Mental health of high school students improved during pandemic: study

A recent study in Japan has observed a reduction in psychological stress and healthier mental health states among adolescents living in Tokyo during the COVID-19 pandemic.

“Analysis revealed that during the COVID-19 pandemic, adolescents were less likely to experience a depressive state and more likely to transition to a healthier psychological state,” said the researchers, who assessed monthly Kessler 6-item Psychological Distress Scale (K6) questionnaire responses from 16- to 18-year-old high school students in the population-neuroscience Tokyo TEEN Cohort (pn-TTC).

Eighty-four adolescents (42 males and 42 females) participated and had a total of 1,278 responses. The pn-TTC, a population-based longitudinal study, followed children to explore their developmental and mental health trajectories.

In addition to conventional statistical approaches, the researchers also applied energy landscape analysis, a method derived from statistical physics that models multivariate psychological states as a dynamic system of interactions among K6 items, to visualize longitudinal changes in psychological distress before and during the COVID-19 pandemic (July 2019 to September 2021).

“Here, we define the depressive and healthy states as configurations in which all six K6 items are above or below each participant’s individual mean, respectively,” the researchers said.

The healthy state before the pandemic occurred 11.0 times as frequently as the depressive state. Conversely, the relative frequency of the healthy state during the pandemic rose to 18.2, 18.5, and 15.0 times that of the depressive state. [PLoS Med 2026;23:e1004884]

“The evolving energy landscape revealed an association between the pandemic period and a lower likelihood of being in a depressive state,” the researchers said.

In addition, two groups of studies with different K6 dynamics and energy landscapes were identified. The first group involved 61 adolescents with relatively low (<5) and stable total K6 score over time, while the second one consisted of 23 individuals with higher (>5) and less stable K6 score.

The second group demonstrated a higher change in cortical thickness in the caudal part of the middle frontal gyrus (t=‒2.36; p=0.019; q=0.048) and the temporal lobe (t=3.08; p=0.0023; q=0.012), as measured by MRI, in the direction of accelerated development of the adolescent brain.

“Because all participants lived in Tokyo, generalizability remains limited, and as the association between psychological states and brain development is descriptive, future studies in diverse cohorts are needed to examine causality,” according to the researchers.

Nuisance

These findings support those from the UK, China, and South Korea, indicating improved mental health states among adolescents in response to the COVID-19 public health emergency. [BMJ 2021;372:n614; Eur Child Adolesc Psychiatry 2024;33:1551-1561; Eur Child Adolesc Psychiatry 2024;33:1551-1561; JAMA Netw Open 2021;4:e2136137]

On the other hand, studies in the US and Europe report contrasting results, indicating a general decline in mental health among adolescents during the pandemic. [Psychiatr Serv 2022;73:1202-1209; Child Adolesc Psychiatry Ment Health 2022;16:109; Int J Environ Res Public Health 2022;19:9347]

“These seemingly contradictory findings point to two different aspects of high school. In one aspect, schools are a fun place that provide face-to-face interaction with peers; the pandemic deprived students of such opportunities,” the researchers said.

“In another aspect, schools are a nuisance, forcing students to participate in mandatory activities and study in preparation for college entrance exams (especially in East Asia, including Japan); the pandemic and school closures freed students from this, if only temporarily,” they added.

Furthermore, external factors, including family socioeconomic status, parental stress, and access to the internet, may have contributed to improvements in mental health among adolescents during the COVID-19 pandemic. [Sci Adv 2023;9:eadh4030; Sci Rep 2021;11:22373]

“In fact, our participants tended to come from relatively affluent families who were cooperative with our repeated surveys; therefore, it is possible that the adolescents were content to stay home rather than go to school,” the researchers said.