New Study Reports High Rates of Anxiety and Depression in 11- to 13-Year-Olds During the COVID-19 Pandemic

Rates of depression in 11- to 13-year-olds increased significantly between the early and middle stages of the COVID-19 pandemic, and rates of anxiety and suicidal ideation stayed consistently high during the same period, according to a new study conducted in three U.S. states. The study, supported by the National Center for Complementary and Integrative Health with co-funding from the National Institute on Drug Abuse, the Office of Disease Prevention, and the Office of Behavioral and Social Sciences Research, and published in the Journal of Adolescence, also showed differences among population subgroups, with the greatest concerns about girls and Hispanic/Latinx youth in the early pandemic and among girls and Medicaid-insured youth at mid-pandemic.

Research conducted before the COVID-19 pandemic showed rates of anxiety, depression, and suicidal ideation among U.S. adolescents ranging from about 4 to 12 percent. Studies conducted during the early stage of the COVID-19 pandemic showed similar or slightly higher rates. This study extended the findings of previous research by analyzing data collected from a group of early adolescents, aged 11 to 13 years, during two time periods within the pandemic: March to September 2020 (early pandemic) and September 2020 to May 2021 (mid-pandemic). 

The 623 participants were recruited from pediatric primary care practices in California, Colorado, and Michigan for a pragmatic trial study testing the feasibility and effectiveness of implementing Guiding Good Choices, a family-focused substance use prevention program for caregivers of younger adolescents in health care systems. They completed a baseline behavioral health survey between March and September 2020, and then, because of a pandemic-related delay in the start of the study, they completed the survey again between September 2020 and May 2021. The survey included measures of anxiety (generalized anxiety disorder scale-7 [GAD-7]) and depression (patient health questionnaire-9 [PHQ-9]). The PHQ-9 item on “thoughts that you would be better off dead or of hurting yourself in some way” was used to assess suicidal ideation. 

During the early stage of the pandemic, 10.5 percent of the youth reported moderate-to-severe depression, with the lowest rate in boys (3.6 percent) and the highest rates in Hispanic/Latinx youth (16.7 percent) and girls (16.0 percent). In the overall sample, the rate of moderate-to-severe depression increased significantly from early to mid-pandemic, from 10.5 to 15.1 percent. The largest increases were seen in boys, black youth, and Medicaid-insured youth. Hispanic/Latinx youth showed a nonsignificant decrease in depression (from 16.7 to 13.9 percent). 

In the early stage of the pandemic, 12.0 percent of the youth reported moderate-to-severe anxiety, with the lowest rates in boys (4.6 percent) and Black youth (7.1 percent), and the highest rates in girls (17.7 percent) and Hispanic/Latinx youth (15.3 percent). The overall sample showed a nonsignificant increase in the prevalence of anxiety between early and mid-pandemic. In contrast, a decrease in the prevalence of anxiety was seen among Hispanic/Latinx youth at mid-pandemic.  

Early in the pandemic, 9.3 percent of the youth reported suicidal ideation, with the lowest rate among boys (4.8 percent) and the highest rates among girls (13.1 percent) and Hispanic/Latinx youth (12.2 percent). Nonsignificant increases were observed in the overall sample and some subgroups from early to mid-pandemic, and a nonsignificant decrease was seen among Hispanic/Latinx youth.

The researchers said that the COVID-19 pandemic may have had a persistent negative impact on mental health in early adolescents, as symptoms did not improve despite reductions in restrictions and closures in response to COVID-19 between early and mid-pandemic. The findings underscore the need for continued support for youth who experienced pandemic-related stressors. The researchers suggested that the possible improvements seen among Hispanic/Latinx youth from early to mid-pandemic might reflect the larger prevalence of multigenerational households in this group, which could contribute to a greater sense of community, perceived support, and resiliency. Additionally, most of the Hispanic/Latinx youth lived in Northern California or Colorado, where cities created outdoor space to promote outdoor activities during the pandemic, and these efforts were shown to significantly lower anxiety and depression.