Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19

Abstract

IMPORTANCE Emerging research suggests that the global prevalence of child and adolescent mental illness has increased considerably during COVID-19. However, substantial variability in prevalence rates have been reported across the literature.OBJECTIVE To ascertain more precise estimates of the global prevalence of child and adolescent clinically elevated depression and anxiety symptoms during COVID-19; to compare these rates with prepandemic estimates; and to examine whether demographic (eg, age, sex), geographical (ie, global region), or methodological (eg, pandemic data collection time point, informant of mental illness, study quality) factors explained variation in prevalence rates across studies.DATA SOURCES Four databases were searched (PsycInfo, Embase, MEDLINE, and Cochrane Central Register of Controlled Trials) from January 1, 2020, to February 16, 2021, and unpublished studies were searched in PsycArXiv on March 8, 2021, for studies reporting on child/adolescent depression and anxiety symptoms. The search strategy combined search terms from 3 themes: (1) mental illness (including depression and anxiety), (2) COVID-19, and (3) children and adolescents (age Յ18 years). For PsycArXiv, the key terms COVID-19, mental health, and child/adolescent were used.STUDY SELECTION Studies were included if they were published in English, had quantitative data, and reported prevalence of clinically elevated depression or anxiety in youth (age Յ18 years). DATA EXTRACTION AND SYNTHESISA total of 3094 nonduplicate titles/abstracts were retrieved, and 136 full-text articles were reviewed. Data were analyzed from March 8 to 22, 2021. MAIN OUTCOMES AND MEASURES Prevalence rates of clinically elevated depression and anxiety symptoms in youth.RESULTS Random-effect meta-analyses were conducted. Twenty-nine studies including 80 879 participants met full inclusion criteria. Pooled prevalence estimates of clinically elevated depression and anxiety symptoms were 25.2% (95% CI, 21.2%-29.7%) and 20.5% (95% CI, 17.2%-24.4%), respectively. Moderator analyses revealed that the prevalence of clinically elevated depression and anxiety symptoms were higher in studies collected later in the pandemic and in girls. Depression symptoms were higher in older children. CONCLUSIONS AND RELEVANCEPooled estimates obtained in the first year of the COVID-19 pandemic suggest that 1 in 4 youth globally are experiencing clinically elevated depression symptoms, while 1 in 5 youth are experiencing clinically elevated anxiety symptoms. These pooled estimates, which increased over time, are double of prepandemic estimates. An influx of mental health care utilization is expected, and allocation of resources to address child and adolescent mental health concerns are essential.

Quality of life and mental health in children and adolescents during the first year of the COVID-19 pandemic: results of a two-wave nationwide population-based study

“…could also have led to the higher rates of mental health problems found in the present study. However, our results are roughly in line with systematic reviews of cross-sectional studies on the impact of the pandemic [ 2 , 3 ]. Those reviews have reported an increase of mental health problems, with only very few studies reporting no negative mental health impact during the pandemic.…”

“…There is increasing empirical evidence of psychological distress among children and adolescents during the pandemic according to systematic reviews of mostly cross-sectional studies [ 2 , 3 ]. These reviews describe an average doubling of clinically elevated anxiety (21%) and depression (25%) symptoms [ 2 ] and high pooled prevalences of depression (29%), anxiety (26%), sleep disorders (44%), and posttraumatic stress symptoms (48%), respectively [ 3 ].…”

“…There is increasing empirical evidence of psychological distress among children and adolescents during the pandemic according to systematic reviews of mostly cross-sectional studies [ 2 , 3 ]. These reviews describe an average doubling of clinically elevated anxiety (21%) and depression (25%) symptoms [ 2 ] and high pooled prevalences of depression (29%), anxiety (26%), sleep disorders (44%), and posttraumatic stress symptoms (48%), respectively [ 3 ]. International cross-sectional studies further report lower levels of health-related quality of life (HRQoL) of children and adolescents comparing data from a population-based study gathered before the pandemic with data of another sample gathered during the pandemic [ 4 ].…”

COVID-19 in children and the importance of COVID-19 vaccination

“…In addition, the impact on the mental health of children and adolescents has increased, including anxiety, depression and disturbances in sleep and appetite [ 30 ]. In a global meta-analysis, the prevalence estimates of children and adolescent depression and anxiety were 25.2% and 20.5% during COVID-19, respectively [ 31 ]. Compared with pre-pandemic estimates, the prevalence of depression and anxiety symptoms during COVID-19 have doubled.…”

COVID-19 Infection in Children, Infants and Pregnant Subjects: An Overview of Recent Insights and Therapies

“…About COVID-19 and the psychological well-being of children and adolescents, data show that mental disorders in children and adolescents increased significantly in the first year of the pandemic, by 25.2% and 20.5%, respectively. Anxiety, depression, uncertainty and loneliness doubled during the pandemic with a prevalence in older adolescents and girls [ 14 , 15 , 16 ].…”