A systematic review and meta-analysis on the prevalence of mental disorders among children and adolescents in Europe

Abstract

Most mental disorders appear by age 14, but in most cases, they remain undiagnosed and untreated well into adulthood. A scoping review showed an absence of systematic reviews that address prevalence rates of mental disorders among children and adolescents in Europe that are based on community studies conducted between 2015 and 2020. To estimate the updated pooled prevalence of Anxiety Disorder, Depressive Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Autism Spectrum Disorder, Eating Disorders, Substance Use Disorders (SUD), among children and adolescents living in Europe, a search strategy was conducted using MEDLINE, Embase and Psych Info and studies were also identified from reference lists and gray literature. Eligible studies were evaluated for reliability, validity, and bias. Trends of prevalence rates for each mental disorder were calculated. Almost one in five young people in Europe were found to suffer from a mental disorder, with a pooled prevalence rate of 15.5%. Anxiety disorders had the highest pooled prevalence rate (7.9% (95% CI 5.1-11.8%, I²: 98.0%)), followed by ADHD (2.9% (95% CI 1.2-6.9%, I² = 94.3%)), ODD (1.9% (95% CI 1.0-3.7%, I² = 98.4%)), depressive disorder (1.7% (95% CI 1.0-2.9%, I² = 97.7%)), CD (1.5% (95% CI 0.6-3.8%, I² = 98.8%)) and ASD (1.4% (95% CI 0.4-5.4%, I² = 99.7%). No studies on SUD were identified. The mental health of children and adolescents may be improved by introducing routine screening, refining diagnostic sensitivity, raising awareness of mental disorders, minimizing stigma and socioeconomic inequality, as well as developing early intervention services. These facilitators of good mental health need to be prioritized, especially at a time of unprecedented risk factors for poor mental health.

Keywords: Child and adolescent; Europe; Mental disorders; Prevalence.

Fig. 1

Prisma flow chart [42] illustrating the selection process

Fig. 2

Forest plot displaying the prevalence rates of mental disorders among European regions [–47]. (Source: Lithuania [47], Austria [45], Turkey [44], Denmark [43], England [46])

Fig. 3

Forest plot displaying the prevalence rates of ‘any anxiety disorder’. (Source: England [46], Austria [45], Turkey [44]), Lithuania [47])

Fig. 4

Forest plot displaying the prevalence rates of depressive disorders [–45, 47, 49, 50]. The lines in magenta show the random effects pooled prevalence rate for each subgroup of depressive disorder. (DMDR disruptive mood dysregulation disorder, PDD persistent depressive disorder, MDD major depressive disorder). (Source: Spain [50], Greece [49], England [46], Austria [45], Denmark [43], Turkey [44]), Lithuania [47])

Fig. 5

Forest plot displaying the prevalence rates of ADHD [–47, 51]. (Source: Italy [51], England [46], Austria [45], Denmark [43], Turkey [44]), Lithuania [47])

Fig. 6

Forest plot displaying the prevalence rates of Oppositional Defiant Disorder [–46, 52]. (Source: Spain [52], England [46], Austria [45], Denmark [43], Turkey [44])

Fig. 7

Forest plot displaying the prevalence rates of conduct disorder [–47]. (Source: Austria [45], Turkey [44], Lithuania [47], England [46], Denmark [43])

Fig. 8

Forest plot displaying the prevalence rates of ASD from register-based studies. (Source: Italy [53], Poland [54], Denmark [55], Finland [55], Iceland [55], SW France [55], SE France [55])

Fig. 9

Forest plot displaying the prevalence rates of ASD from population studies. (Source: Italy [53], Ireland [56], Romania [41], Spain [57], Lithuania [47], England [46], Denmark [43])

Fig. 10

Forest plot displaying the prevalence rates of eating disorders. The lines in magenta show the random effects pooled prevalence rate for each subgroup of eating disorder. (Source: Spain [58], Austria [45])