P=0.007）和抑郁遗传风险较低的青少年（β=-0.03；SE，0.01；P=0.006）。
在这项研究中，年龄较小、父母受教育程度较低或遗传上对抑郁的易感性较低的青少年在多次隔离时似乎更容易受到影响。这些发现强调了在未来危机期间需要采取有针对性的支持策略，以更好地保护青少年的福祉。在 COVID-19 大流行期间经历精神困扰增加的青少年可能面临持续的心理健康问题风险，并需要持续的支持。
