Impactos de la pandemia de COVID-19 en la salud mental de adolescentes uruguayos
Impacts of the COVID-19 pandemic on the mental health of Uruguayan adolescents
Cecilia Cracco , Alejandro Anselmi , Ana Machado , Natalia Estrade , Andrés Estradé , Marco Solmi , Christoph U. Correll
Suma Psicológica, (2025), 32(1), pp. 44-53.
Recibido el 10 de octubre de 2024
Aceptado el 27 de abril de 2025
Objetivos: Este estudio apuntó a la descripción de los niveles de bienestar y sintomatología ansiosa, depresiva, postraumática, problemas de sueño, incidencia de autolesiones, ideación suicida, e intentos de autoeliminación de adolescentes uruguayos durante la pandemia de COVID-19, contrastando con lo reportado para antes de la pandemia y comparando por género y presencia o ausencia de diagnóstico psicopatológico previo. Método: Se utilizó un diseño transversal observacional y se aplicó la encuesta internacional COH-FIT a 282 adolescentes uruguayos de entre 14 y 17 años (56.4 % género femenino) a través de un muestreo por conveniencia. Resultados: Se evidenció aumento en la sintomatología y disminución en el bienestar para los adolescentes en general. Un número importante de adolescentes reportó autolesiones no suicidas (25.9 %), ideación suicida (38.6 %) e intentos de autoeliminación (6.7 %). Las adolescentes mujeres presentaron peores niveles de bienestar, mayores niveles de psicopatología y mayor empeoramiento en casi todos los indicadores. Además, reportaron más autolesiones e ideación suicida que los varones. Los adolescentes con diagnóstico previo de salud mental presentaron menores niveles de bienestar y mayor sintomatología y presencia de autolesiones e ideación suicida. Conclusiones: Existió empeoramiento en la sintomatología y el bienestar durante la pandemia, siendo especialmente relevante la incidencia de ideación suicida.
Palabras clave:
COVID-19, salud mental, adolescentes, bienestar, síntomas psicopatológicos, suicidio
Objectives: This study reports levels of wellbeing and symptoms of anxiety, depression, posttraumatic stress, sleep disturbances, as well as the incidence of self-harm behaviours, suicidal ideation, suicide attempts among Uruguayan adolescents during the COVID-19 pandemic, by comparing self-report data corresponding to the times before and during the pandemic across gender and prior diagnosis of mental health disorder. Method: We conducted a cross-sectional, observational study using data from the international COH-FIT survey, involving 282 Uruguayan adolescents aged 14-17 (56.4% female), who were recruited through convenience sampling. Results: We observed an overall increase in self-reported symptoms of mental disorders and a decrease in wellbeing among adolescents. In addition, a high number of adolescents reported non-suicidal self-harm (25.9%), suicidal ideation (38.6%) and suicide attempts (6.7%). Regarding subgroup analyses, female adolescents and adolescents with a prior diagnosis of a mental health disorder presented lower levels of self-reported wellbeing, higher levels of symptoms of mental disorders, and a higher frequency of self-harm behaviours and suicidal ideation. Conclusion: We observed a deterioration in wellbeing and symptoms of mental disorders during the COVID-19 pandemic, being the high frequency of suicidal ideation of particular concern.
Keywords:
COVID-19, mental health, adolescents, well-being, psychopathological symptoms, suicide
Anselmi, A., Cracco, C., Estradé, A., Solmi, M., & Correll, C. U. (2024). Impactos de la pandemia de COVID-19 sobre el bienestar y la salud mental de adultos uruguayos. Ciencias Psicológicas, 18(2), e-4059. https://doi.org/10.22235/cp.v18i2.4059
Bignardi, G., Dalmaijer, E. S., Anwyl-Irvine, A. L., Smith, T. A., Siugzdaite, R., Uh, S., & Astle, D. E. (2021). Longitudinal increases in childhood depression symptoms during the COVID-19 lockdown. Archives of Disease in Childhood, 106(8), 791-797. https://doi.org/10.1136/archdischild-2020-320372
Carbajal, F., Rovner, H., & Tuzman, D. (2022). Cierre de escuelas en pandemia: los aprendizajes en Uruguay. Grupo Banco Mundial. https://documents1.worldbank.org/curated/en/099516407052273216/pdf/IDU08650fb4707dc304dce0b94a0a0a174b7347d.pdf
Chen, I.-H., Chen, C.-Y., Pakpour, A. H., Griffiths, M. D., & Lin, C.-Y. (2020). Internet-related behaviors and psychological distress among schoolchildren during COVID-19 school suspension. Journal of the American Academy of Child & Adolescent Psychiatry, 59(10), 1099-1102.e1. https://doi.org/10.1016/j.jaac.2020.06.007
Cracco, E., Goossens, L., & Braet, C. (2017). Emotion regulation across childhood and adolescence: Evidence for a maladaptive shift in adolescence. European Child & Adolescent Psychiatry, 26, 909-921. https://doi.org/10.1007/s00787-017-0952-8
Deng, J., Zhou, F., Hou, W., Heybati, K., Lohit, S., Abbas, U., Silver, Z., Wong, C. Y., Chang, O., Huang, E., Zuo, Q. K., Moskalyk, M., Ramaraju, H. B., & Heybati, S. (2022). Prevalence of mental health symptoms in children and adolescents during the COVID-19 pandemic: A meta-analysis. Annals of the New York Academy of Sciences, 1520(1), 53-73. https://doi.org/10.1111/nyas.14947
Dragioti, E., Li, H., Tsitsas, G., Lee, K. H., Choi, J., Kim, J., Choi, Y. J., Tsamakis, K., Estradé, A., Agorastos, A., Vancampfort, D., Tsiptsios, D., Thompson, T., Mosina, A., Vakadaris, G., Fusar-Poli, P., Carvalho, A. F., Correll, C. U., Han, Y. J., Park, S., Shin, J. I., & Solmi, M. (2022). A large-scale meta-analytic atlas of mental health problems prevalence during the COVID-19 early pandemic. Journal of Medical Virology, 94(5), 1935-1949. https://doi.org/10.1002/jmv.27549
Ferrando, S. J., Klepacz, L., Lynch, S., Shahar, S., Dornbush, R., Smiley, A., Miller, I., Tavakkoli, M., Regan, J., & Bartell, A. (2021). Psychiatric emergencies during the height of the COVID-19 pandemic in the suburban New York City area. Journal of Psychiatric Research, 136, 552-559. https://doi.org/10.1016/j.jpsychires.2020.10.029
Fondo Mundial de las Naciones Unidas para la Infancia (Unicef). (2021). Life in lockdown: Child and adolescent mental health and well-being in the time of COVID-19. Unicef. https://www.unicef-irc.org/publications/1227-life-in-lockdown.html
Hamza, C. A., Ewing, L., Heath, N. L., & Goldstein, A. L. (2021). When social isolation is nothing new: A longitudinal study on psychological distress during COVID-19 among university students with and without preexisting mental health concerns. Canadian Psychology, 62(1), 20-30. https://doi.org/10.1037/cap0000255
Harris, P. A., Taylor, R., Minor, B. L., Elliott, V., Fernández, M., O’Neal, L., McLeod, L., Delacqua, G., Delacqua, F., Kirby, J., & Duda, S. N. (2019). The REDCap consortium: Building an international community of software platform partners. Journal of Biomedical Informatics, 95, 103208. https://doi.org/10.1016/j.jbi.2019.103208
Instituto Nacional de la Juventud (INJU), Fondo de Población de Naciones Unidas, & Instituto Nacional de Estadística. (2023). Informe de panel de juventudes. Encuesta Nacional de Adolescencia y Juventud 2018-2022. https://uruguay.unfpa.org/es/panel-enaj
Ionio, C., Ciuffo, G., Villa, F., Landoni, M., Sacchi, M., & Rizzi, D. (2022). Adolescents in the Covid Net: What impact on their mental health? Journal of Child & Adolescent Trauma, 17, 115–121. https://doi.org/10.1007/s40653-022-00497-8
Isumi, A., Doi, S., Yamaoka, Y., Takahashi, K., & Fujiwara, T. (2020). Do suicide rates in children and adolescents change during school closure in Japan? The acute effect of the first wave of COVID-19 pandemic on child and adolescent mental health. Child Abuse & Neglect, 110, 104680. https://doi.org/10.1016/j.chiabu.2020.104680
Keyes, K. M., Gary, D., O’Malley, P. M., Hamilton, A., & Schulenberg, J. (2019). Recent increases in depressive symptoms among US adolescents: Trends from 1991 to 2018. Social Psychiatry and Psychiatric Epidemiology, 54(8), 987-996. https://doi.org/10.1007/s00127-019-01697-8
Khan, A., Khan, N., & Shafiq, M. (2021). The economic impact of COVID-19 from a global perspective. Contemporary Economics, 15(1), 64-75.
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Le Cessie, S., Goeman, J. J., & Dekkers, O. M. (2020). Who is afraid of non-normal data? Choosing between parametric and non-parametric tests. European Journal of Endocrinology, 182(2), E1-E3. https://doi.org/10.1530/eje-19-0922
Ma, L., Mazidi, M., Li, K., Li, Y., Chen, S., Kirwan, R., Zhou, H., Yan, N., Rahman, A., Wang, W., & Wang, Y. (2021). Prevalence of mental health problems among children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Affective Disorders, 293, 78-89. https://doi.org/10.1016/j.jad.2021.06.021
Machado, A. I., Arbach, K., Bobbio, A., & Parra, A. (2021). Prevalence of risk factors associated with psychopathological symptoms in Uruguayan adolescents, using the Personality Assessment Inventory (PAI-A). Mediterranean Journal of Clinical Psychology, 9(3), 1-32. https://doi.org/10.13129/2282-1619/mjcp-3084
Madigan, S., Eirich, R., Pador, P., McArthur, B. A., & Neville, R. D. (2022). Assessment of changes in child and adolescent screen time during the COVID-19 pandemic. JAMA Pediatrics, 176(12), 1188-1198. https://doi.org/10.1001/jamapediatrics.2022.4116
Madigan, S., Racine, N., Vaillancourt, T., Korczak, D. J., Hewitt, J. M. A., Pador, P., Park, J. L., McArthur, B. A., Holy, C., & Neville, R. D. (2023). Changes in depression and anxiety among children and adolescents from before to during the COVID-19 pandemic. JAMA Pediatrics, 177(6), 567-581. https://doi.org/10.1001/jamapediatrics.2023.0846
Magson, N. R., Freeman, J. Y. A., Rapee, R. M., Richardson, C. E., Oar, E. L., & Fardouly, J. (2021). Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic. Journal of Youth and Adolescence, 50(1), 44-57. https://doi.org/10.1007/s10964-020-01332-9
Martin, J., & Hadwin, J. A. (2022). The roles of sex and gender in child and adolescent mental health. JCPP Advances, 2(1), e12059. https://doi.org/10.1002/jcv2.12059
Mayo, L. M., Perini, I., Gustafsson, P. A., Hamilton, J. P., Kämpe, R., Heilig, M., & Zetterqvist, M. (2021). Psychophysiological and neural support for enhanced emotional reactivity in female adolescents with nonsuicidal self-injury. Biological Psychiatry. Cognitive Neuroscience and Neuroimaging, 6(7), 682-691. https://doi.org/10.1016/j.bpsc.2020.11.004
Mazrekaj, D., & De Witte, K. (2023). The impact of school closures on learning and mental health of children: Lessons from the COVID-19 pandemic. Perspectives on Psychological Science, 19(4), 686-693. https://doi.org/10.1177/17456916231181108
Miao, R., Liu, C., Zhang, J., & Jin, H. (2023). Impact of the COVID-19 pandemic on the mental health of children and adolescents: A systematic review and meta-analysis of longitudinal studies. Journal of Affective Disorders, 340, 914-922. https://doi.org/10.1016/j.jad.2023.08.070
Ministerio de Salud Pública (MSP). (2022). Estrategia de abordaje multisectorial de prevención del suicidio en Uruguay. https://www.gub.uy/ministerio-salud-publica/comunicacion/noticias/estrategia-abordaje-multisectorial-prevencion-del-suicidio-uruguay
Morey, L. C. (2007). The personality assessment inventory professional manual. Psychological Assessment Resources.
Mucci, G. A., Collins, E., Pearce, E., Avina, M., Hao, S., Onungwa, C., Bunac, J., Hunte, Y., Coopersmith, L., & Yewell, N. (2024). The lost years: An integrative review of the mental health, educational, and social impact of the pandemic on children and adolescents from 2019 to 2022. Journal of Pediatric Neuropsychology, 10(1), 49-90. https://doi.org/10.1007/s40817-024-00160-0
Oliveira, J. M. D., Butini, L., Pauletto, P., Lehmkuhl, K. M., Stefani, C. M., Bolan, M., Guerra, E., Dick, B., De Luca Canto, G., & Massignan, C. (2022). Mental health effects prevalence in children and adolescents during the COVID-19 pandemic: A systematic review. Worldviews on Evidence-Based Nursing, 19(2), 130-137. https://doi.org/10.1111/wvn.12566
Organización Mundial de la Salud (OMS). (2020). La OMS caracteriza a COVID-19 como una pandemia. https://www.paho.org/es/noticias/11-3-2020-oms-caracteriza-covid-19-como-pandemia#:~:text=La%20epidemia%20de%20COVID%2D19,un%20gran%20n%C3%BAmero%20de%20personas
Organización Mundial de la Salud (OMS). (2024). The World Health Organization-Five Well-Being Index (WHO-5). https://www.who.int/publications/m/item/WHO-UCN-MSD-MHE-2024.01
Pan, K.-Y., Kok, A. A. L., Eikelenboom, M., Horsfall, M., Jörg, F., Luteijn, R. A., Rhebergen, D., Oppen, P. van, Giltay, E. J., & Penninx, B. W. J. H. (2021). The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: A longitudinal study of three Dutch case-control cohorts. The Lancet Psychiatry, 8(2), 121-129. https://doi.org/10.1016/s2215-0366(20)30491-0
Panchal, U., Salazar de Pablo, G., Franco, M., Moreno, C., Parellada, M., Arango, C., & Fusar-Poli, P. (2021). The impact of COVID-19 lockdown on child and adolescent mental health: Systematic review. European Child & Adolescent Psychiatry, 32, 1151–1177. https://doi.org/10.1007/s00787-021-01856-w
Raccanello, D., Rocca, E., Vicentini, G., & Brondino, M. (2023). Eighteen months of COVID-19 pandemic through the lenses of self or others: A meta-analysis on children and adolescents’ mental health. Child & Youth Care Forum, 52(4), 737-760. https://doi.org/10.1007/s10566-022-09706-9
Rescorla, L., Ivanova, M. Y., Achenbach, T. M., Begovac, I., Chahed, M., Drugli, M. B., Emerich, D. R., Fung, D. S., Haider, M., Hansson, K., Hewitt, N., Jaimes, S., Larsson, B., Maggiolini, A., Marković, J., Mitrović, D., Moreira, P., Oliveira, J. T., Olsson, M., Ooi, Y. P., …, & Zhang, E. Y. (2012). International epidemiology of child and adolescent psychopathology II: Integration and applications of dimensional findings from 44 societies. Journal of the American Academy of Child and Adolescent Psychiatry, 51(12), 1273-1283. https://doi.org/10.1016/j.jaac.2012.09.012
Richter, S. A., & Nunes, M. L. (2022). Sleep quality of parents and children during the COVID-19 pandemic – A South-Brazilian sample. Sleep Medicine, 100(1), S93-S94. https://doi.org/10.1016/j.sleep.2022.05.261
Sahoo, S., & Patra, S. (2023). A rapid systematic review of the prevalence of suicide and self-harm behaviors in adolescents during the COVID-19 pandemic. Crisis, 44(6), 497-505. https://doi.org/10.1027/0227-5910/a000906
Smith, D. T., Mouzon, D. M., & Elliott, M. (2016). Reviewing the assumptions about men’s mental health: An exploration of the gender binary. American Journal of Men’s Health, 12(1), 78-89. https://doi.org/10.1177/1557988316630953
Solmi, M., Estradé, A., Thompson, T., Agorastos, A., Radua, J., Cortese, S., Dragioti, E., Leisch, F., Vancampfort, D., Thygesen, L. C., Aschauer, H., Schloegelhofer, M., Akimova, E., Schneeberger, A., Huber, C. G., Hasler, G., Conus, P., Do, K. Q., von Känel, R., …, & Correll, C. U. (2022). Physical and mental health impact of COVID-19 on children, adolescents, and their families: The Collaborative Outcomes study on Health and Functioning during Infection Times – Children and Adolescents (COH-FIT-C&A). Journal of Affective Disorders, 299, 367-376. https://doi.org/10.1016/j.jad.2021.09.090
Solmi, M., Thompson, T., Estradé, A., Agorastos, A., Radua, J., Cortese, S., Dragioti, E., Leisch, F., Vancampfort, D., Thygesen, L. C., Aschauer, H., Schlögelhofer, M., Aschauer, E., Schneeberger, A., Huber, C. G., Hasler, G., Conus, P., Do, K. Q., von Känel, R., …, & Correll, C. U. (2023). Validation of the Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) questionnaire for adults. Journal of Affective Disorders, 326, 249-261. https://doi.org/10.1016/j.jad.2022.12.022
Solmi, M., Thompson, T., Cortese, S., Estradé, A., Agorastos, A., Radua, J., Dragioti, E., Vancampfort, D., Thygesen, L. C., Aschauer, H., Schlögelhofer, M., Aschauer, E., Schneeberger, A. A., Huber, C. G., Hasler, G., Conus, P., Do Cuénod, K. Q., von Känel, R., Arrondo, G., …, & Correll, C. U. (2024a). Collaborative outcomes study on health and functioning during infection times (COH-FIT): global and risk-group stratified course of well-being and mental health during the COVID-19 pandemic in adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 64(4), 499-519. https://doi.org/10.1016/j.jaac.2024.07.932
Solmi, M., Thompson, T., Estradé, A., Agorastos, A., Radua, J., Cortese, S., Dragioti, E., Vancampfort, D., Thygesen, L. C., Aschauer, H., Schlögelhofer, M., Aschauer, E., Schneeberger, A., Huber, C. G., Hasler, G., Conus, P., Cuénod, K. Q. D., von Känel, R., Arrondo, G., …, & Correll, C. U. (2024b). Global and risk-group stratified well-being and mental health during the COVID-19 pandemic in adults: Results from the international COH-FIT study. Psychiatry Research, 342, 115972. https://doi.org/10.1016/j.psychres.2024.115972
Solmi, M., Thompson, T., Cortese, S., Estradé, A., Agorastos, A., Radua, J., Dragioti, E., Vancampfort, D., Thygesen, L. C., Aschauer, H., Schlögelhofer, M., Aschauer, E., Schneeberger, A., Huber, C. G., Hasler, G., Conus, P., Cuénod, K. Q. D., von Känel, R., Arrondo, G., …, & Correll, C. U. (2025). Collaborative outcomes study on health and functioning during infection times (COH-FIT): Insights on modifiable and non-modifiable risk and protective factors for wellbeing and mental health during the COVID-19 pandemic from multivariable and network analyses. European Neuropsychopharmacology, 90, 1-15. https://doi.org/10.1016/j.euroneuro.2024.07.010
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder. Archives of Internal Medicine, 166(10), 1092-1097. https://doi.org/10.1001/archinte.166.10.1092
Stentiford, L., Koutsouris, G., & Allan, A. (2023). Girls, mental health and academic achievement: A qualitative systematic review. Educational Review, 75(6), 1224-1254. https://doi.org/10.1080/00131911.2021.2007052
Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). – Standard [Measurement instrument]. https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.pdf
Zimmerman, D. W. (2004). A note on preliminary tests of equality of variances. British Journal of Mathematical and Statistical Psychology, 57(1), 173-181. https://doi.org/10.1348/000711004849222