Longitudinal Change in Adolescent Mental Health During the COVID-19 Outbreak – A Prospective Population-Based Study of Teenagers in Norway

Background:The lockdown of societies enforced by governments across the globe to limit the spread of the Sars-Cov-2 virus has had unknown consequences for children and youths. We examined changes in mental health in the adolescent population from before to three months into the outbreak. Methods: The study was part of an ongoing longitudinal survey in a representative sample of youths in Norway, with baseline data collected in February 2019 and a follow-up in June 2020. The sample comprised 3572 adolescents (49% girls, n = 1737) aged between 13 and 16 years ( M = 14·7, SD = 4.1). Mental health was assessed using the Hopkins Symptom Checklist (HSCL-10). Linear mixed-effects models were used to identify predictors for changes in mental health complaints during the pandemic outbreak. Outcomes: Clinical levels of mental health problems in adolescents increased slightly but significantly from 5·3% in 2019 to 6·2% in June 2020. Sex, pre-existing mental health problems, and living in a single-parent household in 2019, predicted higher HSCL scores during the pandemic. Symptom levels of adolescents living in a single-parent household increased significantly more than in their peers, while for those with poor family economy, or those with a history of maltreatment, increased significantly less compared to peers who did not present with these risks. Interpretation: Mental health problems in Norwegian youths increased slightly during the lockdown. Some groups of adolescents reported significantly higher symptom levels both before and during the pandemic outbreak, indicating that health inequities persist for adolescents in risk groups. Funding Statement: The study was funded by the Norwegian Directorate for Children, Adolescents and Family affairs (Bufdir). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study protocol was approved by the Regional Committee for Ethics in Medical and Health Research in the Southeastern region of Norway (Case #2018/522). All participants provided informed written consent.