OBJECTIVE To identify the COVID-19 impact on well-being/mental health, coping strategies and risk factors in adolescent worldwide. METHOD Anonymous online multi-national/language survey in the general population (representative/weighted non-representative samples, 14-17years), measuring change in well-being (WHO-5/range=0-100) and psychopathology (validated composite P-score/range=0-100), WHO-5 <50 and <29, pre- versus during COVID-19 pandemic (26/04/2020-26/06/2022). Coping strategies, nine a-priori defined individual/cumulative risk factors were measured. χ2, penalized cubic splines, linear regression, and correlation analyses were conducted. RESULTS Analyzing 8,115 of 8,762 initiated surveys (representative=75.1%), the pre-pandemic WHO-5 and P-score remained stable during the study (excluding relevant recall bias/drift), but worsened intra-pandemic by 5.55±17.13 (standard deviation) and 6.74±16.06 points, respectively (effect size d=0.27 and d=0.28). The proportion of adolescents with WHO-5 scores suggesting depression screening (<50) and major depression (<29) increased from 9% to 17% and 2% to 6%. WHO-5 worsened (descending magnitude, with cumulative effect) in adolescents with a mental or physical disorder, female gender, and with school closure. Results were similar for P-score, with the exception of school closure (not significant) and living in a low-income country, as well as not living in a large city (significant). Changes were significantly but minimally related to COVID-19 deaths/restrictions, returning to near-pre-pandemic values after >2 years. The three most subjectively effective coping strategies were internet use, exercise/walking, and social contacts. CONCLUSION Overall, well-being/mental health worsened (small effect sizes) during early stages of COVID-19, especially in vulnerable subpopulations. Identified at-risk groups, association with pandemic-related measures, and coping strategies can inform individual behaviours and global public health strategies.

中文翻译：

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感染期间健康和功能的合作结果研究 （COH-FIT）：青少年 COVID-19 大流行期间的全球和风险组幸福感和心理健康分层过程。


目的 确定 COVID-19 对全球青少年福祉/心理健康、应对策略和风险因素的影响。方法 对普通人群（代表性/加权非代表性样本，14-17 岁）进行匿名在线多国/语言调查，测量幸福感（WHO-5/范围=0-100）和精神病理学（经过验证的综合 P 分数/范围=0-100）、WHO-5 <50 和 <29，与 COVID-19 大流行前（2020 年 4 月 26 日至 2022 年 6 月 26 日）。应对策略，测量了 9 个先验定义的个体/累积风险因素。进行了 χ2 、罚三次样条、线性回归和相关分析。结果分析 8,115 项启动调查中的 8,762 项（代表 = 75.1%），大流行前 WHO-5 和 P 评分在研究期间保持稳定（不包括相关的回忆偏倚/漂移），但在大流行期间恶化了 5.55±17.13 （标准差） 和 6.74±16.06 分 （效应量 d=0.27 和 d=0.28）。WHO-5 评分提示抑郁症筛查 （<50） 和重度抑郁症 （<29） 的青少年比例从 9% 增加到 17%，从 2% 增加到 6%。WHO-5 在患有精神或身体障碍、女性和学校关闭的青少年中恶化 （降序幅度，具有累积效应）。P 分数的结果相似，但学校关闭 （不显著） 和生活在低收入国家，以及不住在大城市 （显著） 除外。变化与 COVID-19 死亡/限制相关显着但最小，在 >2 年后恢复到接近大流行前的值。三种最主观有效的应对策略是互联网使用、锻炼/步行和社交接触。 结论 总体而言，在 COVID-19 的早期阶段，幸福感/心理健康恶化（效应量小），尤其是在弱势群体中。确定的高危人群、与大流行相关措施的关联以及应对策略可以为个人行为和全球公共卫生策略提供信息。