The Impact of COVID-19-Related Lockdown on Adolescent Mental Health in China: A Prospective Study

Background: The potentially devastating impact of novel coronavirus disease 2019 (COVID-19) has led to wide-spread concern about how individuals’ mental health will be affected. Evidence suggests that mental health in the general population has worsened due to enforced isolation during this pandemic, but it remains unknown how lockdown measures have specifically affected the wellbeing of children and adolescents.Methods: This longitudinal study investigated the psychological impact and mental health status of 1349 adolescents before, during and after the Chinese lockdown from 21 January 2020 to 13 April 2020 and identified risk and protective factors.Outcomes: Counter to our expectations, during the lockdown, school closures had a beneficial effect by reducing depression and anxiety symptoms, whereas the lockdown itself, online learning, and tracking of health information worsened these outcomes as expected. Compared with before the pandemic, unexpectedly, an overall decrease in depressive and anxiety symptoms, state anhedonia, and bullying victimization were found before, during and after lockdown. Protective factors included positive attributional style, whereas COVID-19-related stressors, anhedonia, negative attributional style, bullying, bullying victimization and schizotypal personality traits were potential risk factors.Interpretation: The decrease in emotional and behavioural problems relative to previous trends indicated that school closures may have improved the mental health of adolescents in China overall. The results investigated risk and protective factors related to COVID-19 that may better protect children and adolescents. Funding: Social Science Foundation of Hunan ProvinceDeclaration of Interests: There are no conflicts of interest specifically related to this work.Ethics Approval Statement: The study was approved by the Wenzhou Medical University ethics committee (2020-131).