To study the psychological impact of lockdown in middle and late adolescents by evaluating the cognitions and coping behaviors of the study population.

This pilot study was approved by the Kauvery hospital ethics committee. An online survey was created with a 12-item semi-structured questionnaire on a secure platform compatible with survey studies. The questionnaire was reviewed by a panel of experts that included eminent psychiatrists, clinical psychologist, and psychiatric social workers. The survey link was distributed online through various platforms such as WhatsApp groups and Facebook pages to reach a wide variety of participants and was active from 1 pm on April 21, 2020 till 5 pm on April 29, 2020. The link directed individuals to the questionnaire where the nature of the study and method of consent was explained. Consent was indicated through the submission of their response. They were informed about the purpose of the study and that their responses are confidential.

Consenting English speaking middle & late adolescents aged (14 - 20years) as per WHO definition were included for the study ⁵. The survey used convenient sampling, seeking responses only from this age group. A total of 507 responses were received and 461 respondents’ data were used based on completed forms and those fulfilling eligibility criteria.

The first 6 questions of the survey were demographics followed by 6 questions addressing thoughts, emotions, physicalproblems, impactonmental health, and coping behaviors. Demographic questions obtained data regarding age, gender, education, place of stay, people they are staying with, and the number of days of social distancing. Dichotomous questions were asked, and responses were taken as ‘Yes’ or ‘No’ for the presence of coping behaviors, emotional impact, physical problems, negative cognitions, and impact on productivity. Time spent on each coping behavior was also probed on a 3-point scale (1 = less than 1 hr; 2 = 1 to 2 hrs; and 3 = more than 2 hrs.). Furthermore, levels of each emotion and physical problems were queried and answers were recorded on a 5-point Likert scale (1 = Not at all; 2 = Rarely; 3 = Sometimes; 4 = Often; and 5 = Always). Lastly, productivity, positive mental health impact, and negative mental health impact levels were obtained using a 10-point scale (1 = very less to 10 = very high).

Statistical Package for the Social Sciences (SPSS) version 24 was used to conduct all quantitative analysis ⁶. The collected raw data from 507 participants had to be prepared before the evaluation. First, the descriptive data were obtained for all variables to examine the nature of the missing data and outliers.

Some responses were removed if missing values were high. Outliers were insignificant, hence retained. After data preparation, a preliminary analysis was done to check if any cofounding variables existed in the demographics and to find descriptive statistics of questions. Spearman’s correlation tests were also performed.

The responses from 461 subjects were garnered and descriptive and correlational analysis was done. The preliminary analysis of the socio-demographic items revealed that 85.0% of the participants were female were mostly from Chennai (87.6%) and remaining from other districts and states in India (12.4%). The ages 14 to 16yrs being salient (mean age - 15.91 yrs; SD - 1.908), the education level was correspondent of 9th grade (13.7%), 10th grade (31.5%), 11th grade (18.0%), and 12th grade (16.9%). The rest reported pursuing a degree or a professional course (19.7%). Almost all of them were staying with their family (98.3%) while the remaining were staying with relatives or friends.

Happiness was reported by the majority of the study population (Table 1). The next most common emotion expressed was boredom. The study sample experienced a happy emotional state the most often, followed by boredom. Irritability, sadness, and anxiety were also noted in the sample. Cognitions were mainly anxious, related to uncertainty about the future, fear of direct exposure to the virus, and frustration because of exam postponement (Table 1). Furthermore, nearly 60 - 70 % acknowledged no significant impact on mental health or productivity or physical health due to lockdown. Correlation analysis (Table 2) indicated that productivity was significantly positively correlated with a happy or relaxed mood (r = 0.248, p < 0.01). The positive impact had a significant positive correlation with negative impact (r = .457, p < 0.01), i.e., positive impact scores increased with an increase in negative impact scores.

Table 3 highlights the coping behaviors ranging from excessive social media (YouTube and Instagram) & phone use (mobile games), spending time with family, chatting with friends, and pursuing hobbies (such as listening to music and cooking). Online gaming, schoolwork, and excessive sleep also topped the list. The participants noted that the activities that they spent more time on (more than 2 hours in a day) were watching news/movies/series with family and playing mobile/online games.

Amongst the young adults, 70.1% acknowledged no significant impact on mental health while 29.1% mentioned having a significant impact. The impact on physical health was present for 37.7% and non-existent for 61.4% of the sample. No change in productivity was witnessed in 70.3% of the participants, and some difference in 28.2%. With regards to the rate of productivity (mean = 6.04, SD = 2.201), 46.1% contended to a high level of productivity (7 to 10), 41.5% were moderately productive (4 to 6), and 12.4% had low productivity (1 to 3). Productivity was positively correlated to ‘happy/relaxed’ mood (r = 0.248, p < 0.01).

This study was an online survey during the pandemic so respondent responses may vary depending on the timing and perceived stress related to lockdown. A face-to-face interview using a structured questionnaire with adolescents could have improved the fidelity of the study. This study is cross-sectional, and a prospective assessment over different timelines during the lockdown could have tested these associations more robustly.