Pediatric Depression, Anxiety Rates Doubled During COVID-19

Nicole Racine, PhD

New pooled research shows 25% of the global youth are experience clinically elevated depression symptoms since the beginning of the COVID-19 pandemic, while 20% are experiencing clinically elevated anxiety symptoms.

It is widely believed that the COVID-19 pandemic might lead to a litany of mental health problems, particularly for children and adolescents.

However, there has been significant variance on just how much mental illnesses have increased among pediatric patients during the pandemic compared to the prepandemic rates of 11.6% and 12.9% for depression and anxiety, respectively.

A team, led by Nicole Racine, PhD, RPsych, Department of Psychology, University of Calgary, produced more precise estimates on the global prevalence of child and adolescent clinically elevated depression and anxiety symptoms during the COVID-19 pandemic, compared to prepandemic estimates.

“The COVID-19 pandemic, and its associated restrictions and consequences, appear to have taken a considerable toll on youth and their psychological well-being,” the authors wrote. “Loss of peer interactions, social isolation, and reduced contact with buffering supports (eg, teachers, coaches) may have precipitated these increases.”

The Study

In the study, the investigators searched various databases for controlled trials between January 1, 2020 and February 16, 2021, as well as unpublished studies reporting on child and adolescent depression and anxiety symptoms.

The investigators also examined whether certain demographics, such as age and sex, geography, or methodological factors can help explain the variance in prevalence rates of depression and anxiety across different studies.

The team identified 3094 studies and ultimately reviewed 136 full-text articles.

The investigators sought main outcomes of the prevalence rates of clinically elevated depression and anxiety symptoms in young patients.

In the analysis, they used a random-effect meta-analyses to identify 29 studies involving 80,879 patients that met the full inclusion criteria, 26 involving youth symptom reports and 3 studies with parent reports of child symptoms.

Subgroup Estimates

The investigators identified pooled prevalence estimates of clinically elevated depression and anxiety of 25.2% (95% CI, 21.2%-29.7%) and 20.5% (95% CI, 17.2%-24.4%), respectively.

However, moderator analyses showed that the prevalence of clinically elevated depression and anxiety symptoms were higher in studies collected later in the pandemic (b = 0.27; 95% CI, 0.10-0.44). The prevalence of clinically elevated depression and anxiety symptoms was also found to be higher in female patients (b = 0.04; 95% CI, 0.01-0.07), while just depression symptoms were higher in older children.

The investigators also found clinically elevated anxiety was higher in European countries (k = 4; rate = 0.34; 95% CI, 0.23-0.46; P = .01) compared with East Asian countries (k = 14; rate = 0.17; 95% CI, 0.13-0.21; P < .001).

“These pooled estimates, which increased over time, are double of prepandemic estimates,” the authors wrote. “An influx of mental health care utilization is expected, and allocation of resources to address child and adolescent mental health concerns are essential.”

The study, “Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19,” was published online in JAMA Pediatrics.