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Meta-Analysis
. 2022 May 23:12:05011.
doi: 10.7189/jogh.12.05011.

Mental health symptoms during the COVID-19 pandemic in developing countries: A systematic review and meta-analysis

Jiyao Chen  1 , Stephen X Zhang  2 , Allen Yin  3 , Jaime A Yáñez  4   5
Affiliations
Meta-Analysis

Mental health symptoms during the COVID-19 pandemic in developing countries: A systematic review and meta-analysis

Jiyao Chen et al. J Glob Health. .

Abstract

Background: This systematic review aims to 1) summarize the prevalence of anxiety, depression, distress, insomnia, and PTSD in the adult population during the first year of the COVID pandemic in developing countries and 2) uncover and highlight the uneven distribution of research on mental health in all developing countries across regions.

Methods: Several literature databases were systemically searched for meta-analyses published by September 22, 2021, on the prevalence rates of mental health symptoms in developing countries worldwide. We meta-analysed the raw data of the individual empirical results from the previous meta-analysis papers in developing countries in different regions.

Results: The prevalence rates of mental health symptoms were summarized based on 341 empirical studies with a total of 1 704 072 participants from 40 out of 167 developing countries in Africa, Asia (East, Southeast, South, and West), Europe, and Latin America. Comparatively, Africa (39%) and West Asia (35%) had the worse overall mental health symptoms, followed by Latin America (32%). The prevalence rates of overall mental health symptoms of medical students (38%), general adult students (30%), and frontline health care workers (HCWs) (27%) were higher than those of general HCWs (25%) and general populations (23%). Among five mental health symptoms, distress (29%) and depression (27%) were the most prevalent. Interestingly, people in the least developing countries suffered less than those in emergent and other developing countries. The various instruments employed lead to result heterogeneity, demonstrating the importance of using the well-established instruments with the standard cut-off points (eg, GAD-7, GAD-2, and DASS-21 for anxiety, PHQ-9 and DASS-21 for depression, and ISI for insomnia).

Conclusions: The research effort on mental health in developing countries during COVID-19 has been highly uneven in the scope of countries and mental health outcomes. This meta-analysis, the largest on this topic to date, shows that the mental health symptoms are highly prevalent yet differ across regions. The accumulated systematic evidence from this study can help enable the prioritization of mental health assistance efforts to allocate attention and resources across countries and regions.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE Unified Competing Interest Form (available upon request from the corresponding author) and declare no conflicts of interests.

Figures

Figure 1
Figure 1
Country distribution of mental health prevalence studies in developing countries during COVID-19 pandemic.
Figure 2
Figure 2
The predicted prevalence rates of depression symptoms by countries or regions, based on the meta-analytical regression model.
Figure 3
Figure 3
The predicted prevalence rates of anxiety symptoms by countries or regions, based on the meta-analytical regression model.
See this image and copyright information in PMC

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