Adolescent mental health before, during, and after the COVID-19 pandemic in Iceland: a repeated, cross-sectional, population-based study.
cross_sectional · Level IV
Where this comes from
- Record sourced from PubMed, PMID 40950396.
- Also identified by DOI 10.1016/j.lanepe.2025.101301 and PMC identifier 12432985.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Adolescents' mental health declined during the COVID-19 pandemic, yet little is known about the long-term outcomes after the pandemic's declassification as a global health emergency (5 May 2023). This study examined changes in adolescent mental health in Iceland from 2016 to 2023, using a bioecological framework to identify risk and protective factors. Youth in Iceland surveys were administered nationwide to 13-15-year-olds in 2016, 2018, 2020, 2021, 2022 and 2023, with an average 75% response rate across the years. The surveys included measures on depressive symptoms, anxiety and hostility (Symptom Checklist-90), parental social support (Perceived Parental Support Scale), screen time, and stress/trauma exposure (Negative Life Events Scale). Stepwise-reduced mixed-effects models assessed the association of age, gender, time and risk/protective factors and their effect on mental health. Multiple imputation addressed missing data, and Bonferroni corrections adjusted for multiple testing. 62,011 adolescents participated: 48.2% female (n = 29,890), 50.0% male (n = 31,002), 1.8% non-binary (n = 1119). Depressive symptoms showed signs of improvement post-pandemic (2023) compared to 2021 (β 0.19, 95% CI 0.13-0.24), yet remained higher than pre-pandemic levels (2016: β -0.38, 95% CI -0.44 to -0.33; 2018: β -0.26, 95% CI -0.31 to -0.20). Anxiety and hostility also increased and remained higher than pre-pandemic levels in 2023 (anxiety: 2016 β -0.29, 95% CI -0.35 to -0.24, 2018 β -0.20, 95% CI -0.26 to -0.15; hostility: 2016 β -0.26, 95% CI -0.31 to -0.20, 2018 β -0.12, 95% CI -0.18 to -0.07). Across all the models examining the predictors from diverse bioecological spheres, low parental social support, high social media use, and bad grades were consistently associated with poor mental health, regardless of mental health outcome and gender. The COVID-19 pandemic has had a serious and continuing negative effect on adolescents' mental health. Targeted interventions are needed to address the increase in mental health problems during the COVID-19 pandemic, with a focus on enhancing parental support and managing screen use. Icelandic Research Fund (217612-051); NordForsk (147386).