Earlier Bedtime and Effective Coping Skills Predict a Return to Low-Risk of Depression in Young Adults during the COVID-19 Pandemic

Qingyu Zhao, Kevin Wang, Orsolya Kiss, Dilara Yuksel, Massimiliano de Zambotti, Duncan B. Clark, David B. Goldston, Kate B. Nooner, Sandra A. Brown, Susan F. Tapert, Wesley K. Thompson, Bonnie J. Nagel, Adolf Pfefferbaum, Edith V. Sullivan, Kilian M. Pohl, Fiona C. Baker

Research output: Contribution to journalArticlepeer-review


To determine the persistent effects of the pandemic on mental health in young adults, we categorized depressive symptom trajectories and sought factors that promoted a reduction in depressive symptoms in high-risk individuals. Specifically, longitudinal analysis investigated changes in the risk for depression before and during the pandemic until December 2021 in 399 young adults (57% female; age range: 22.8 ± 2.6 years) in the United States (U.S.) participating in the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) study. The Center for Epidemiologic Studies Depression Scale (CES-D-10) was administered multiple times before and during the pandemic. A score ≥10 identified individuals at high-risk for depression. Self-reported sleep behavior, substance use, and coping skills at the start of the pandemic were assessed as predictors for returning to low-risk levels while controlling for demographic factors. The analysis identified four trajectory groups regarding depression risk, with 38% being at low-risk pre-pandemic through 2021, 14% showing persistent high-risk pre-pandemic through 2021, and the remainder converting to high-risk either in June 2020 (30%) or later (18%). Of those who became high-risk in June 2020, 51% were no longer at high-risk in 2021. Logistic regression revealed that earlier bedtime and, for the older participants (mid to late twenties), better coping skills were associated with this declining risk. Results indicate divergence in trajectories of depressive symptoms, with a considerable number of young adults developing persistent depressive symptoms. Healthy sleep behavior and specific coping skills have the potential to promote remittance from depressive symptoms in the context of the pandemic.

Original languageEnglish (US)
Article number10300
JournalInternational journal of environmental research and public health
Issue number16
StatePublished - Aug 2022


  • COVID-19
  • coping
  • depressive symptoms
  • sleep
  • young adults

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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