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Adolescent Depression and Suicide Risk Increases During the Pandemic
Mental health concerns have risen since the onset of COVID-19, yet screenings for depression and suicide have not been examined in pediatric primary care, according to research published in the Pediatrics journal.
“Researchers in several studies have reported high prevalence of mental health concerns among children and adolescents during the pandemic,” writes Stephanie Mayne, PhD, MHS, Children’s Hospital of Philadelphia, and colleagues. “However, few studies to date have examined changes in depression and suicidality, as well as changes in screening for these concerns, among adolescents from before to during the pandemic.”
Dr Mayne and coauthors performed a repeat cross-sectional analysis of electronic health records, including 91 188 well visits attended by 68 669 adolescents, of which 43 504 were prepandemic (June to December 2019) and 47 684 occurred during the pandemic (June to December 2020).
The researchers found that overall primary care visits declined from 77.6% to 75.8% during the pandemic period. They also note an increase of 5.0% to 6.2% of adolescents screening positive for depressive symptoms, as well as a rise from 6.1% to 7.1% with positive suicide risk screens. Of particular importance, female adolescence showed a 34% relative increase in reporting suicidal thoughts.
Depression in Childhood Hampers Health and Functioning in Adulthood
Of adolescents screening positive for depressive symptoms, greater increases were shown among females and non-Hispanic Black and non-Hispanic White youths. The study group ranged from 12 to 21 years who attended the Children’s Hospital of Pennsylvania between June 1, 2019, and December 31, 2020.
Screenings for mental health concerns are not only done during routine wellness checks with primary care physicians but are also commonplace in schools. The change from in-person learning to virtual learning created one less touch point to help identify students that could require additional care, while simultaneously and inadvertently increasing the risk of these symptoms.
“Social isolation and loneliness are associated with increased risk of depression in children and adolescents, and school closures and other COVID-19 mitigation measures have restricted social interactions among adolescents,” pens Mayne et al. “Adverse effects of social media (eg, bullying) have been implicated as potential contributors to the greater burden of depression among girls, and these effects may have been magnified during the pandemic as in-person social interactions have declined or shifted online.”
The findings of this study solidify the importance of regular depression and suicide risk screeners to be continued during well checks with primary care providers as well as reinstituted in schools transitioning back to in-person classes. It also stresses the importance of primary care physicians working closely with mental health providers and social workers to facilitate more effective mental health treatment and follow-up.
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