Depression and anxiety among children and adolescents during COVID-19

1. Prevalence of depression and anxiety has significantly increased over the first year of the pandemic among children and adolescents.

Evidence Rating Level: 2 (Good)

Study Rundown: Anxiety and depression are relatively common mental health concerns among children and adolescents. Prior to the pandemic, prevalence rates were roughly 11.6% and 12.9%, respectively. Since the start of the COVID-19 pandemic, with the introduction of necessary precautions such as social distancing and isolation, these rates have increased among various at-risk populations. Based on extant literature, however, prevalence rates have become unclear in the context of youth.

This meta-analysis sought to investigate global prevalence rates of clinically elevated anxiety and depressive symptoms among children and adolescents during the COVID-19 pandemic. Overall, during the first year of the pandemic, 20% of children and adolescents were experiencing elevated anxiety and 25% were experiencing elevated depressive symptoms, which were increases from pre-pandemic years.

Random-effect meta-analyses suggest that depression and anxiety symptoms among children and adolescents have increased over the course of the pandemic, with the highest symptoms occurring later in the pandemic. Further, with nearly one-fifth and one-fourth of children and adolescents experiencing elevated symptoms of anxiety and depression, respectively, healthcare systems must be poised to confront the mental health concerns to ensure that they do not negatively impact neurodevelopment or social abilities moving forward.

Click to read the study in JAMA Pediatrics

Relevant Reading: Child and Adolescent Mental Illness During COVID-19: A Rapid Review

In-Depth [ meta-analysis]:

Effects of the COVID-19 pandemic have been widespread globally, with some populations being at greater risk than others at different phases. It has become clear that mental health has been a major concern among all persons, particularly these at-risk populations. Children and adolescents are also in a unique, at-risk position due to the necessary precautions, such as social distancing, closed schools, and isolation. In terms of global prevalence of depression and anxiety among this group, the literature is unclear. This meta-analysis sought to clarify the global prevalence of these symptoms on children and adolescents during the COVID-19 pandemic.

This meta-analysis searched PsycINFO, MEDLINE, Embase, and Cochrane with a period of January 1, 2020 to February 16, 2021. PsycArXiv was also searched for unpublished works relating specifically to child and adolescent symptoms of depression or anxiety. Search themes included mental illness, COVID-19, and children and adolescents (below 18 years of age). Inclusion criteria included English language, quantitative data, and reports of prevalence of elevated anxiety or depression among children or adolescents. A total of 136 full-text articles were reviewed out of the 3,094 abstracts retrieved. Authors included 29 studies that included 80,879 participants meeting full inclusion criteria. Pooled estimates of clinically elevated (significant) anxiety and depressive symptoms were 20.5% (95% CI 17.2% to 24.4%) and 25.2% (95% CI 21.2% to 29.7%), respectively. Prevalence of elevated anxiety and depression symptoms were significantly greater in studies conducted later in the pandemic, as well as among female children and adolescents. Depression symptoms were generally higher among older children, compared to younger children. Compared to pre-pandemic prevalence rates, anxiety and depression in this population have nearly doubled.

Image: PD

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