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Research on health records of 200,000 Israeli adolescents

Big data shows mental health issues spiked during pandemic among teen girls

Huge Israeli study reveals markedly higher rates of depression, stress, anxiety, eating disorders, and associated medication among girls, though experts say boys impacted as well

Nathan Jeffay is The Times of Israel's health and science correspondent

Illustrative image: A teenage girl suffering from depression (Ridofranz vis iStock by Getty Images)
Illustrative image: A teenage girl suffering from depression (Ridofranz vis iStock by Getty Images)

The number of teenage girls in Israel being diagnosed with depression has nearly doubled since before the pandemic, and their use of antidepressants and antipsychotics has rocketed by 40 percent and 68% respectively.

That’s according to recently published data on more than 200,000 Israeli 12 to 17-year-olds, which appears to indicate that the pandemic has had a markedly more severe impact on the developing minds of girls, while more boys were left relatively unscathed. Experts, however, believe boys have been impacted as well, in ways not necessarily borne out by the data.

The numbers show that between 2019 and 2021 depression diagnoses jumped from 4.8 per 1,000 girls to 8.1 per thousand.

Over that same period, the use of antidepressants among girls rose from 8.8 per 1,000 to 13.8.

Anxiety diagnoses among girls shot up from 8.3 per 1,000 in 2019 to 11.8 last year. For stress in females the jump was from 12 per 1,000 to 15.5, and for eating disorders the increase was from 4 to 6.6.

The research by Maccabi Healthcare Services, which was published online but has not yet peer reviewed, used anonymized data from all members in the relevant age bracket.

Rather than rely on a relatively small number of surveys or self-assessments to gain a picture of mental during the pandemic, the study instead utilized a big data approach by tapping into objective data about diagnoses and prescriptions among a massive cohort.

Illustrative image: a teenage girl at an appointment with a psychologist (iStock via Getty Images)

The authors, led by Maccabi analyst Yonatan Blu, wrote that the major mental health changes “can be attributed to anything from fear of the new unknown illness to extended lockdowns and school closures causing prolonged social isolation, lack of physical activity and inadequate healthy daily routines.”

Policymakers tried to mitigate the virus but overlooked children and neglected the need for preventative steps in mental health

Policymakers and experts have long warned about the potentially deleterious effect the pandemic has had on young people, who have had to navigate school closures, changed social structures and a world radically changed in the blink of an eye by a deadly plague.

“Policymakers tried to mitigate the virus but overlooked children and neglected the need for preventative steps in mental health, while closing many of the structures that support children and families for long periods,”  Prof. Carmit Katz, of Tel Aviv University’s School of Social Work, told The Times of Israel.

“Now, after two years, we’re starting to see how the policies, without the addition of measures to look after mental health, have affected children,” said Katz, who was not involved in the research.

According to Katz, if not well handled, the mental health impact of the pandemic on teenagers could be felt “for many years.”

Despite the large amounts of data backing the research, the Maccabi authors cautioned that some of the change in the mental health picture could have resulted from parents being more attuned to the mental health of their children as they spent more time together during lockdowns.

“Closures and extended contact with the parents at home may also increase parental awareness and there may also be an increase in legitimacy to discuss mental distress during these times,” wrote Blu and his colleagues.

Illustrative image: classroom at an elementary school in Tel Aviv is empty after Israel closed schools ahead of a nationwide lockdown to halt the spread of the coronavirus, September 17, 2020. (AP Photo/Sebastian Scheiner)

They added: “Stay-at-home policies and school closures may have given teenagers more opportunity to share such problems with their parents, and for parents to observe such difficulties even if they were not verbally communicated.”

Yet the study also suggests that the mental health toll of the pandemic has either been far lighter on teenage boys, or they haven’t sought medical help to the same extent.

New anxiety diagnosis for boys rose from 6.3 per 1,000 in 2019 to 7.7 in 2021; for stress the figures were 8.4 and 9 respectively, and for eating disorders, a rise from 1.1 to 1.3. The rate of diagnoses from depression went from 3.5 to 3.4 per 1,000.

The authors suggest the discrepancy between genders may be related to school closures. They claim educators are more adept at referring boys than girls to mental health services, as their mental health challenges are more likely to cause disruptive behavior that trigger teachers to recommend assessment.

“Since schools were closed during large parts of the analyzed period, potential increase due to the pandemic may have been offset by the decrease in school referrals,” they wrote.

Katz too believes that boys’ mental health issues from the pandemic exist, even if they don’t show in the stats.

“Boys are also going through distress but boys are far more reluctant to disclose this, and we’re actually overlooking mental issues faced by boys, which worries me further,” she said.

Mental health for all kids has been neglected during the pandemic, Katz said.

“We overlooked the mental needs of children and now we have to focus on national efforts to prioritize this,” she said. ”How long this lasts for depends on us. If we act fast we can mitigate this in around two years, whereas if we don’t respond, this could be with us for many years.”

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