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

IF 5.5 2区医学 Q1 PEDIATRICS Journal of Adolescent Health Pub Date : 2024-12-01 DOI:10.1016/j.jadohealth.2024.09.012

Mengmeng Li, Sam Beckwith, Shoshanna L Fine, Eric Mafuta, Qiguo Lian, Michelle Martinez-Baack, Caroline Moreau

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Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Discussion: 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.

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了解 COVID-19 大流行期间青少年广泛焦虑症的发展轨迹：来自中国和刚果民主共和国的证据。

目的：本研究旨在评估 COVID-19 大流行期间的焦虑趋势，并评估与大流行相关的逆境如何改变来自两种不同环境的贫困青少年的焦虑轨迹：数据来自全球青少年早期研究的中国上海和刚果民主共和国金沙萨研究点。在大约两年的时间里，共收集了三次数据：大流行之前（T1）和大流行期间（T2、T3）。分析对象包括在所有时间点上具有广泛性焦虑症（GAD）完整信息的青少年（10-16 岁）（上海：548 人；金沙萨：334 人）。加权广义估计方程评估了 T2 和 T3 阶段相对于 T1 阶段的焦虑程度。采用效应修正分析来研究与COVID-19相关的逆境是否会改变焦虑的轨迹：大流行发生六个月后，15.3%（上海）和4.1%（金沙萨）的青少年报告患有中度至重度焦虑症。调整后的广义估计方程模型表明，在大流行期间，两地的 GAD 均未增加。然而，上海的女性青少年在疫情发生半年后出现了焦虑增加（调整后的几率比 [aOR]：2.27，95% 置信区间：1.30-3.99）。这一趋势并未持续。在金沙萨，与 COVID 相关的逆境并没有改变焦虑的轨迹。在上海，大流行发生一年后，我们观察到所有青少年（aOR：0.31，0.17-0.58）和女性青少年（aOR：0.25，0.08-0.75）在没有与大流行相关的负面家庭经历的情况下，患 GAD 的几率有所下降：讨论：COVID-19大流行对青少年焦虑的影响因时间、地点和性别而异。未来的研究应探讨社会环境和复原力的作用，以便更好地了解青少年的精神痛苦，并为促进青少年健康的项目和政策提供指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Adolescent Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

10.40

自引率

3.90%

发文量

526

审稿时长

46 days

期刊介绍： The Journal of Adolescent Health is a scientific publication dedicated to enhancing the health and well-being of adolescents and young adults. Our Journal covers a broad range of research topics, spanning from the basic biological and behavioral sciences to public health and policy. We welcome a variety of contributions, including original research papers, concise reports, literature reviews, clinical case reports, opinion pieces, and letters to the editor. We encourage professionals from diverse disciplines such as Anthropology, Education, Ethics, Global Health, Health Services Research, Law, Medicine, Mental and Behavioral Health, Nursing, Nutrition, Psychology, Public Health and Policy, Social Work, Sociology, and Youth Development to share their expertise and contribute to our mission of promoting adolescent health. Moreover, we value the voices of young individuals, family and community members, and healthcare professionals, and encourage them to submit poetry, personal narratives, images, and other creative works that provide unique insights into the experiences of adolescents and young adults. By combining scientific peer-reviewed research with creative expressions, our Journal aims to create a comprehensive understanding of the challenges and opportunities in adolescent and young adult health.