Differing impact of the COVID-19 pandemic on youth mental health: combined population and clinical study

Lu Qi, Zuo Zhang, Lauren Robinson, Marina Bobou, Chantal Gourlan, Jeanne Winterer, Rebecca Adams, Kofoworola Agunbiade, Yuning Zhang, Sinead King, Nilakshi Vaidya, Eric Artiges, Tobias Banaschewski, Arun Bokde, M. Broulidakis, Rüdiger Brühl, Herta Flor, Juliane Fröhner, Hugh Garavan, Antoine GrigisAndreas Heinz, Sarah Hohmann, Marie-Laure Martinot, Sabina Millenet, Frauke Nees, Betteke Noort, Dimitri Orfanos, Luise Poustka, Julia Sinclair, Michael Smolka, Robert Whelan, Argyris Stringaris, Henrik Walter, Gunter Schumann, Ulrike Schmidt, Sylvane Desrivieres

Research output: Contribution to journalArticlepeer-review


Background: Identifying youths most at risk to COVID-19-related mental illness is essential for the development of effective targeted interventions.

Aims: To compare trajectories of mental health throughout the pandemic in youth with and without prior mental illness and identify those most at risk of COVID-19-related mental illness.

Method: Data were collected from individuals aged 18-26 years (N = 669) from two existing cohorts: IMAGEN, a population-based cohort; and ESTRA/STRATIFY, clinical cohorts of individuals with pre-existing diagnoses of mental disorders. Repeated COVID-19 surveys and standardised mental health assessments were used to compare trajectories of mental health symptoms from before the pandemic through to the second lockdown.

Results: Mental health trajectories differed significantly between cohorts. In the population cohort, depression and eating disorder symptoms increased by 33.9% (95% CI 31.78-36.57) and 15.6% (95% CI 15.39-15.68) during the pandemic, respectively. By contrast, these remained high over time in the clinical cohort. Conversely, trajectories of alcohol misuse were similar in both cohorts, decreasing continuously (a 15.2% decrease) during the pandemic. Pre-pandemic symptom severity predicted the observed mental health trajectories in the population cohort. Surprisingly, being relatively healthy predicted increases in depression and eating disorder symptoms and in body mass index. By contrast, those initially at higher risk for depression or eating disorders reported a lasting decrease.

Conclusions: Healthier young people may be at greater risk of developing depressive or eating disorder symptoms during the COVID-19 pandemic. Targeted mental health interventions considering prior diagnostic risk may be warranted to help young people cope with the challenges of psychosocial stress and reduce the associated healthcare burden.
Original languageEnglish
Article numbere217
JournalBJPsych Open
Issue number6
Early online date20 Nov 2023
Publication statusPublished - 20 Nov 2023


  • COVID – 19
  • Adolescent
  • Alcohol use disorder
  • Depression
  • Eating disorder

Cite this