{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:27:55Z","timestamp":1792448875981,"version":"4.5.0"},"reference-count":71,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000278","name":"Department for International Development, UK Government","doi-asserted-by":"publisher","award":["200425"],"award-info":[{"award-number":["200425"]}],"id":[{"id":"10.13039\/501100000278","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,3,23]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To provide evidence on the effect of the COVID-19 pandemic on the mental health of young people who grew up in poverty in low\/middle-income countries (LMICs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A phone survey administered between August and October 2020 to participants of a population-based longitudinal cohort study established in 2002 comprising two cohorts born in 1994\u20131995 and 2001\u20132002 in Ethiopia, India (Andhra Pradesh and Telangana), Peru and Vietnam. We use logistic regressions to examine associations between mental health and pandemic-related stressors, structural factors (gender, age), and lifelong protective\/risk factors (parent and peer relationship, wealth, long-term health problems, past emotional problems, subjective well-being) measured at younger ages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A geographically diverse, poverty-focused sample, also reaching those without mobile phones or internet access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>10\u2009496 individuals were approached; 9730 participated. Overall, 8988 individuals were included in this study; 4610 (51%) men and 4378 (49%) women. Non-inclusion was due to non-location or missing data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Symptoms consistent with at least mild anxiety or depression were measured by Generalized Anxiety Disorder-7 (\u22655) or Patient Health Questionnaire-8 (\u22655).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Rates of symptoms of at least mild anxiety (depression) were highest in Peru at 41% (32%) (95%\u2009CI 38.63% to 43.12%; (29.49\u201333.74)), and lowest in Vietnam at 9% (9%) (95%\u2009CI 8.16% to 10.58%; (8.33\u201310.77)), mirroring COVID-19 mortality rates. Women were most affected in all countries except Ethiopia. Pandemic-related stressors such as health risks\/expenses, economic adversity, food insecurity, and educational or employment disruption were risk factors for anxiety and depression, though showed varying levels of importance across countries. Prior parent\/peer relationships were protective factors, while long-term health or emotional problems were risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pandemic-related health, economic and social stress present significant risks to the mental health of young people in LMICs where mental health support is limited, but urgently needed to prevent long-term consequences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-049653","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T14:18:56Z","timestamp":1618496336000},"page":"e049653","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":102,"title":["Impact of the COVID-19 pandemic on anxiety and depression symptoms of young people in the global south: evidence from a four-country cohort study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8578-1744","authenticated-orcid":false,"given":"Catherine","family":"Porter","sequence":"first","affiliation":[{"name":"Management School, Lancaster University, Lancaster, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Favara","sequence":"additional","affiliation":[{"name":"Oxford Department of International Development, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annina","family":"Hittmeyer","sequence":"additional","affiliation":[{"name":"Oxford Department of International Development, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Scott","sequence":"additional","affiliation":[{"name":"Oxford Department of International Development, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"S\u00e1nchez Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Ni\u00f1os del Milenio, Grupo de An\u00e1lisis para el Desarrollo (GRADE), Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Revathi","family":"Ellanki","sequence":"additional","affiliation":[{"name":"Director, Centre for Economic and Social Studies, Begumpet, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tassew","family":"Woldehanna","sequence":"additional","affiliation":[{"name":"Department of Economics, Addis Ababa University, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le Thuc","family":"Duc","sequence":"additional","affiliation":[{"name":"Centre for Analysis and Forecasting, Vietnam Academy of Social Sciences, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle G","family":"Craske","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Oxford, Oxford, UK"},{"name":"School of Public Health, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"2025121600314299000_11.4.e049653.1","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S2215-0366(20)30168-1","article-title":"Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science","volume":"7","author":"Holmes","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"2025121600314299000_11.4.e049653.2","unstructured":"WHO . 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