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LETTER TO EDITOR
Year : 2020  |  Volume : 9  |  Issue : 4  |  Page : 378-379

COVID-19 crisis: Concerns about depression and obesity among adolescents in India


Department of Psychiatry, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India

Date of Submission08-Jul-2020
Date of Decision20-Jul-2020
Date of Acceptance07-Aug-2020
Date of Web Publication15-Oct-2020

Correspondence Address:
Dr. M Kishor
Department of Psychiatry, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_160_20

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How to cite this article:
Tandure M, Kishor M. COVID-19 crisis: Concerns about depression and obesity among adolescents in India. Int J Health Allied Sci 2020;9:378-9

How to cite this URL:
Tandure M, Kishor M. COVID-19 crisis: Concerns about depression and obesity among adolescents in India. Int J Health Allied Sci [serial online] 2020 [cited 2020 Oct 21];9:378-9. Available from: https://www.ijhas.in/text.asp?2020/9/4/378/298113



Sir,

India is the second largest country by population with 1.35 billion people, and adolescents constitute about 21%. Adolescence is defined by the World Health Organization as the period in human growth and development that occurs after childhood and before adulthood (10–19 years). This transition from childhood to adulthood is the time when many important psychosocial, biological, and cognitive changes take place in the adolescent's life. These changes along with peer pressure, parental pressure, and students' own expectation can make it a troubled phase. Any mental health disorder during this period could have consequences, and one of the frequent mental health disorders that have an adolescent onset is depression.

The prevalence rates of depression among adolescents range from 3% among school-going adolescents to 11.2% in school dropouts in India.[1] The problem of adolescent depression is complicated by a variety of symptoms which often overlap with behavior seen in normal adolescence.[2] The atypical presentation of adolescent depression and decreased awareness makes it difficult to recognize it. Adolescent depression may affect socialization, family relations, and performance at school often with potentially serious long-term consequences. Depression in adolescence increases risk of hospitalizations, recurrent episodes of depressions, psychosocial impairment, abuse of alcohol and/or other substance in early or future life, as well as antisocial behaviors. Moreover, early-onset depression is associated with an increase in comorbidity of other mental illnesses in adult life. There has been an increase in adolescent suicides in the last decade. Multiple factors that can lead to depression listed above also increase the risk of suicide in adolescents. Studies have found a significant association between depression and obesity in adolescents. Obesity in adolescents may lead to feelings of shame, humiliation, negative stigma, low self-esteem, and body image dissatisfaction, all of which can in turn lead to depressed mood.

COVID-19 pandemic is an unprecedented disaster and this can have serious impact on adolescents, affecting their mental health and physical health. In India, current pandemic and earlier lockdown has led to humanitarian crisis.[3] Psychological effect in the age group of 14–87 years, as seen in an online study to see the effect of COVID-19 lockdown of 1685 participants, found that 38.2% had anxiety, 10.5% had depression, moderate level of stress was reported in 74.1%, and 71.7% reported poor well-being.[4] There is, however, a dearth of studies to assess the effect of lockdown on adolescent's mental health. As schools have closed in India since the last week of March 2020 as part of necessary measures, being not able to do everyday activities such as attending school, meeting friends, and going out can become confusing for the younger children and sometimes frustrating to the older adolescents. Constant news and discussion regarding COVID-19 can make one anxious and worry about future.

Children might experience worry, anxiety, and fear, and this can include a fear of dying, a fear of their relatives dying, or a fear of what it means to receive medical treatment. Children may wish to be closer to their parents than before, make more demands on them, and in turn, some parents or caregivers may be under undue pressure themselves.[5] With schools and colleges shifting to online classes, they are spending more time in online, sometimes without monitoring, and this might lead to their exposure to inappropriate content affecting the mental health. On the other side, for a country like India, learning by digital mode might not be accessible to millions of children from poor socioeconomic strata. This, in addition with parents facing salary cut or losses of jobs due to pandemic, can affect adolescents' mental health at a very young age. Being at home can put some children at increased risk of or increased exposure to domestic violence if their home is not a safe place. There have been reports of increase in child abuse during lockdown worldwide. All these factors can adversely affect mental health of children.

Lockdown and restriction of outdoor activity reduces the opportunity to do physical activity and this could lead to increase in obesity. India already has consistently shown increase in childhood obesity prevalence from 16.3% reported in 2005 to 19.3% in 2010.[6] When confined to home, one tends to become less active and reduce the physical activity to a minimum. This along with the increase in consumption of food due to boredom can lead to increase in weight and childhood obesity. With most schools closed, children are spending more time in front of the screens which can also increase lethargy. Less recreational activity and lack of peer group for play in the pandemic can further lead to weight gain and predispose to depression. Depression can reduce activity by loss of interest, fatigue, and low mood. Thus, obesity and depression are closely interlinked and can become concern among adolescences during pandemic.

Parents should keenly observe for any emotional changes in children and maintain mental health by listening to them, acknowledging their difficulties, reassuring them, setting a routine, engaging them, and seeking for urgent professional help if required. Monitoring children activity and right food intake in safe environment can sustain required physical activity and appropriate weight.

To conclude, adolescents in India are vulnerable for depression and obesity during the ongoing COVID-19 crisis and its aftermath; more studies are needed to know the magnitude of the problem and for implementing appropriate intervention strategies.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Nair MK, Paul MK, John R. Prevalence of depression among adolescents. Indian J Pediatr 2004;71:523-4.  Back to cited text no. 1
    
2.
Arlington VA. American Psychiatric Association. In: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Chicago: American Psychiatric Publishing; 2013. p. 160-64.  Back to cited text no. 2
    
3.
Andrade C. COVID-19: humanitarian and health care crisis in a third world country. J Clin Psychiatry. 2020;81:e1-e6.  Back to cited text no. 3
    
4.
Grover S, Sahoo S, Mehra A, Avasthi A, Tripathi A, Subramanyan A, et al. Psychological impact of COVID-19 lockdown: An online survey from India. Indian J Psychiatry 2020;62:354-62.  Back to cited text no. 4
  [Full text]  
5.
World Health Organisation. Mental Health and PsychologicalResilience Duringthe COVID-19 Pandemic. Available from: https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/mental-health-and-psychological-resilience-during-the-covid-19-pandemic. [Last accessed on 2020 July 05].  Back to cited text no. 5
    
6.
Ranjani H, Mehreen TS, Pradeepa R, Anjana RM, Garg R, Anand K, et al. Epidemiology of childhood overweight and obesity in India: A systematic review. Indian J Med Res 2016;143:160-74.  Back to cited text no. 6
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