Depressive Symptoms Among Children and Adolescents in China During the Coronavirus Disease-19 Epidemic: A Systematic Review and Meta-Analysis

Jianghe Chen; Kun Yang; Yujia Cao; Yun Du; Ningqun Wang; Miao Qu

doi:10.3389/fpsyt.2022.870346

Depressive Symptoms Among Children and Adolescents in China During the Coronavirus Disease-19 Epidemic: A Systematic Review and Meta-Analysis

Front Psychiatry. 2022 Apr 8:13:870346. doi: 10.3389/fpsyt.2022.870346. eCollection 2022.

Authors

Jianghe Chen^{1

2}, Kun Yang³, Yujia Cao⁴, Yun Du⁵, Ningqun Wang¹, Miao Qu¹

Affiliations

¹ Department of Neurology, Xuan Wu Hospital of Capital Medical University, Beijing, China.
² Department of Neurology, Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China.
³ Evidence-Based Medicine Center, Xuan Wu Hospital of Capital Medical University, Beijing, China.
⁴ Xian Fifth Hospital, Xi'an, China.
⁵ Department of Rheumatology Immunology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.

Abstract

Background: The Coronavirus Disease-19 (COVID-19) pandemic negatively impacts mental health. Some published studies have investigated the prevalence of depression among children and adolescents in China during the pandemic. However, the results vary widely. We aimed to systematically analyze and estimate the prevalence of depressive symptoms and attempted to reveal the reasons for prevalence variety in previous studies.

Methods: Published studies were searched in PubMed, Embase, Cochrane Central, the Chinese Scientific Journal Database (VIP Database), China National Knowledge database (CNKI), and the WanFang database from December 2019 to May 2021. The quality of all included studies was assessed by the Joanna Briggs Institute (JBI) checklist and the American Agency for Health Care Quality and Research's (AHRQ) cross-sectional study quality evaluation items. Meta-analysis was performed using random-effects modeling.

Results: Of the 1,708 references screened, 13 related reports that involve 41,729 participants were included. The results suggested that the pooled prevalence of depressive symptoms among Chinese children and adolescents during the COVID-19 epidemic was 28.6%. Subgroup analyses showed that the pooled prevalence was highest among the studies using the Patient Health Questionnaire (PHQ)-9 (46.8%) and lowest among these using Depression Self-Rating Scale for Children (DSRSC) (11.4%). All studies using PHQ-9 set the cutoff at 5 points instead of 10. The pooled prevalence of studies that include primary school students was lower (16.5%) than that of studies excluding primary school students (39.1%).

Conclusion: The meta-analysis suggests that depressive symptoms were relatively prevalent among Chinese children and adolescents during COVID-19, especially among the secondary school students. The suitable screening tools and cutoff should be carefully chosen in the survey.

Keywords: COVID-19; China; children and adolescent; depression; meta-analysis.

Publication types

Systematic Review