A recurring observation in medical history is that with certain pandemics, groups of people experience associated neuropsychiatric symptoms, especially after they recover from the infection. As a clinician, Kathryn Cullen, MD, an associate professor in the Department of Psychiatry and Behavioral Sciences, has personally observed the toll that viral pandemics can have on someone’s mental health. 

“In 2009, a lot of my adolescent patients who got sick during the H1N1 pandemic experienced severe depression afterwards,” Dr. Cullen said. “Are we going to see something similar with those affected with COVID-19? We are only just beginning to appreciate how this pandemic is impacting young people.” 

Because of COVID-19, many adolescents have experienced significant losses. They have missed out on major milestones, like graduation and prom, and opportunities to shine in performances and in athletics. They are experiencing social isolation due to school closures, and for many students, the quality of online education doesn’t compare to learning in the classroom. Some families have experienced economic and other social hardship due to the pandemic’s impact on our society as well.

“To take those away has strong negative consequences on their brain development and mental health. We need to understand the extent of the impact in order to plan how to best help them,” Dr. Cullen said. 

To do that, Dr. Cullen applied for a CO:VID (Collaborative Outcomes: Visionary Innovation & Discovery) grant. Her and her team will assess how the COVID-19 pandemic—both direct infection with the virus and fallout of public health requirements—impacts adolescent mental health.

“We are looking at the impacts of the COVID-19 pandemic on adolescent mental health from two perspectives: psychological and biological,” Dr. Cullen said. 

To tackle the psychological perspective, the research team is inviting adolescents with and without non-suicidal self-injury who are already participating in a longitudinal study led by Dr. Cullen. This group of adolescents, as part of that study, already had detailed clinical and MRI assessments prior to the COVID-19 pandemic and have future clinical and MRI assessments planned—both of which will be critical to Dr. Cullen’s COVID-19 research. 

Along with those scans, these participants and their parents are now being invited to participate in a substudy, which involves completing three monthly surveys focusing on impact of the COVID-19 pandemic that assess a range of aspects, including mental health symptoms, wellness, family functioning and economic losses. Also, given the current global attention on social injustice issues, the team included some assessment of the adolescents’ experiences following the death of George Floyd and subsequent related events.

The research team is now beginning to collect their first wave of data. Dr. Cullen explained that over the coming months they “will track how these psychological and mental health symptoms are changing over time during the pandemic.”

To tackle the biological perspective, the research team will use MRI to examine brain changes due to pandemic-related stress and brain changes directly related to COVID-19 infection.

“Since some adolescents will get COVID-19 and possibly remain asymptomatic, they won’t know they had it if we just ask them,” Dr. Cullen said. To address this, she and her team plan to administer serology tests at the time of each adolescent’s next brain scan.

Adolescence is a period of particular vulnerability, with suicide being the second highest cause of death in young people. With rates of suicide increasing in the past two decades, Dr. Cullen said, “The results of our study will provide important information about how pandemic might be contributing to suicide risk in teenagers.”