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Cited by 159COVID-19 and Mental HealthDigital Mental Health InterventionsImpact of Technology on Adolescents

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Social isolation, mental health, and use of digital interventions in youth during the COVID-19 pandemic: A nationally representative survey

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Rauschenberg, Christian, Schick, Anita, Goetzl, Christian, Roehr, Susanne, Riedel-Heller, Steffi G., Koppe, Georgia, Durstewitz, Daniel, Krumm, Silvia, Reininghaus, Ulrich·2021·European Psychiatry
DOI 10.1192/j.eurpsy.2021.17PMC PMC7985650

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Abstract

Background: Public health measures to curb SARS-CoV-2 transmission rates may have negative psychosocial consequences in youth. Digital interventions may help to mitigate these effects. We investigated the associations between social isolation, COVID-19-related cognitive preoccupation, worries, and anxiety, objective social risk indicators, and psychological distress, as well as use of, and attitude toward, mobile health (mHealth) interventions in youth. Methods: Data were collected as part of the “Mental Health And Innovation During COVID-19 Survey”—a cross-sectional panel study including a representative sample of individuals aged 16–25 years ( N = 666; M age = 21.3; assessment period: May 5, 2020 to May 16, 2020). Results: Overall, 38% of youth met criteria for moderate or severe psychological distress. Social isolation worries and anxiety, and objective 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 toward using mHealth interventions, whereas psychological distress, worries, and anxiety were associated with actual use. Conclusions: Public health measures during pandemics may be associated with poor mental health outcomes in youth. Evidence-based digital interventions may help mitigate the negative psychosocial impact without risk of viral infection given there is an objective need and subjective demand.

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Figure 1. Associations of social isolation with psychological distress. Notes: Odds ratios and 95% confidence intervals are shown. *p < 0.05; **p < 0.001. aK10 cutoff of >19 has been used to index presence vs. absence of any mild, moderate, or severe psychological distress as the outcome variable. bModel adjusted for age, gender, educational level, migrant/ethnic minority group position, and employment status.
Figure 1. Associations of social isolation with psychological distress. Notes: Odds ratios and 95% confidence intervals are shown. *p < 0.05; **p < 0.001. aK10 cutoff of >19 has been used to index presence vs. absence of any mild, moderate, or severe psychological distress as the outcome variable. bModel adjusted for age, gender, educational level, migrant/ethnic minority group position, and employment status.CC BY · PubMed Central
Figure 2. Associations of psychological distress with the positive attitude toward using mHealth apps. Notes: Odds ratios and 95% confidence intervals are shown. *p < 0.05; **p < 0.001. aModel adjusted for age and gender and social risk indicators (i.e., education, migrant/ethnic minority group position, and employment status). bThe following K10 cutoffs were used to categorize severity levels of psychological distress: “none” (range score: 10–19); “mild” (range score: 20–24); “moderate” (range score: 25–29); “severe” (range score: 30–50).
Figure 2. Associations of psychological distress with the positive attitude toward using mHealth apps. Notes: Odds ratios and 95% confidence intervals are shown. *p < 0.05; **p < 0.001. aModel adjusted for age and gender and social risk indicators (i.e., education, migrant/ethnic minority group position, and employment status). bThe following K10 cutoffs were used to categorize severity levels of psychological distress: “none” (range score: 10–19); “mild” (range score: 20–24); “moderate” (range score: 25–29); “severe” (range score: 30–50).CC BY · PubMed Central

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  1. Mallet, 1997, MRC sociodemographic schedule

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Authors
Rauschenberg, C., Schick, A., Goetzl, C., Roehr, S., Riedel-Heller, S. G., Koppe, G., Durstewitz, D., Krumm, S., & Reininghaus, U.
Affiliations
  • Heidelberg University (DE)
  • Leipzig University (DE)
  • Universität Ulm (DE)
  • King's College London (GB)
Corresponding author
Rauschenberg, Christian
ORCID
Venue
European Psychiatry
Publisher
Royal College of Psychiatrists
Published
2021
Volume
64
Issue
1
Pages
e20-e20
ISSN
  • 0924-9338 (ISSN-L)
  • 1778-3585
DOI
10.1192/j.eurpsy.2021.17
PMC
PMC7985650
OpenAlex
W3134046440
Cited by
158
References
60
Citations by year
2026: 6 · 2025: 21 · 2024: 27 · 2023: 37 · 2022: 38 · 2021: 28
FWCI
22.34
Type
journal article
Language
en
Open access
Licence
Locations
  • European Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion, other-oa)
  • PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
  • PsyArXiv (OSF Preprints) (submittedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
Keywords
social isolation, youth mental health, COVID-19 pandemic, mobile health intervention, digital interventions, psychological distress, anxiety, worry, public health measures, adolescents and young adults
MeSH terms
Internet-Based Intervention, COVID-19, SARS-CoV-2, Anxiety, Cross-Sectional Studies, Female, Germany, Humans, Male, Mental Health, Quarantine, Social Isolation, Stress, Psychological, Telemedicine, Young Adult

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