The study found that negative mental health outcomes were disproportionately reported by girls and older adolescents (13-18-year-olds), compared to same-age peers prior to the pandemic. At the same time, it revealed a decline in cigarette smoking, e-cigarette usage and alcohol intoxication among 15-18-year-old adolescents during the pandemic.
"The decrease observed in substance use during the pandemic may be an unintended benefit of the isolation that so many adolescents have endured during quarantine," said collaborating senior investigator John Allegrante, an affiliated professor of sociomedical sciences at Columbia University Mailman School of Public Health and an applied behavioral scientist.
Thorhildur Halldorsdottir, a clinical psychologist and assistant professor of psychology at Reykjavik University who is the study co-principal investigator, said the study represents a "landmark contribution to what we now know about just how psychologically devastating being socially isolated from peers and friends during the ongoing pandemic has been for young people."
According to the researchers, prior studies have not been designed to determine whether clinically relevant levels of depression--as opposed to self-reported depressive symptoms--and substance use have increased during the pandemic.
Inga Dora Sigfusdottir, professor of sociology at Reykjavik University, scientific director of the Icelandic Centre for Social Research and Analysis, and research professor of health education at Teachers College, said the study "differs in methodology from previous studies in that it tracked population-based prevalence of mental health outcomes and substance use over several years in order to better understand the potential effects of COVID-19 from recent upward trends in adolescent mental health problems.
Previous studies of adolescents during COVID-19 found evidence of increased mental health problems and certain types of substance use that had been rising before the pandemic. This study, however, compares current data with several pre-pandemic time points, which enabled the researchers to separate the effect of COVID-19 from other recent, downward trends in adolescent mental health.
The implication of the new study is that interventions intended to lessen the negative impact of the pandemic on adolescent mental health might help improve the mental health outlook for young people around the world who have been caught up in the pandemic, observed Allegrante, who is also senior professor of health education at Columbia Teachers College.
"Isolation during the pandemic has been universal and it is global, and it is having a clinically important, negative impact on young people who have not been in school during the pandemic. Whether an adolescent was an Icelander in Reykjavik who had been at home for most of the last year or an American in New York City, living under the same circumstances - being at home, engaged in remote learning and separated from friends--the consequences of not going to school not only set back their learning but also negatively affected their mental health. What we don't know is by how much."
The study shows that population-level prevention efforts, especially for girls, are warranted," but that "more study is needed to determine the long-term effects of quarantine and being socially isolated from one's peers, including the effects on learning and academic achievement and relationships with parents, siblings, and peers," said Allegrante.
Ingibjorg Eva Thorisdottir, chief data analyst at the Icelandic Centre for Social Research and Analysis (ICSRA) at Reykjavik University (who studied at Teachers College in 2009 as part of an exchange with Reykjavik University), was the principal investigator and lead author of the report.
Alfgeir L. Kristjansson, Senior Scientist at ICSRA and Associate Professor of Public Health at West Virginia University and a co-author of the study, said the "results underline the significance of social relationships in the health and well-being of youth and the importance of nurturing and maintaining strong social support mechanisms in their lives. The Lancet Psychiatry study report highlights these findings at population scale." Kristjansson was a postdoctoral fellow with Allegrante at Teachers College during 2010-2012.
In a commentary that accompanies the article's publication, Gertrud Sofie Hafstad and Else-Marie Augusti, both senior researchers at the Norwegian Centre for Violence and Traumatic Stress Studies in Oslo, write that the study "clearly shows that gauging the mental health status of adolescents over time is of imminent importance."
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Additional investigators and coauthors on the study, which was funded by the Icelandic Research Fund, include Bryndis Bjork Asgeirsdottir, professor of psychology at Reykjavik University; Heiddis Bjork Valdimarsdottir, professor of psychology at Reykjavik University and the Icahn School of Medicine at Mount Sinai; and Erla Maria Jonsdottir Tolgyes, chief project officer, and Jon Sigfusson, managing director, both at the Icelandic Center for Social Research and Analysis.
Columbia University Mailman School of Public Health
Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the seventh largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master's and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit http://www.mailman.columbia.edu.
Founded in 1887, Teachers College, Columbia University, the first and largest graduate school of education in the United States, is perennially ranked among the nation's best. Teachers College's mission is to create a smarter, healthier, and more equitable and peaceful world. Teachers College engages in research and prepares professionals in its three main areas of expertise--education, health and psychology-- to work with public and private entities in local, national and global communities and inform public policy. Students choose from among 150 separate programs to earn graduate degrees, which are conferred by Columbia University. While it is closely affiliated with Columbia University and collaborates with it on many programs, the College is an independent, autonomous institution with a separate, independent governing board, president, and financial endowment. For more information, go to: https://www.tc.columbia.edu/
Reykjavík University is the largest private university in Iceland with more than 3,500 students. It is chartered by the Chamber of Commerce, the Federation of Icelandic Industries, and the Confederation of Icelandic Employers. The university consists of seven academic departments in two schools. For more information, go to: https://en.ru.is/
The Icelandic Centre for Social Research and Analysis is a youth research centre that has specialized in youth research since 1999. The Centre analyzes the social well-being of youth and focuses on determinants of various health related lifestyles and changes over time and across Europe and other countries. For more information, go to: https://rannsoknir.is/
