This global pandemic has negatively impacted the mental health of adults and children around the world, but little is known about its impact on youth admitted to psychiatric hospitals. Among positive patients, the most common psychiatric diagnosis was posttraumatic stress disorder (63%), followed by disruptive mood dysregulation disorder (42%), attention deficit/hyperactivity disorder (42%), major depressive disorder (37%), and oppositional defiant disorder (32%). Depression and anxiety symptoms were noted to escalate early in the disease course. Externalizing behaviours increased as physical health improved.Within a short period, the pandemic and social distancing measures significantly impacted daily life for adolescents, through school closures and the consequent shift to remote learning, restrictions on leaving their homes, and the inability to gather with friends. Adolescence sees significant shifts in interpersonal relationships, particularly with parents and peers. Physiological changes associated with puberty usher in an increased sensitivity to social belonging, and attachment needs shift to friends and romantic partners to accommodate growing independence from parents. Adolescents spend more time with friends than with parents, and the parent-child relationship experiences tension around adolescents’ emerging independence. During this time, parent-child conflict intensifies, and parent-child intimacy slightly declines. Meanwhile, friendships and romantic relationships emerge as a key source of social support and identity exploration, as well as a unique training ground for long-term social competencies. Many of the changes during the early months of COVID-19 reshaped adolescents’ unique relational landscape. Social distancing measures restricted interactions with friends and increased time spent at home with family. Prominent adolescent theories emphasize the importance of social environments that “fit” adolescent’s current developmental needs. From this lens, COVID-19 and social distancing may challenge adolescents’ unique intimacy and autonomy needs, creating a suboptimal person-environment fit that undermines mental health. Adolescents also experience significant changes in emotionality. On average, adolescents experience more intense positive and negative emotions than adults, with higher frequency and greater volatility. Emotional experience plays a key role in the underlying mental health of youth, and so COVID-19 related stressors, such as worrying about infection and feeling socially isolated, may contribute to fluctuations in adolescents’ emotionality. Many adolescents identified the inability to physically gather with others as distinctly challenging. This typically referred to friends and romantic partners, but occasionally also included extended and non–residential family members. According to a study that has been brought on by the Arizona State University’s psychology department and published by the Journal of Adolescent Health, adolescents expressed a desire for emotional connection and social support, digital means of connecting with friends but it resulted often insufficient and some felt they lacked an emotional outlet.Some adolescents were frustrated by the inability to get out of the house. This included the inability to socialize in outdoor settings with friends and family and to participate in activities that were important to them, such as sports, choir, school plays, and prom. Some reported difficulties arising from increased time with their families, noting particularly the lack of privacy and personal space, in a few cases this led to increased irritation with one another and caused tension and conflict. And talking more specifically and closer about COVID-19 some of them expressed fear and anxiety surrounding the virus. They expressed concerns about their own and their family’s safety, and specifically the possibility they could spread the virus to a loved one, also felt confused and helpless about the current state of the world in general and its future. Emotional difficulties and struggled to get going have been also reported; they said that the lack of routine was challenging and led to feelings of lethargy and sadness, the shift to online, remote learning created mental and emotional strain. COVID-19 is anticipated to stay with us for some time. Despite many unknowns in the near and intermediate future, including plans for schools, fluctuating rates of infection, and potential additional lockdowns, the pandemic will undoubtedly continue to impact adolescents’ lives. Adolescents in this study experienced social and emotional difficulties directly due to the pandemic, and these were uniquely associated with their self-reported mental health problems.
By Francesca Branchi