Table 4. Adjusted and Weighted Logistic Regression Analysis.
| Variable | Pre–COVID-19 pandemic (2005-2019) (estimated weighted No. [SD], 50 987 544 [218 458]) | COVID-19 pandemic (2020-2021) (estimated weighted No. [SD], 5 135 095 [58 931]) | Ratio of wOR (pandemic to prepandemic) (95% CI) | P value | ||
|---|---|---|---|---|---|---|
| wOR (95% CI)a | P value | wOR (95% CI)a | P value | |||
| Sadness related b | ||||||
| School grade | ||||||
| 7-9 (Middle school) | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| 10-12 (High school) | 1.270 (1.259-1.281) | <.001 | 1.152 (1.121-1.184) | <.001 | 0.907 (0.881-0.933) | <.001 |
| Sex | ||||||
| Male | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| Female | 1.755 (1.743-1.772) | <.001 | 1.809 (1.756-1.860) | <.001 | 1.031 (1.001-1.062) | .04 |
| BMI | 0.998 (0.997-0.999) | <.001 | 1.000 (0.996-1.004) | .85 | 1.002 (0.998-1.006) | .34 |
| Residence | ||||||
| Rural | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| Urban | 0.965 (0.957-0.974) | <.001 | 1.081 (1.050-1.112) | <.001 | 1.120 (1.087-1.153) | <.001 |
| Current smoking | 1.541 (1.518-1.565) | <.001 | 1.748 (1.634-1.870) | <.001 | 1.134 (1.059-1.216) | <.001 |
| Current alcohol use | 1.671 (1.651-1.690) | <.001 | 1.756 (1.677-1.838) | <.001 | 1.051 (1.002-1.102) | .04 |
| Highest educational level of parents | ||||||
| High school or lower | 1.141 (1.131-1.152) | <.001 | 1.129 (1.090-1.170) | <.001 | 0.989 (0.954-1.026) | .57 |
| College or higher | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| Unknown | 0.863 (0.851-0.874) | <.001 | 0.965 (0.935-0.996) | .03 | 1.118 (1.080-1.157) | <.001 |
| Economic level | ||||||
| High | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| Middle-high | 0.951 (0.934-0.969) | <.001 | 0.974 (0.925-1.026) | .32 | 1.024 (0.969-1.082) | .39 |
| Middle | 0.946 (0.929-0.963) | <.001 | 0.922 (0.878-0.969) | .001 | 0.975 (0.925-1.027) | .34 |
| Middle-low | 1.332 (1.305-1.359) | <.001 | 1.360 (1.279-1.447) | <.001 | 1.021 (0.957-1.090) | .53 |
| Low | 1.836 (1.788-1.885) | <.001 | 1.951 (1.767-2.154) | <.001 | 1.063 (0.959-1.177) | .25 |
| School performance | ||||||
| High | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| Middle-high | 1.092 (1.075-1.109) | <.001 | 1.046 (0.994-1.101) | .09 | 0.958 (0.908-1.010) | .11 |
| Middle | 1.180 (1.162-1.199) | <.001 | 1.121 (1.066-1.179) | <.001 | 0.950 (0.901-1.001) | .06 |
| Middle-low | 1.374 (1.352-1.397) | <.001 | 1.352 (1.283-1.425) | <.001 | 0.984 (0.931-1.040) | .57 |
| Low | 1.598 (1.568-1.629) | <.001 | 1.689 (1.588-1.795) | <.001 | 1.057 (0.991-1.127) | .09 |
| Suicidality related c | ||||||
| School grade | ||||||
| 7-9 (Middle school) | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| 10-12 (High school) | 0.960 (0.950-0.970) | <.001 | 0.981 (0.945-1.018) | .31 | 1.022 (0.983-1.062) | .27 |
| Sex | ||||||
| Male | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| Female | 1.882 (1.861-1.903) | <.001 | 2.002 (1.924-2.083) | <.001 | 1.064 (1.021-1.109) | .003 |
| BMI | 1.001 (0.999-1.002) | .34 | 1.002 (0.997-1.007) | .40 | 1.001 (0.996-1.006) | .71 |
| Residence | ||||||
| Rural | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| Urban | 0.954 (0.943-0.964) | <.001 | 1.066 (1.026-1.107) | .001 | 1.117 (1.074-1.162) | <.001 |
| Current smoking | 1.667 (1.638-1.697) | <.001 | 1.716 (1.579-1.863) | <.001 | 1.029 (0.946-1.120) | .50 |
| Current alcohol use | 1.687 (1.664-1.710) | <.001 | 1.759 (1.660-1.865) | <.001 | 1.043 (0.982-1.107) | .17 |
| Highest educational level of parents | ||||||
| High school or lower | 1.134 (1.122-1.147) | <.001 | 1.093 (1.042-1.146) | <.001 | 0.964 (0.918-1.012) | .14 |
| College or higher | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| Unknown | 0.909 (0.893-0.924) | <.001 | 0.882 (0.844-0.921) | <.001 | 0.970 (0.924-1.018) | .22 |
| Economic level | ||||||
| High | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| Middle-high | 0.961 (0.939-0.984) | .001 | 1.092 (1.014-1.175) | .02 | 1.136 (1.052-1.228) | .001 |
| Middle | 0.961 (0.940-0.983) | .001 | 1.076 (1.002-1.155) | .04 | 1.120 (1.039-1.206) | .003 |
| Middle-low | 1.484 (1.448-1.522) | <.001 | 1.909 (1.757-2.074) | <.001 | 1.286 (1.180-1.403) | <.001 |
| Low | 2.200 (2.213-2.269) | <.001 | 2.743 (2.433-3.092) | <.001 | 1.247 (1.105-1.406) | <.001 |
| School performance | ||||||
| High | 1 [Reference] | NA | 1 [Reference] | NA | NA | NA |
| Middle-high | 1.015 (0.996-1.036) | .13 | 0.941 (0.878-1.009) | .94 | 0.927 (0.862-0.997) | .04 |
| Middle | 1.041 (1.021-1.062) | <.001 | 0.917 (0.856-0.982) | .01 | 0.881 (0.820-0.946) | .001 |
| Middle-low | 1.203 (1.179-1.227) | <.001 | 1.112 (1.036-1.193) | .003 | 0.924 (0.859-0.995) | .04 |
| Low | 1.386 (1.355-1.418) | <.001 | 1.402 (1.294-1.520) | <.001 | 1.012 (0.930-1.100) | .79 |
Abbreviations: BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); NA, not applicable; wOR, weighted odds ratio.
a
Calculated for a 1-unit increase in BMI.
b
This model was adjusted for grade, sex, BMI, residence, smoking status, current alcohol use, highest educational level of parents, economic level, and school performance.
c
This model was adjusted for grade, sex, BMI, residence, smoking status, current alcohol use, highest educational level of parents, economic level, and school performance.