Changes in depressive symptoms in times of crisis and identification of mental health stressors

Abstract Background It is important to provide information about stressors that may increase the risk of psychological and somatic symptoms during crises. Thus, our study examined changes in depressive symptoms in relation to the COVID-19 pandemic and possible associations between, poor family economy, high academic pressure, low social support, loneliness and depressive symptoms. Methods Cross-sectional data were collected in 2018 (n = 28.218), 2021 (n = 24.311) and 2023 (n = 29.388) among Norwegian adolescents, aged 13-19. Multivariable binary logistic regression models, adjusted for sex and age, were used to examine possible associations between poor family economy, high academic pressure, low social support from teachers and friends, loneliness and depressive symptoms. Results The highest prevalence of depressive symptoms at all time-points was found among girls with poor family economy (2018: 49% vs. 2021: 56% vs. 2023:51%). Logistic regression models showed that more adolescents had depressive symptoms during the pandemic period (2021) compared to the pre-pandemic period (2018), and poor perceived family economy was associated with increased odds of depressive symptoms (OR 1.1; 95% CI 1.0-1.2 and 2.3;2.1-2.6). Experiencing high academic pressure and low support from teachers was also associated with increased odds of depressive symptoms (4.3; 4.1-4.5 and 1.9; 1.8-2.0). Likewise, low support from friends and being lonely was linked to increased odds of depressive symptoms (1.3; 1.2-1.4 and 13.6; 12.7-14.6). Finally, results revealed a stronger association between low support from friends and depressive symptoms in 2023 (1.4;1.3-1.6) compared to 2018 (1.2;1.0-1.3). Conclusions Prevalence of depressive symptoms increased during the pandemic, and especially among girls with poor family economy. In addition, high academic pressure, low support from teachers and friends and loneliness were associated with depressive symptoms. Key messages • The global crisis which involved school closure affected the mental well-being of adolescents, especially girls with poor family economy. • Academic pressure, low support from teachers and friends, and especially loneliness, were strongly linked to depressive symptoms among adolescents.