Mental health of adolescents amidst preparation for university entrance exams during the second pandemic-related lockdown in Greece

•Adolescents facing national entrance university exams experience high levels of depressive and anxiety symptoms.•Increased conflicts with parents were independently associated with higher anxiety and depression levels.•Thematic analysis of the students’ responses to the open-ended survey item revealed negative affective and cognitive content of their experiences.•Targeted interventions are imperative to address the needs of young people in future waves of pandemic. This study investigated the mental health among 187 final-year-senior-high-school students during the six-months pandemic-related lockdown. Above the thresholds on GAD-7 for severe anxiety (≥17) and PHQ-9 for severe depressive symptoms (≥20) scored 20.3% and 20.7% respectively. Higher levels of experienced lockdown distress and increased conflicts with parents were associated with higher anxiety and depression levels; COVID-related worry was associated only with anxiety, whereas having any family health problem with depression only. Thematic analysis of the open-ended survey item provided a means of gaining students’ perspective regarding the challenges aggravated by the pandemic during the process of preparing for the exams. The findings call to action aiming at mitigating mental health risks of the on-going pandemic on youth's mental health.