Understanding Trajectories of Generalized Anxiety Disorder Among Adolescents During the COVID-19 Pandemic: Evidence From China and the Democratic Republic of the Congo.

Journal: The Journal of adolescent health : official publication of the Society for Adolescent Medicine

Volume: 75

Issue: 6S

Year of Publication: 2024

Affiliated Institutions:  Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: Mengmeng.Li@jhu.edu. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Department of Health Systems Management and Policy, School of Public Health, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo. Institute of Public Health and Health Policy, Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, China. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Soins Primaires et Prevention, Inserm U, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France.

Abstract summary 

This study aims to assess anxiety trends over the COVID-19 pandemic and evaluate how pandemic-related adversities modify trajectories among underprivileged adolescents from two distinct settings.Data came from the Shanghai, China and Kinshasa, Democratic Republic of the Congo sites of the Global Early Adolescent Study. Data were collected three times over approximately two years: prior to the pandemic (T1) and during the pandemic (T2, T3). Analyses included adolescents (aged 10-16) with complete information on generalized anxiety disorder (GAD) across all time points (Shanghai N = 548; Kinshasa N = 334). Weighted Generalized Estimating Equations assessed anxiety at T2 and T3 relative to T1. Effect modification analyses were used to investigate if COVID-19-related adversities modified anxiety trajectories.Six months into the pandemic, 15.3% (Shanghai) and 4.1% (Kinshasa) of adolescents reported having moderate-to-severe GAD. Adjusted Generalized Estimating Equation models did not suggest increases in GAD during the pandemic across both sites. However, female adolescents from Shanghai experienced increased anxiety (adjusted odds ratio [aOR]: 2.27, 95% confidence interval: 1.30-3.99) half a year into the pandemic. The trend was not sustained. COVID-related adversities did not modify anxiety trajectories in Kinshasa. In Shanghai, one year into the pandemic, we observed decreased odds of GAD among all (aOR: 0.31, 0.17-0.58) and female adolescents (aOR: 0.25, 0.08-0.75) without pandemic-associated negative household experiences.The COVID-19 pandemic differentially affected adolescent anxiety by time, place, and gender. Future research should examine the roles of social context and resilience to better understand adolescents' mental distress and to guide health-promoting programs and policies for young people.

Authors & Co-authors:  Li Mengmeng M Beckwith Sam S Fine Shoshanna L SL Mafuta Eric E Lian Qiguo Q Martinez-Baack Michelle M Moreau Caroline C

Study Outcome 

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Citations : 
Authors :  7
Identifiers
Doi : 10.1016/j.jadohealth.2024.09.012
SSN : 1879-1972
Study Population
Female
Mesh Terms
Humans
Other Terms
Adolescence;COVID-19 pandemic;Mental health;Pandemic-related adversities;Underprivileged adolescents
Study Design
Study Approach
Country of Study
Republic of the congo
Publication Country
United States