Perceived Epidemic Impacts and Mental Symptom Trajectories in Adolescents Back to School After COVID-19 Restriction: A Longitudinal Latent Class Analysis

Rong, Rong; Xu, Qiaochu; Jordan, Kelvin P.; Chen, Ying

Abstract

Purpose
This study aimed to assess the impacts of COVID-19 epidemic on various life aspects and identify the trajectories of common mental symptoms among adolescents back to school after COVID-19 restriction. Furthermore, potential predictors associated with those trajectories were investigated.

Methods
This longitudinal study, with five data collection points and a total follow-up of 68.4 days, was conducted among 1,393 junior high school students (mean age: 13.8 years; male, 53.3%) shortly after school reopened during the first COVID-19 outbreak in China. Questions on sociodemographics and perceived COVID-19 epidemic impacts were completed at the baseline while the Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Insomnia Severity Index were measured throughout the study for depression, anxiety, and insomnia symptoms, respectively. Trajectories of mental symptoms were classified by longitudinal latent class analysis, and the associated predictive factors were identified with multinomial regression modelling.

Results
Our study revealed high but steadily declining prevalence of depression, anxiety, and insomnia symptoms (p trend < .001). Five distinctive trajectories were identified for both depression and anxiety (“resistance,” “low symptom,” “recovery,” “chronic dysfunction,” and “delayed dysfunction”) and three for insomnia (“resistance,” “low symptom,” and “chronic dysfunction”). Besides the significant association between the mental symptom trajectories and students' perceived COVID-19 impacts on study practice, family income, and family relationship, female gender, lower school grade, and higher body mass index were found to be predictive of high severity trajectories.

Discussion
Our findings may help locate the most psychologically vulnerable adolescents during the epidemic and foster better implementation of targeted intervention..

Citation

Rong, R., Xu, Q., Jordan, K. P., & Chen, Y. (2023). Perceived Epidemic Impacts and Mental Symptom Trajectories in Adolescents Back to School After COVID-19 Restriction: A Longitudinal Latent Class Analysis. Journal of Adolescent Health, 74(3), 487-495. https://doi.org/10.1016/j.jadohealth.2023.09.011

• Journal Article Type: Article
• Acceptance Date: Sep 8, 2023
• Online Publication Date: Nov 14, 2023
• Publication Date: 2023-11
• Deposit Date: Nov 15, 2023
• Journal: Journal of Adolescent Health
• Print ISSN: 1054-139X
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 74
• Issue: 3
• Pages: 487-495
• DOI: https://doi.org/10.1016/j.jadohealth.2023.09.011
• Keywords: Psychiatry and Mental health; Public Health, Environmental and Occupational Health; Pediatrics, Perinatology and Child Health
• Public URL: https://keele-repository.worktribe.com/output/635560
• Additional Information: This article is maintained by: Elsevier; Article Title: Perceived Epidemic Impacts and Mental Symptom Trajectories in Adolescents Back to School After COVID-19 Restriction: A Longitudinal Latent Class Analysis; Journal Title: Journal of Adolescent Health; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.jadohealth.2023.09.011; Content Type: article; Copyright: © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc.