key: cord-0921916-ca1z8mlg
authors: Chen, Fangping; Zheng, Dan; Liu, Jing; Gong, Yi; Guan, Zhizhong; Lou, Didong
title: Depression and anxiety among adolescents during COVID-19: A cross-sectional study
date: 2020-05-25
journal: Brain Behav Immun
DOI: 10.1016/j.bbi.2020.05.061
sha: 6ce08979c8b4df1bcf5686eedae1b3ca6b5af550
doc_id: 921916
cord_uid: ca1z8mlg

nan

The novel coronavirus disease 2019 (COVID-19), a hideous pandemic disease outbreaking in 2019, has swept extensive regions around the world. Recent studies have shown different levels of psychological distress among people differently exposed to the COVID-19 epidemic (Wang et al., 2020; Zhang et al., 2020) . Adolescents, a vulnerable population, have been carrying on their school curriculums online and conducting daily activities indoors since the outbreak of COVID-19 in China. This life-style transformation and threat of being infected may cause depressive and anxious disorders. Without appropriate psychological interventions, depression and anxiety among adolescents often persist into adulthood and elevate the risk factors of agerelated disease, such as cardiovascular disease (Danese et al., 2009; Jones, 2013) . However, the direct evidence that reflected depression and anxiety among adolescents during COVID-19 was blank. In this study, we filled this gap through an online questionnaire.

Due to the quarantine management, the online questionnaire comprising Depression Self-Rating Scale for Children (DSRS-C, Cronbach's α=0.73), Screen for Child Anxiety Related Disorders (SCARED, Cronbach's α= 0.43-0.89) and some basic demographic characteristics was issued and gathered by a mobile application called "Sojump" (www.sojump.com). This questionnaire was accessible from April 16, 2020 to April 23, 2020 for adolescents in Guiyang, China. Finally, a total of 1109 individuals filled in the questionnaire, in which 1036 questionnaires met the admittance criterion for subsequent analysis.

For DSRS-C, the minimum score used to identify depression is 15, while the minimum score used to identify anxiety by SCARED is 25. According to this guidance, 112 (11.78%) cases with depression and 196 (18.92%) cases with anxiety were identified, and 68 (6.56%) cases presented both depression and anxiety. Logistic regression analysis was conducted following single-factor analysis for 10 potentially relevant factors (Table 1 ). Logistic regression suggested that gender, age, educational of parents, companion on weekdays and physical exercise were associated with depression significantly, and that gender, physical exercise and companion on weekdays were associated with anxiety significantly (Figure 1) .

Consistent with previous studies, the female adolescents showed higher risk of depression and anxiety during COVID-19. The elder adolescents, in our sample, were more depressed than the younger ones. However, no association was detected with anxiety when it came to different age groups. There is a common phenomenon that children are left at home on weekdays without any companion. Our data indicated that adolescents without companion on workdays were more likely to be depressed and anxious during COVID-19. Without surprise, physical exercise was associated with both depression and anxiety and showed some protective effect for adolescent mental health during this global public health emergency (Chekroud et al., 2018) .

When it comes to psychological problems, prevention and early identification exceed treatment.

We call for more attention to the mental health of female adolescents, more companion for the left-home adolescents and more physical exercise for all adolescents, during COVID-19. We believe this study will provide guidance to teachers, psychologists and political leaders for timely and effective intervention targeting mental health of adolescents.

This study was supported by the National Natural Science Foundation of China (NSFC #81760336 to Didong Lou).

Association between physical exercise and mental health in 1.2 million individuals in the USA between 2011 and 2015: a cross-sectional study. The lancet

Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation, and clustering of metabolic risk markers

Adult mental health disorders and their age at onset. The British journal of psychiatry

A longitudinal study on the mental health of general population during the COVID-19 epidemic in China

The differential psychological distress of populations affected by the COVID-19 pandemic

These authors declare no conflict of interest.

All procedures in this study have been approved by ethics committee of The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine. The characteristics for each factor and the statistical results.