Among about 1.7 million US youths, both girls and boys experienced increases in some common mental illnesses during the COVID-19 pandemic, but girls were particularly affected, with more than a doubling of eating disorders among adolescent girls, according to a study published yesterday in JAMA Network Open.
Researchers from Brigham and Women's Hospital and Stanford University used a commercial healthcare claims database to evaluate the monthly percentage of youths aged 6 to 18 years who received one of four mental illness diagnoses—anxiety disorders, attention-deficit hyperactivity disorder [ADHD], depression, and eating disorders—from January 2018 to March 2022.
On average for any given month, 25.3% of participants were 6- to 12-year-old girls , 23.6% were 13- to 18-year-old girls, 26.5% were boys aged 6 to 12, and 24.5% were boys aged 13 to 18.
The researchers noted that the pandemic disrupted daily life, increased isolation and social media use, lowered access to care, and exacerbated the financial situations of many families—all which could have influenced children's mental health.
Eating disorders up in all groups
When schools began to reopen after the first waves of the pandemic (October 2020 to March 2022), the prevalence of all four mental illnesses rose immediately among girls aged 13 to 18. Diagnoses of all disorders other than depression increased faster during than before the pandemic. Notably, the prevalence of eating disorders more than doubled among adolescent girls after the pandemic began (from 0.26% in March 2020 to 0.56% in March 2022).
Among participants aged 6 to 12, the rates of all mental illness diagnoses were lower than those of adolescents except for ADHD, with eating disorders following a similar trajectory to that of 13- to 18-year-olds.
The prevalence of eating disorders was much lower in 13- to 18-year-old boys, but trends were comparable to those of girls of the same age (0.03% of boys in March 2020 to 0.06% in March 2022). Changes in the prevalence of other mental illness diagnoses were not seen among teen boys from before to during the pandemic.
Among participants aged 6 to 12, the rates of all mental illness diagnoses were lower than those of adolescents except for ADHD, with eating disorders following a similar trajectory to that of 13- to 18-year-olds from before to during the pandemic (from 0.03% to 0.05% among girls and 0.01% to 0.03% among boys).
Urgent action needed to protect girls
"This cross-sectional study suggests that trends in MH [mental health] diagnoses differed greatly by age and sex over the course of the COVID-19 pandemic," the study authors wrote.
"Female youth, especially female adolescents, represented the most vulnerable population with regard to marked increases in the prevalence of MH diagnoses during the pandemic, the most pronounced being the prevalence of eating disorders."
The results, they said, underscore the urgency of taking action "to identify the underlying factors associated with the increase in MH diagnoses in female adolescents (eg, social isolation or accelerated reliance on social media), so that targeted mitigation strategies can be developed to reverse the alarming trend which has continued several years into the COVID-19 pandemic."