Self-perceived impact of COVID-19 measures and adolescent mental health: gender, age and socioeconomic differences in 22 Countries

Abstract Background The COVID-19-pandemic had a profound impact on the adolescents’ lives worldwide. In our study, we examined the self-perceived impact of the COVID-19 pandemic measures and its association with mental health and well-being among a representative sample of 13-and 15-years-old adolescents from 22 countries. Methods Data from the cross-national Health Behaviour in School-aged Children (HBSC) 2021/22 study was used (N = 67,544; 51.9% girls). Self-perceived impact of COVID-19 measures was assessed by 10 items asking about its impact on e.g., relationships with family and friends, health, or eating behaviours. Mental health was evaluated by loneliness, psychosomatic health complaints, and life satisfaction. First, a non-parametric multilevel latent class analysis considering individual, and country-levels was conducted to identify COVID-19 impact groups. Second, logistic regression models adjusted by age and socioeconomic status were applied in order to assess the association between COVID-19 impact classes and mental health. The regression analyses were stratified by gender. Results Three classes were identified on individual level encompassing a neutral (51%), negative (18%) or positive (31%) perception of COVID-19 impact. No heterogeneous results of distribution were found within and across countries. Within the positive impact class, social relationships were the most important dimension, whereas mental health problems were mostly represented within the negative impact class. Adolescents with a negative perception of the COVID-19 showed worse mental health than peers with a neutral or positive perception. Girls with a negative perception showed higher levels of loneliness and psychosomatic health complaints and lower life satisfaction compared to boys and peers with a neutral or positive perception. Older adolescents and those with a low socioeconomic status showed more loneliness and lower life satisfaction. Conclusions The impact of COVID-19 pandemic showed quite heterogeneous patterns both within and across countries. Support interventions and health promotion should focus especially on girls, older adolescents, and those with a low SES as they were at higher risk of suffering from pandemic measures and associated problems of loneliness, psychosomatic complaints, and low life satisfaction. Adolescents are able to reflect on measures that impact their health and therefore should be involved in the decision-making process.