Top

Child and Adolescent Psychiatry and Mental Health

Published in:

Open Access 01-12-2023 | COVID-19 | Research

Risk and protective factors related to changes in mental health among adolescents since COVID-19 in Hong Kong: a cross-sectional study

Authors: Cheuk Yui Yeung, Vera Yu Men, Wendy W. Y. So, Daniel Yee Tak Fong, Mona Wai Cheung Lam, Derek Yee Tak Cheung, Paul Siu Fai Yip

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2023

Abstract

Background

Most research has suggested that children and adolescents had poorer mental health than pre-COVID-19 pandemic status. There have been few investigations into factors associated with pre-peri pandemic differences in young people’s mental health status. Our study aimed to investigate the association between sociodemographic factors, attitudes, and daily life experiences and these differences.

Methods

We used self-reported cross-sectional data from the Youth Sexuality Survey (YSS) by the Family Planning Association of Hong Kong, collected from secondary school students aged 10–16 between the fourth and fifth waves of the pandemic. The study outcome was pre-peri pandemic differences in mental health (better, unchanged, or poorer). Associations between the study outcome with age, sex, satisfaction with academic performance, school life, relationship with classmates and family life, and average sleeping and exercising time in the past month, were assessed through multinomial logistic regression, controlling for depressive/anxiety symptoms and change in physical health status since the pandemic.

Results

There were 6,665 respondents. Compared with pre-pandemic, approximately 30% reported poorer mental health, whilst 20% reported better mental health. Females (OR = 1.355, 95% CI = 1.159–1.585) and those dissatisfied with their academic performance (OR = 1.468, 95% CI = 1.233–1.748) were significantly more likely to report poorer mental health with reference to unchanged status, while those satisfied with family life had improved mental health with reference to unchanged (OR = 1.261, 95% CI = 1.006–1.579) and poorer status (OR = 1.369, 95% CI = 1.085–1.728).

Conclusion

Policy and community strategies that promote good family relationships are thus essential for young people’s mental health during societal challenges such as the COVID-19 pandemic.

Available only for authorised users

Mantovani A, Rinaldi E, Zusi C, Beatrice G, Saccomani MD, Dalbeni A. Coronavirus disease 2019 (COVID-19) in children and/or adolescents: a meta-analysis. Pediatr Res [Internet]. Springer US; 2021;89:733–7. Available from: https://doi.org/10.1038/s41390-020-1015-2.

Viner R, Russell S, Saulle R, Croker H, Stansfield C, Packer J, et al. School Closures during Social Lockdown and Mental Health, Health Behaviors, and well-being among children and adolescents during the First COVID-19 Wave: a systematic review. JAMA Pediatr. 2022;176:400–9.CrossRefPubMed

Department of Health. Data in Coronavirus Disease (COVID-19) [Internet]. 2023. Available from: https://data.gov.hk/en-data/dataset/hk-dh-chpsebcddr-novel-infectious-agent.

Wong S-C, Au AK-W, Lo JY-C, Ho P-L, Hung IF-N, To KK-W et al. Evolution and Control of COVID-19 Epidemic in Hong Kong. Viruses [Internet]. 2022;14:2519. Available from: https://www.mdpi.com/1999-4915/14/11/2519.

Fong M, Cowling B, Leung G, Wu P. Letter to the editor: COVID-19 cases among school-aged children and school-based measures in Hong Kong, July 2020. Eurosurveillance [Internet]. 2020;25. Available from: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.37.2001671.

Okuyama J, Seto S, Fukuda Y, Funakoshi S, Amae S, Onobe J et al. Mental Health and Physical Activity among Children and Adolescents during the COVID-19 Pandemic. Tohoku J Exp Med [Internet]. 2021;253:203–15. Available from: https://www.jstage.jst.go.jp/article/tjem/253/3/253_203/_article.

Creswell C, Shum A, Pearcey S, Skripkauskaite S, Patalay P, Waite P. Young people’s mental health during the COVID-19 pandemic. Lancet Child Adolesc Heal [Internet]. 2021;5:535–7. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2352464221001772.

Cost KT, Crosbie J, Anagnostou E, Birken CS, Charach A, Monga S et al. Mostly worse, occasionally better: impact of COVID-19 pandemic on the mental health of Canadian children and adolescents. Eur Child Adolesc Psychiatry [Internet]. Springer Berlin Heidelberg; 2022;31:671–84. Available from: https://doi.org/10.1007/s00787-021-01744-3.

Patrick SW, Henkhaus LE, Zickafoose JS, Lovell K, Halvorson A, Loch S, et al. Well-being of parents and children during the COVID-19 pandemic: a National Survey. Pediatrics. 2020;146:e2020016824.CrossRefPubMed

10.

Penner F, Hernandez Ortiz J, Sharp C. Change in Youth Mental Health During the COVID-19 Pandemic in a Majority Hispanic/Latinx US Sample. J Am Acad Child Adolesc Psychiatry [Internet]. Elsevier Inc; 2021;60:513–23. Available from: https://doi.org/10.1016/j.jaac.2020.12.027.

11.

Secretary for Justice. Hong Kong e-Legislation Cap. 226 Juvenile Offenders Ordinance [Internet]. 2020. Available from: https://www.elegislation.gov.hk/hk/cap226?pmc=0&m=0&pm=1.

12.

Paruthi S, Brooks LJ, D’Ambrosio C, Hall WA, Kotagal S, Lloyd RM et al. Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine. J Clin Sleep Med [Internet]. 2016;12:785–6. Available from: https://doi.org/10.5664/jcsm.5866.

13.

Department of Health Student Health Service. Exercise and keep fit [Internet]. 2021. Available from: https://www.studenthealth.gov.hk/english/health/health_pe/health_pe_ekf.html.

14.

Löwe B, Kroenke K, Gräfe K. Detecting and monitoring depression with a two-item questionnaire (PHQ-2). J Psychosom Res [Internet]. 2005;58:163–71. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0022399904006361.

15.

Plummer F, Manea L, Trepel D, McMillan D. Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis. Gen Hosp Psychiatry [Internet]. 2016;39:24–31. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0163834315002406.

16.

Stine RA. Graphical Interpretation of Variance Inflation Factors. Am Stat [Internet]. 1995;49:53. Available from: https://www.jstor.org/stable/2684812?origin=crossref.

17.

Stewart SM, Lewinsohn PM, Lee PWH, Ho LM, Kennard B, Hughes CW, et al. Symptom patterns in depression and “subthreshold” depression among adolescents in Hong Kong and the United States. J Cross Cult Psychol. 2002;33:559–76.CrossRef

18.

Ng CSM, Hurry J. Depression Amongst Chinese Adolescents in Hong Kong: an evaluation of a stress moderation model. Soc Indic Res. 2011;100:499–516.CrossRef

19.

Hyde JS, Mezulis AH, Abramson LY. The ABCs of Depression: integrating Affective, Biological, and cognitive models to explain the emergence of the gender difference in Depression. Psychol Rev. 2008;115:291–313.CrossRefPubMed

20.

Santomauro DF, Mantilla Herrera AM, Shadid J, Zheng P, Ashbaugh C, Pigott DM et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet [Internet]. 2021;398:1700–12. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0140673621021437.

21.

Panagouli E, Stavridou A, Savvidi C, Kourti A, Psaltopoulou T, Sergentanis TN, et al. School performance among children and adolescents during covid-19 pandemic: a systematic review. Children. 2021;8:1–12.CrossRef

22.

Lau EYH, Lee K. Parents’ Views on Young Children’s Distance Learning and Screen Time During COVID-19 Class Suspension in Hong Kong. Early Educ Dev [Internet]. Routledge; 2021;32:863–80. Available from: https://doi.org/10.1080/10409289.2020.1843925.

23.

Möhring K, Naumann E, Reifenscheid M, Wenz A, Rettig T, Krieger U et al. The COVID-19 pandemic and subjective well-being: longitudinal evidence on satisfaction with work and family. Eur Soc [Internet]. Taylor & Francis; 2021;23:S601–17. Available from: https://doi.org/10.1080/14616696.2020.1833066.

24.

Our Hong Kong Foundation. Lacunae in Land Planning: Undersized, Undersupplied and Underestimated [Internet]. 2018. Available from: https://ourhkfoundation.org.hk/sites/default/files/media/pdf/land_housing_research_report_engv3.pdf.

25.

Legislative Council. Statistical Highlights: Working hours in Hong Kong [Internet]. 2019. Available from: https://www.legco.gov.hk/research-publications/english/1920issh06-working-hours-in-hong-kong-20191108-e.pdf.

26.

Education Bureau. Report on Student Enrolment Statistics [Internet]. 2021. Available from: https://www.edb.gov.hk/attachment/en/about-edb/publications-stat/figures/Enrol_2020.pdf.

Title: Risk and protective factors related to changes in mental health among adolescents since COVID-19 in Hong Kong: a cross-sectional study
Authors: Cheuk Yui Yeung
Vera Yu Men
Wendy W. Y. So
Daniel Yee Tak Fong
Mona Wai Cheung Lam
Derek Yee Tak Cheung
Paul Siu Fai Yip
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: COVID-19
Published in: Child and Adolescent Psychiatry and Mental Health / Issue 1/2023
Electronic ISSN: 1753-2000
DOI: https://doi.org/10.1186/s13034-023-00622-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk and protective factors related to changes in mental health among adolescents since COVID-19 in Hong Kong: a cross-sectional study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2023

Identification of subgroups of children in the Australian Autism Biobank using latent class analysis

Prenatal antidepressant exposure and emotional disorders until age 22: a danish register study

Artificial intelligence in pediatric behavioral health

Factors influencing junior high school students’ perceptions of attending school in Japan

Work-family interface and children's mental health: a systematic review

Social media use of adolescents who died by suicide: lessons from a psychological autopsy study