Impact of COVID-19 pandemic on adolescents’ mental health: a Tuscany surveillance study in the post-pandemic era

Aim To assess the mental health status of Tuscany adolescents and to determine whether there is an association between various health determinants and both severe psychological distress and self-injury in the post-pandemic era. Subject and methods A total of 8833 students (aged 14–19 years) completed a survey with 14 sections covering sociodemographic characteristics, well-being, mental health, COVID-19, driving, health behaviours (smoking, alcohol consumption, recreational drug consumption, physical activity, and dietary habits) and risk behaviours (gambling, bullying and cyberbullying, gender identity). Results Analysis showed that severe distress (female = 70.3% vs male = 35.7%, p < 0.001) increased with age, peaking at 21.1% in adolescents over 16 years of age. Severe distress, a condition of non-specific psychological discomfort, characterised primarily by symptoms of anxiety and depression, was strongly linked to poor or very poor parental relationships (odds ratio [OR] = 4.36, 95% confidence interval [CI] 2.92–6.52; p < 0.001), poor peer relationships (OR = 5.83, 95% CI 3.07–11.07; p < 0.001), and bad or very bad school results (OR = 3.01, 95% CI 2.17–4.18; p < 0.001). Increasing age was protective against self-injury (OR = 0.76, 95% CI 0.71–0.81; p < 0.001). Self-injury was also closely associated with poor/very poor parental relationships (OR = 3.65, 95% CI 2.64–5.05; p < 0.001), poor peer relationships (OR =3.65, 95% CI 2.21–6.02; p < 0.001), and bad or very bad school results (OR =1.86, 95% CI 1.26–2.74; p = 0.002). Additionally, getting drunk, using technological devices more than 5 h per day, being bullied, and consuming substances increased the risk of severe distress and self-injury. Conclusion These findings suggest that severe distress and self-injury are strongly associated with the quality of relationships and school results. Moreover, certain habits and lifestyles appear to elevate the risk for severe psychological distress and self-injury.