Data-Driven Assessment of Adolescents’ Mental Health During the COVID-19 Pandemic

Abstract

Adolescents' mental health was severely compromised during the COVID-19 pandemic. Longitudinal real-world studies on changes in mental health of adolescents during the later phase of the pandemic are limited. We aimed to quantify the effect of COVID-19 pandemic on adolescents' mental health outcomes based on electronic health records (EHR). A retrospective cohort study utilizing the computerized database of a 2.5 million members' state-mandated health organization in Israel. Rates of mental health diagnoses, and psychiatric drug dispensations were measured among adolescents aged 12-17 with and without pre-existing mental history, for 2017-2021 years. Relative risks were computed between the years and interrupted time series (ITS) analysis evaluated changes in monthly incidence rates of psychiatric outcomes. Average population size was 218,146 in 2021. During the COVID-19 period a 36% increase was observed in the incidence of depression (95%CI: 25-47), 31% in anxiety (95%CI: 23-39), 20% in stress (95%CI: 13-27), 50% in eating disorders (95%CI: 35-67), 25% in antidepressants (95%CI: 25-33) and 28% in antipsychotics (95%CI: 18-40). A decreased rate of 26% (95% CI: 0.80-0.88) was observed in ADHD diagnoses. The increase of the examined outcomes was most prominent among youth without psychiatric history, females, general secular Jewish population, medium-high SES, and 14-15 years age group. ITS analysis confirmed a significantly higher growth in the incidence of psychiatric outcomes during the COVID-19 period, compared to previous years. This real-world study highlights the deterioration of adolescents' mental health during the COVID-19 pandemic and suggests that youth mental health should be considered during health policy decision making.