Pandemic Anxiety Among Adolescents Associated With Depression, Poor Health

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A team of investigators assessed the impact of the COVID-19 pandemic on the mental and physical health of adolescents.

In a cohort of adolescents surveyed before and during the pandemic, COVID-19-related anxiety was found to be associated with greater odds of depression and poorer physical health, according to study data published in JAMA Network Open.  However, students who did not report pandemic-related anxiety did not appear to be at significantly increased risk for adverse psychiatric outcomes.

Investigators extracted data from the MyLife study, an ongoing prospective cohort study of adolescents in Norway. Briefly, students at 33 participating schools were invited to complete annual electronic surveys capturing information pertaining to physical and mental health. Two study cohorts were assembled for the present analysis: the pre-COVID-19 cohort and the COVID-19 cohort. Individuals in the pre-COVID-19 cohort entered high school (grade 10) in 2018 and completed a follow-up survey in 2019. The COVID-19 cohort completed their baseline survey in the fall of 2020, during the pandemic. Students were asked to describe their physical health and report symptoms of depression using the Patient Health Questionnaire-9 (PHQ-9). Students were also asked to report the number of close friends they had, as well as information about their participation in organized sports. Nested regression models were used to assess differences in these factors between the pre-pandemic and pandemic periods. Models were adjusted for sociodemographic covariates and for students’ baseline data.

The analytic cohort comprised 2536 adolescents (59.4% girls), among whom 1621 entered high school before the pandemic and 915 entered high school during the pandemic. Demographic characteristics were comparable between the pre-COVID-19 and COVID-19 cohorts. A total of 158 adolescents (17.3%) in the COVID-19 group reported high pandemic anxiety. In nested regression models, the COVID-19 cohort did not have increased odds of depression compared with the pre-COVID-19 cohort. However, the pandemic cohort had significantly lower odds of participating in organized sports (odds ratio [OR], 0.69; 95% CI, 0.56-0.87). Additionally, compared with the pre-COVID-19 cohort, adolescents with high pandemic anxiety were at significantly increased risk for symptoms of depression (OR, 2.16; 95% CI, 1.39-3.37) and poor self-reported physical health (OR, 1.53; 95% CI, 1.01-2.31).

Data from these Norwegian cohorts suggest that the COVID-19 pandemic did not elevate the overall risk for depression and anxiety in adolescents. However, individuals with high pandemic-related anxiety were more likely to experience poor mental and physical health.

Study limitations include the short follow-up period; the long-term psychological effects of COVID-19 have yet to be explored. Further, data are not necessarily generalizable to other countries, particularly those with different COVID-19 transmission levels and public health responses.

“Additional research is needed to identify risk factors and characteristics associated with heightened stress and anxiety during the pandemic period among adolescents,” the investigators wrote. “[A]t-risk groups of adolescents may be disproportionately affected by the pandemic and may require specialized strategies addressing their mental and physical health needs.”


Burdzovic Andreas J, Brunborg GS. Self-reported mental and physical health among Norwegian adolescents before and during the COVID-19 pandemic. JAMA Netw Open. Published online August 24, 2021. doi:10.1001/jamanetworkopen.2021.21934