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Meta-Analysis
. 2021 Oct 1:293:78-89.
doi: 10.1016/j.jad.2021.06.021. Epub 2021 Jun 18.

Prevalence of mental health problems among children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis

Lu Ma  1 , Mohsen Mazidi  2 , Ke Li  1 , Yixuan Li  1 , Shiqi Chen  1 , Richard Kirwan  3 , Haixia Zhou  1 , Na Yan  1 , Atif Rahman  4 , Weidong Wang  5 , Youfa Wang  6
Affiliations
Meta-Analysis

Prevalence of mental health problems among children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis

Lu Ma et al. J Affect Disord. .

Abstract

Background: This systematic review and meta-analysis examined the prevalence of depression, anxiety, sleep disorders, and posttraumatic stress symptoms among children and adolescents during global COVID-19 pandemic in 2019 to 2020, and the potential modifying effects of age and gender.

Methods: A literature search was conducted in PubMed, Web of Science, PsycINFO, and two Chinese academic databases (China National Knowledge Infrastructure and Wanfang) for studies published from December 2019 to September 2020 that reported the prevalence of above mental health problems among children and adolescents. Random-effects meta-analyses were used to estimate the pooled prevalence.

Results: Twenty-three studies (21 cross-sectional studies and 2 longitudinal studies) from two countries (i.e., China and Turkey) with 57,927 children and adolescents were identified. Depression, anxiety, sleep disorders, and posttraumatic stress symptoms were assessed in 12, 13, 2, and 2 studies, respectively. Meta-analysis of results from these studies showed that the pooled prevalence of depression, anxiety, sleep disorders, and posttraumatic stress symptoms were 29% (95%CI: 17%, 40%), 26% (95%CI: 16%, 35%), 44% (95%CI: 21%, 68%), and 48% (95%CI: -0.25, 1.21), respectively. The subgroup meta-analysis revealed that adolescents and females exhibited higher prevalence of depression and anxiety compared to children and males, respectively.

Limitations: All studies in meta-analysis were from China limited the generalizability of our findings.

Conclusions: Early evidence highlights the high prevalence of mental health problems among children and adolescents during the COVID-19 pandemic, especially among female and adolescents. Studies investigating the mental health of children and adolescents from countries other than China are urgently needed.

Keywords: Adolescents; COVID-19 pandemic; Children; Mental health problems; Review.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of the literature search and study selection according to the PRISMA standard
Fig. 2
Fig. 2
Meta-analysis of the pooled prevalence of depression among children and adolescents (n=13) Abbreviations: DSRS-C: Depression Self-Rating Scale for Children; PHQ-9: 9-item Patient Health Questionnaire; CDI-S: Children's Depression Inventory–Short Form; CES-D: Center for Epidemiologic Studies Depression Scale; CDI: Children's Depression Inventory; DSRS-C: Depression Self-Rating Scale for Children; PQSPHE: Psychological Questionnaire for Sudden Public Health Events; SDS: Self-rating Depression Scale; MMHI-60: Mental Health Inventory of Middle-school students. Prevalence was calculated based on the random-effect models.
Fig. 3
Fig. 3
Meta-analysis of the pooled prevalence of anxiety among all children and adolescents (n=12) Abbreviations: SCARED: Screen for Child Anxiety Related Emotional Disorders; GAD-7: 7-item Generalized Anxiety Disorder Scale; SAS: Self-Rating Anxiety Scale; PQSPHE: Psychological Questionnaire for Sudden Public Health Events; MMHI-60: Mental Health Inventory of Middle-school students. Prevalence was calculated based on the random-effect models.
Fig. 4
Fig. 4
Meta-analysis of the pooled prevalence of sleep disorders among all children and adolescents (n=2) Abbreviations: ISI: Insomnia Severity Index; CSHQ: Children's Sleep Habit Questionnaire. Prevalence was calculated based on the random-effect models.
Fig. 5
Fig. 5
Meta-analysis of the pooled prevalence of posttraumatic stress symptoms among all children and adolescents (n=2) Abbreviations: PCL-C: The PTSD Cheeklist-CivilianVersion; IES-R: Impact of Events Scale-Revised. Prevalence was calculated based on the random-effect models.
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