Association of Health Behaviors with Mental Health Problems in More than 7000 Adolescents during COVID-19
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Association of Smartphone Usage with Mental Health Problems
3.2. Association of Physical Activity with Mental Health Problems
3.3. Changes in Health Behaviors during COVID-19 Compared to Pre-Pandemic Times
4. Discussion and Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Li, S.H.; Beames, J.R.; Newby, J.M.; Maston, K.; Christensen, H.; Werner-Seidler, A. The Impact of COVID-19 on the Lives and Mental Health of Australian Adolescents. Eur. Child Adolesc. Psychiatry. 2021, 1–13. [Google Scholar] [CrossRef] [PubMed]
- Pieh, C.; Dale, R.; Plener, P.L.; Humer, E.; Probst, T. Stress Levels in High-School Students after a Semester of Home-Schooling. Eur. Child. Adolesc. Psychiatry 2021, 1–3. [Google Scholar] [CrossRef] [PubMed]
- Humer, E.; Dale, R.; Plener, P.L.; Probst, T.; Pieh, C. Assessment of Mental Health of High School Students 1 Semester After COVID-19–Associated Remote Schooling Measures Were Lifted in Austria in 2021. JAMA Netw. Open 2021, 4, e2135571. [Google Scholar] [CrossRef] [PubMed]
- The Lancet Regional Health—Europe. Protecting the mental health of youth. Lancet Reg. Health Eur. 2022, 12, 100306. [Google Scholar] [CrossRef] [PubMed]
- Ornell, F.; Borelli, W.V.; Benzano, D.; Schuch, J.B.; Moura, H.F.; Sordi, A.O.; Kessler, F.H.P.; Scherer, J.N.; von Diemen, L. The next Pandemic: Impact of COVID-19 in Mental Healthcare Assistance in a Nationwide Epidemiological Study. Lancet Reg. Health Am. 2021, 4, 100061. [Google Scholar] [CrossRef] [PubMed]
- Sañudo, B.; Fennell, C.; Sánchez-Oliver, A.J. Objectively-Assessed Physical Activity, Sedentary Behavior, Smartphone Use, and Sleep Patterns Pre- and during-COVID-19 Quarantine in Young Adults from Spain. Sustainability 2020, 12, 5890. [Google Scholar] [CrossRef]
- Kandola, A.; Ashdown-Franks, G.; Hendrikse, J.; Sabiston, C.M.; Stubbs, B. Physical Activity and Depression: Towards Understanding the Antidepressant Mechanisms of Physical Activity. Neurosci. Biobehav. Rev. 2019, 107, 525–539. [Google Scholar] [CrossRef] [PubMed]
- Pearce, M.; Garcia, L.; Abbas, A.; Strain, T.; Schuch, F.B.; Golubic, R.; Kelly, P.; Khan, S.; Utukuri, M.; Laird, Y.; et al. Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-Analysis. JAMA Psychiatry 2022, 79, 550. [Google Scholar] [CrossRef] [PubMed]
- Spitzer, R.L. Validation and Utility of a Self-Report Version of PRIME-MD. The PHQ Primary Care Study. JAMA 1999, 282, 1737. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Spitzer, R.L.; Kroenke, K.; Williams, J.B.W.; Löwe, B. A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Arch. Intern. Med. 2006, 166, 1092. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Morin, C.M.; Belleville, G.; Bélanger, L.; Ivers, H. The Insomnia Severity Index: Psychometric Indicators to Detect Insomnia Cases and Evaluate Treatment Response. Sleep 2011, 34, 601–608. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cohen, S.; Kamarck, T.; Mermelstein, R. A Global Measure of Perceived Stress. J. Health Soc. Behav. 1983, 24, 385. [Google Scholar] [CrossRef] [PubMed]
- Kroenke, K.; Spitzer, R.L.; Williams, J.B.W. The PHQ-9: Validity of a Brief Depression Severity Measure. J. Gen. Intern. Med. 2001, 16, 606–613. [Google Scholar] [CrossRef] [PubMed]
- Richardson, L.P.; McCauley, E.; Grossman, D.C.; McCarty, C.A.; Richards, J.; Russo, J.E.; Rockhill, C.; Katon, W. Evaluation of the Patient Health Questionnaire-9 Item for Detecting Major Depression Among Adolescents. Pediatrics 2010, 126, 1117–1123. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Löwe, B.; Decker, O.; Müller, S.; Brähler, E.; Schellberg, D.; Herzog, W.; Herzberg, P.Y. Validation and Standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the General Population. Med. Care 2008, 46, 266–274. [Google Scholar] [CrossRef] [PubMed]
- Mossman, S.A.; Luft, M.J.; Schroeder, H.K.; Varney, S.T.; Fleck, D.E.; Barzman, D.H.; Gilman, R.; DelBello, M.P.; Strawn, J.R. The Generalized Anxiety Disorder 7-Item (GAD-7) Scale in Adolescents with Generalized Anxiety Disorder: Signal Detection and Validation. Ann. Clin. Psychiatry 2017, 29, 227A–234A. [Google Scholar]
- Teutsch, F.; Ramelow, D.; Maier, G.; Felder-Puig, R. Lineartabellen zu den Ergebnissen der HBSC-Studie 2018: Gesundheit und Gesundheitsverhalten von Schülerinnen und Schülern in Österreich; Bundesministerium für Arbeit, Soziales, Gesundheit und Konsumentenschutz: Vienna, Austria, 2018. [Google Scholar]
- The Lancet Child & Adolescent Health Growing up in a Digital World: Benefits and Risks. Lancet Child Adolesc. Health 2018, 2, 79. [CrossRef]
- Abi-Jaoude, E.; Naylor, K.T.; Pignatiello, A. Smartphones, Social Media Use and Youth Mental Health. CMAJ 2020, 192, E136–E141. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Silva, B.M.C.; Rodrigues, J.J.P.C.; de la Torre Díez, I.; López-Coronado, M.; Saleem, K. Mobile-Health: A Review of Current State in 2015. J. Biomed. Inform. 2015, 56, 265–272. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Higgins, J.P. Smartphone Applications for Patients’ Health and Fitness. Am. J. Med. 2016, 129, 11–19. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Variable | N | % |
---|---|---|
Age | ||
14 | 595 | 8.3 |
15 | 1181 | 16.4 |
16 | 1569 | 21.8 |
17 | 1785 | 24.8 |
18 | 1345 | 18.7 |
19 | 510 | 7.1 |
20 | 216 | 3.0 |
Gender | ||
Female | 5056 | 70.2 |
Male | 1994 | 27.7 |
Diverse | 151 | 2.1 |
Migration background | ||
No | 5722 | 81.2 |
Yes | 1323 | 18.8 |
School type | ||
College for Higher Vocational Education | 2820 | 39.2 |
Academic Secondary School | 2744 | 38.1 |
Vocational Education/Apprenticeship | 1527 | 21.2 |
Others | 110 | 1.5 |
Time | ||
February 2021 | 3052 | 42.4 |
March–May 2021 | 1261 | 17.5 |
June–July 2021 | 720 | 10.0 |
September–November 2021 | 1505 | 20.9 |
April–May 2022 | 663 | 9.2 |
Region | ||
North-East (Vienna, Lower Austria, Upper Austria) | 4322 | 60.0 |
South-East (Carinthia, Styria, Burgenland) | 1599 | 22.2 |
West (Tyrol, Salzburg, Vorarlberg) | 1280 | 17.8 |
Smartphone Usage (h/d) vs. <1 h/d | |||||
---|---|---|---|---|---|
1–2 h/d | 3–4 h/d | 5–6 h/d | 7–8 h/d | >8 h/d | |
Depressive symptoms | 1.42 | 1.98 | 3.30 | 4.96 | 6.79 |
(0.91–2.22) | (1.28–3.06) | (2.13–5.11) | (3.14–7.83) | (4.28–10.78) | |
Anxiety symptoms | 1.22 | 1.42 | 2.05 | 2.50 | 3.96 |
(0.78–1.92) | (0.92–2.20) | (1.32–3.19) | (1.59–3.93) | (2.51–6.24) | |
Insomnia symptoms | 1.03 | 1.34 | 2.10 | 2.32 | 3.23 |
(0.60–1.79) | (0.79–2.28) | (1.23–3.57) | (1.35–4.00) | (1.88–5.56) | |
Moderate or high stress | 1.24 | 1.93 | 3.20 | 4.86 | 5.75 |
(0.80–1.95) | (1.25–2.99) | (2.03–5.04) | (2.89–8.18) | (3.35–9.89) |
Variable | Smartphone Usage | p-Value | |||||
---|---|---|---|---|---|---|---|
<1 h/d | 1–2 h/d | 3–4 h/d | 5–6 h/d | 7–8 h/d | >8 h/d | ||
Depressive symptoms | 28.2% | 37.0% | 46.8% | 61.3% | 71.8% | 78.3% | <0.001 |
Anxiety symptoms | 26.5% | 31.9% | 37.1% | 48.3% | 54.8% | 66.1% | <0.001 |
Insomnia symptoms | 14.3% | 15.1% | 19.3% | 28.1% | 30.9% | 39.7% | <0.001 |
Moderate or high stress | 68.4% | 74.9% | 83.6% | 90.7% | 94.4% | 95.5% | <0.001 |
Physically Active Days per Week vs. 0 Physically Active Days | |||||||
---|---|---|---|---|---|---|---|
1 Day | 2 Days | 3 Days | 4 Days | 5 Days | 6 Days | 7 Days | |
Depressive | 0.74 | 0.59 | 0.51 | 0.44 | 0.38 | 0.29 | 0.35 |
symptoms | (0.60–0.91) | (0.49–0.72) | (0.41–0.62) | (0.36–0.55) | (0.30–0.48) | (0.22–0.38) | (0.28–0.44) |
Anxiety | 0.88 | 0.73 | 0.61 | 0.55 | 0.51 | 0.43 | 0.46 |
symptoms | (0.74–1.06) | (0.61–0.88) | (0.51–0.73) | (0.45–0.68) | (0.41–0.64) | (0.33–0.56) | (0.37–0.58) |
Insomnia | 0.82 | 0.72 | 0.67 | 0.64 | 0.60 | 0.47 | 0.66 |
symptoms | (0.68–1.00) | (0.60–0.88) | (0.55–0.81) | (0.51–0.80) | (0.47–0.77) | (0.35–0.64) | (0.52–0.85) |
Moderate or high | 1.02 | 0.77 | 0.60 | 0.51 | 0.43 | 0.35 | 0.37 |
stress | (0.73–1.44) | (0.56–1.05) | (0.44–0.82) | (0.37–0.71) | (0.32–0.60) | (0.25–0.50) | (0.27–0.50) |
Physically Active Days per Week | p-Value | ||||||||
---|---|---|---|---|---|---|---|---|---|
0 Days | 1 Day | 2 Days | 3 Days | 4 Days | 5 Days | 6 Days | 7 Days | ||
Depressive symptoms | 71.6% | 66.5% | 59.1% | 54.8% | 48.7% | 42.6% | 37.7% | 37.5% | <0.001 |
Anxiety symptoms | 56.9% | 54.8% | 48.0% | 43.2% | 38.4% | 34.5% | 31.6% | 29.8% | <0.001 |
Insomnia symptoms | 34.1% | 29.2% | 25.3% | 23.1% | 20.9% | 19.0% | 16.0% | 19.7% | <0.001 |
Moderate or high stress | 92.5% | 92.8% | 89.9% | 87.6% | 83.8% | 80.0% | 77.7% | 74.4% | <0.001 |
Variable | Smartphone Usage | p-Value | |||||||
---|---|---|---|---|---|---|---|---|---|
<1 h/d | 1–2 h/d | 3–4 h/d | 5–6 h/d | 7–8 h/d | >8 h/d | ||||
Pre-pandemic | 3.6% | 25.7% | 41.9% | 19.3% | 6.2% | 3.3% | <0.001 | ||
Pandemic | 1.7% | 14.6% | 34.3% | 25.1% | 12.1% | 12.2% | <0.001 | ||
Physically Active Days per Week | |||||||||
0 days | 1 day | 2 days | 3 days | 4 days | 5 days | 6 days | 7 days | ||
Pre-pandemic | 8.4% | 17.3% | 21.8% | 20.1% | 12.1% | 8.1% | 5.4% | 6.7% | <0.001 |
Pandemic | 14.7% | 15.6% | 17.7% | 16.2% | 11.1% | 9.5% | 5.7% | 9.4% | <0.001 |
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Humer, E.; Probst, T.; Wagner-Skacel, J.; Pieh, C. Association of Health Behaviors with Mental Health Problems in More than 7000 Adolescents during COVID-19. Int. J. Environ. Res. Public Health 2022, 19, 9072. https://doi.org/10.3390/ijerph19159072
Humer E, Probst T, Wagner-Skacel J, Pieh C. Association of Health Behaviors with Mental Health Problems in More than 7000 Adolescents during COVID-19. International Journal of Environmental Research and Public Health. 2022; 19(15):9072. https://doi.org/10.3390/ijerph19159072
Chicago/Turabian StyleHumer, Elke, Thomas Probst, Jolana Wagner-Skacel, and Christoph Pieh. 2022. "Association of Health Behaviors with Mental Health Problems in More than 7000 Adolescents during COVID-19" International Journal of Environmental Research and Public Health 19, no. 15: 9072. https://doi.org/10.3390/ijerph19159072
APA StyleHumer, E., Probst, T., Wagner-Skacel, J., & Pieh, C. (2022). Association of Health Behaviors with Mental Health Problems in More than 7000 Adolescents during COVID-19. International Journal of Environmental Research and Public Health, 19(15), 9072. https://doi.org/10.3390/ijerph19159072