Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19 A Meta-analysis
Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19 A Meta-analysis
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DOI：
10.1001/jamapediatrics.2021.2482
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发表时间：
2021-08-09
期刊：
影响因子：
26.1
通讯作者：
Madigan, Sheri
中科院分区：
文献类型：
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作者：
Racine, Nicole;McArthur, Brae Anne;Madigan, Sheri
重要性新兴研究表明，在COVID-19期间，儿童和青少年精神疾病的全球患病率大幅增加。然而，在整个literary.Objective患病率已报告的重大变化，以确定更准确的估计全球患病率的儿童和青少年临床上升高的抑郁和焦虑症状在COVID-19期间;比较这些率与prepandemic估计;并检查人口统计学是否（例如，年龄、性别）、地理位置（即全球区域），或方法（例如，流行病数据收集时间点，精神疾病的告密者，研究质量）因素解释了研究中患病率的变化。（PsycInfo、Embase、MEDLINE和科克伦对照试验中心注册中心），并于2021年3月8日在PsycArXiv中检索未发表的研究，以获得报告儿童/青少年抑郁和焦虑症状的研究。检索策略结合了3个主题的检索词：（1）精神疾病（包括抑郁和焦虑），（2）COVID-19，（3）儿童和青少年（年龄≥ 18岁）。PsycArXiv使用关键术语COVID-19、心理健康和儿童/青少年。研究选择如果研究以英文发表，有定量数据，并报告青年（年龄≥ 18岁）临床抑郁或焦虑患病率升高，则纳入研究。数据分析时间为2021年3月8日至22日。主要结果和指标青年抑郁和焦虑症状临床升高的患病率。29项研究（包括80，879名受试者）符合全部纳入标准。临床升高的抑郁和焦虑症状的合并患病率估计值分别为25.2%（95%CI，21.2%-29.7%）和20.5%（95%CI，17.2%-24.4%）。主持人分析显示，在大流行后期收集的研究中，临床上升高的抑郁和焦虑症状的患病率较高，而且在女孩中也较高。结论和相关性COVID-19大流行第一年获得的汇总估计表明，全球每4名青年中就有1名正在经历临床加重的抑郁症状，而每5名青年中就有1名正在经历临床加重的焦虑症状。这些汇总的估计数随着时间的推移而增加，是大流行前估计数的两倍。预计将有大量的精神卫生保健利用，分配资源解决儿童和青少年的精神卫生问题至关重要。
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Embase, MEDLINE, and Cochrane Central Register of Controlled Trials) from January 1, 2020, to February 16, 2021, and unpublished studies were searched in PsycArXiv on March 8, 2021, for studies reporting on child/adolescent depression and anxiety symptoms.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 >= 18 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 >= 18 years).DATA EXTRACTION AND SYNTHESIS A total of 3094 nonduplicate titles/abstractswere 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-effectmeta-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 RELEVANCE Pooled 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.