Adolescents with a history of depression reported lower depressive and anxiety symptoms in the first year of the COVID-19 pandemic than they did the year before, according to a report published this week in the Journal of the American Academy of Child & Adolescent Psychiatry. Adolescents without a history of depression experienced increasing symptoms of depression over time.
“Our findings are in line with studies on clinically depressed adult populations for whom having a pre-pandemic diagnosis did not predict significantly worsened depressive or anxiety symptoms,” wrote Neda Sadeghi, Ph.D., of the National Institute of Mental Health.
Sadeghi and colleagues analyzed data from the National Institute of Mental Health Characterization and Treatment of Depression (NIMH CAT-D) cohort, an ongoing longitudinal study that began before the pandemic. Participants in the CAT-D study were between the ages of 11 and 17 at the time of enrollment and had either a past or current diagnosis of major depressive disorder (MDD) or subthreshold depression (s-MDD) or no history of depression. Most of the CAT-D participants were from the District of Columbia, Maryland, and Virginia.
All CAT-D participants were seen once a year for a full clinical assessment, and participants in the s-MDD and MDD groups were seen on a regular basis between yearly follow up visits. Adolescent depressive symptoms were measured using either the parent- or youth-reported Mood and Feelings Questionnaire (MFQ), with scores ranging from 0 to 26 (higher score reflects greater depressive symptoms). Adolescent anxiety symptoms were measured using either the parent- or youth-reported Screen for Child Anxiety Related Disorders (SCARED), with scores ranging from 0 to 10 (higher score reflects greater anxiety symptoms). As part of the CAT-D study, adolescents with depression were also offered treatment at NIMH.
In total, 166 adolescents (109 girls and 96 adolescents with depression) had completed at least one assessment for anxiety and/or depression before the pandemic (between March 11, 2019, and March 10, 2020) and at least one assessment for anxiety and/or depression during the pandemic (between March 11, 2020, and March 11, 2021).
Adolescents without a history of depression had a mean depression score of 1.76 before the pandemic compared with 11.16 in adolescents with depression—a 9.40 point difference between the two groups. During the pandemic, the mean depression score of adolescents without a history of depression increased by 1.16 points compared with a slight drop in the mean depression score of 0.89 points in adolescents with depression—a 7.35 point difference between the two groups. A comparison of the groups’ anxiety scores before and during the pandemic revealed similar changes, with a slight increase in anxiety symptoms in the adolescents without a history of depression and a slight decrease in anxiety symptoms in the adolescents with depression.
Sadeghi and colleagues offered several explanations as to why the depressed youth in the study may have experienced a reduction in depression and anxiety symptoms during the pandemic, including that “the general increase in worry in the population might have led adolescents with depression to feel less isolated.” However, they cautioned, “the effects of the pandemic could be worse for adolescents with depression who did not have access to mental health care; whose access to care was even more restricted by the pandemic; or those who, for geographic, ethnic, and socio-economic reasons, are severely underserved.”
For related information, see the Psychiatric News article “Surgeon General Calls for Action to Address Youth Mental Health Crisis.”
(Image: iStock/courtneyk)
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