Boys' depressive symptoms rise with pandemic; girls improved during initial school closures

A study opens in new tab/window in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) opens in new tab/window, published by Elsevier, found that girls and boys were affected differently by the pandemic. The study focused on depressive symptoms among 16-year-olds surveyed during the pandemic compared to those surveyed pre-pandemic. There was an increase in depressive symptoms in boys beyond the expected age-related trajectory, which emerged later in the first year of the pandemic and then early into the second year. In contrast, the overall increase in depressive symptoms for girls was within the expected natural age-related increase.

Studies report a decline in adolescent mental health during the COVID-19 pandemic. However, many of these studies lacked pre-pandemic comparison data or did not consider the natural age-related changes in mental health problems experienced during adolescence, making it challenging to accurately evaluate the impact of the pandemic on adolescent mental health. Moreover, many studies focused on the initial months of the pandemic, therefore, little is known about the impact of the pandemic into the second year.

This longitudinal study utilized data from 2,034 adolescents in the Tokyo Teen Cohort, a population-based cohort in Tokyo, which continuously collected data throughout the pandemic. The study compared self-reported depressive symptoms of 16-year-olds surveyed before (February 2019-February 2020) or during the pandemic (March 2020-September 2021). Importantly, the study is innovative by comparing symptoms of 16-year-olds before or during the pandemic while controlling for within-person symptom changes, which allowed the researchers to determine whether changes in depressive symptoms were within the expected sex- and age-related trajectories.

Depressive symptoms showed a small but significant increase during the pandemic; however, this increase varied by sex and pandemic phase. While girls showed greater average depressive symptoms than boys at age 16, a significant increase during the pandemic was observed only in boys. For boys, the increase emerged in the late first year of the pandemic and enlarged into the second year. In contrast, girls’ depressive symptoms decreased in the school-closure phase (March-May, 2020) during the early pandemic period, and returned to the pre-pandemic level after the reopening of schools, with no additional increases during the pandemic. No differences by household income were observed.

Mariko Hosozawa, MD, PhD, lead author from the National Center for Global Health and Medicine, said “The impact of the COVID-19 pandemic on the mental health of adolescents in Tokyo was more pronounced among boys. This may partly be due to extended restrictions on school activity for infection control, which may have affected boys more, and to gendered social norms that discourage boys from seeking help.”

She adds, “The findings highlight the need for continuous monitoring and approaches to support adolescent mental health at the population level. Changing social norms around help-seeking and encouraging help-seeking for mental health issues, particularly among boys, is an important approach. Implementing these approaches and accumulating scientific evidence on the pandemic's effects on adolescent mental health, will help enhance pandemic preparedness and build a more resilient society.”

Notes for editors

The article is "Sex Differences in Adolescent Depression Trajectory Before and Into the Second Year of COVID-19 Pandemic," by Mariko Hosozawa, MD, PhD, Shuntaro Ando, MD, PhD, Satoshi Yamaguchi, PhD,Syudo Yamasaki, PhD, Jordan DeVylder, PhD, Mitsuhiro Miyashita, MD, PhD, Kaori Endo, PhD, Daniel Stanyon, MSc, Gemma Knowles, PhD, Miharu Nakanishi, RN, PhD, Satoshi Usami, PhD, Hiroyasu Iso, MD, PhD, Toshi A. Furukawa, MD, PhD, Mariko Hiraiwa-Hasegawa, PhD, Kiyoto Kasai, MD, PhD, Atsushi Nishida, MD, PhD (https://doi.org/10.1016/j.jaac.2023.08.016). It appears in Journal of the American Academy of Child and Adolescent Psychiatry, volume 63, issue 5(May 2024), published by Elsevier opens in new tab/window.

This research was conducted by a team at National Center for Global Health and Medicine, Tokyo Metropolitan Institute of Medical Science, University of Tokyo and multiple other institutions.

Copies of this paper are available to credentialed journalists upon request; please contact Mariko Hosozawa, PhD, at [email protected].

About JAACAP

Journal of the American Academy of Child and Adolescent Psychiatry opens in new tab/window (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescents. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

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