gms | German Medical Science

Background and current state of (inter)national research: Most European countries have adopted public health measures to lower the transmission of SARS-CoV-2 coronavirus. Physical distancing and quarantine have been amongst the most important non-pharmacological measures to reduce infection rates of coronavirus disease 2019 (COVID-19). These preventive measures may have a profound impact on public mental health. Initial reports on the negative psychosocial correlates are largely in line with findings on earlier pandemics and increased depression, anxiety, and loneliness have been reported. Digital interventions may help to mitigate these effects.

Research questions and objectives: We aimed to investigate the associations between social isolation, COVID-19-related cognitive preoccupation, worries, and anxiety, objective social risk indicators, psychological distress as well as use of, and attitude towards, digital mobile health (mHealth) interventions in youth during the COVID-19 pandemic.

Methods or hypothesis: Data were collected as part of the ‘Mental Health And Innovation During COVID-19 Survey’ – a cross-sectional panel study conducted in Germany including a representative sample of individuals aged 16 to 25 years (N=666; Mage 21·3). The study commenced on May 7^th and was completed on May 16^th, 2020. Logistic regression was used to test hypotheses.

Results: We found that 38% of youth met criteria for moderate mental health problems and 30% felt ‘often’ or ‘very often’ socially isolated, even after most restrictive infection control measures had been lifted. Social isolation, COVID-19-related worries and anxiety, and social risk indicators were associated with psychological distress, with evidence of dose-response relationships for some of these associations. For instance, psychological distress was progressively more likely to occur as levels of social isolation increased (reporting ‘never’ as reference group: ‘occasionally’: adjusted odds ratio [aOR] 9·1, 95% confidence interval [CI] 4·3 – 19·1, p<0·001; ‘often’: aOR 22·2, CI 9·8 – 50·2, p<0·001;’very often’: aOR 42·3, CI 14·1 – 126·8, p<0·001). There was evidence that psychological distress, worries, and anxiety were associated with a positive attitude towards using mHealth tools, whereas high levels of psychological distress, worries, and anxiety were associated with actual use.

Discussion: Public health measures during pandemics may be associated with poor mental health outcomes in youth. Digital interventions may help mitigate the negative psychosocial impact without risk of viral infection given there is an objective need and subjective demand.

Practical implications: Young people use digital tools to manage their mental health at times of public health crises. As the quality of evidence of currently available apps is often unknown or very limited, there is an urgent need to 1) develop and evaluate digital interventions specifically designed to address social isolation and poor mental health during public health crises across the full spectrum of public mental health provision (i.e., mental health promotion, prevention, treatment) and 2) make evidence-based digital interventions publicly available to improve public mental health.