COVID-19 lockdowns in Denmark did not increase self-injury, suicidality and eating disorder symptoms among young adults

Disease and treatment 19. mar 2023 2 min PhD Stine Danielsen Written by Morten Busch

When the global COVID-19 pandemic was declared in 2020, experts feared that the widespread lockdowns would adversely affect the mental health of young adults so strongly that it could increase self-injury, suicidality and eating disorder symptoms. However, one of the largest studies so far found no evidence supporting this. The researchers think that physical distancing may have benefitted some young adults since they had more time, fewer commitments and more family time. Nevertheless, the proportion of young adults with mental health problems is still alarmingly high.

The COVID-19 pandemic was a negative experience for most people. Adults 18–25 years old have especially been highlighted as indirect victims of the pandemic. Despite having low risk of serious illness, many still had to isolate at home with their parents and younger siblings – away from the social gatherings and friends that are so important for young people in creating their identity. Now the largest study to date has quantified how the pandemic lockdown affected the mental health of these young adults.

“We had expected the proportion of young adults with self-injury, suicidality and eating disorder symptoms to increase but did not find any change. In some cases, we even found a decline,” explains a lead researcher of the study, Stine Danielsen, Danish Research Institute for Suicide Prevention, Mental Health Center Copenhagen.

Snapshots and changes over time

The researchers were carrying out a large questionnaire survey of young adults’ well-being and mental health problems in Denmark when the World Health Organization declared a global pandemic on 11 March 2020. They therefore had the opportunity to compare the mental health of young respondents before and during the lockdown. In addition, they collected more data during the lockdown specifically about how the lockdown affected young adults.

“Most other studies have been cross-sectional – taking a snapshot at certain times during the pandemic – but lack a basis for comparison with the pre-pandemic situation, and determining with certainty whether things improved or got worse is difficult. We were fortunate to have a solid starting-point since we were already in full swing with our investigation when the pandemic started,” says Stine Danielsen.

The new project combines a longitudinal study with data obtained more than once to examine trends over time from 7,500 people through the Danish National Birth Cohort. Cross-sectional studies also compared the mental health of almost 25,000 people before and during the pandemic until spring 2021.

“The research on how the lockdowns affected mental health has various sources of bias. We therefore investigated this in various ways to reduce this bias. We did not find any increase in self-injury, suicidality and eating disorder symptoms. In the longitudinal study, we found a small decline but do not want to conclude too much from this, since the reason may be that people who respond several times are healthier than those who choose not to participate,” explains Stine Danielsen.

Still far too many

The researchers emphasise that this study was carried out at the population level, and the lockdown might have affected young adults differentially. The pressure on young adults to conform to social norms may have improved the mental health of some and worsened that of others.

“The survey indicates no change – perhaps even a slight decline. We can only guess at the reasons. Physical distancing could have benefitted some young people. During the lockdown, they were closer to their families and had more time and fewer commitments such as sports, jobs and parties,” says Stine Danielsen.

Although this is basically good news that COVID-19 did not immediately aggravate the problem, the situation was pretty bad before.

“Examining the data may enable insight into whether and why the pandemic made life easier for some young adults and harder for others. Maybe this knowledge can help us to reduce the overall number of people with major problems,” concludes Stine Danielsen.

If you are in crisis or have suicidal thoughts, tell someone. In Denmark, you can contact the Livslinien help line at +45 70 201 201 every day of the year between 11:00 and 5:00.

Self-injury, suicidality and eating disorder symptoms in young adults following COVID-19 lockdowns in Denmark” has been published in Nature Human Behaviour. The Danish National Birth Cohort was established with a grant from the Danish National Research Foundation. Additional support was provided by the Danish Regional Committees, the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Health Foundation and other minor grants. The Danish National Biobank has received support from the Lundbeck Foundation and the Novo Nordisk Foundation.

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