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Embase, MEDLINE, and Cochrane Central Register of Controlled Trials) from January 1, 2020, to February 16, 2021, and unpublished studies were searched in PsycArXiv on March 8, 2021, for studies reporting on child/adolescent depression and anxiety symptoms.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/abstracts were 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-effect meta-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.

中文翻译：

---

COVID-19 期间儿童和青少年抑郁和焦虑症状的全球流行：一项荟萃分析。

重要性 新兴研究表明，在 COVID-19 期间，全球儿童和青少年精神疾病的患病率显着增加。然而，文献报道了患病率的显着差异。目的 确定对 COVID-19 期间儿童和青少年临床上抑郁和焦虑症状升高的全球患病率的更准确估计；将这些比率与大流行前的估计值进行比较；并检查人口统计学（例如，年龄、性别）、地理（例如，全球区域）或方法学（例如，大流行数据收集时间点、精神疾病的知情人、研究质量）因素是否解释了研究中流行率的变化。数据源 自 2020 年 1 月 1 日起，搜索了四个数据库（PsycInfo、Embase、MEDLINE 和 Cochrane Central Register of Controlled Trials），至 2021 年 2 月 16 日，并于 2021 年 3 月 8 日在 PsycArXiv 中搜索了未发表的研究，以获取报告儿童/青少年抑郁和焦虑症状的研究。该搜索策略结合了来自 3 个主题的搜索词：(1) 精神疾病（包括抑郁和焦虑），(2) COVID-19，以及 (3) 儿童和青少年（年龄≤18 岁）。对于 PsycArXiv，使用了关键术语 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，并且报告了青少年（年龄≤18 岁）临床上抑郁或焦虑升高的患病率，则纳入研究。数据提取与综合 共检索到 3094 篇不重复的标题/摘要，并审查了 136 篇全文文章。数据分析时间为 2021 年 3 月 8 日至 22 日。主要结果和措施 青少年临床上升高的抑郁和焦虑症状的患病率。结果进行了随机效应荟萃分析。包括 80 879 名参与者在内的 29 项研究符合完全纳入标准。临床上抑郁和焦虑症状升高的综合患病率估计分别为 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和女孩中，临床上抑郁和焦虑症状升高的患病率更高。大龄儿童的抑郁症状较高。结论和相关性 在 COVID-19 大流行的第一年获得的汇总估计表明，全球四分之一的青年正在经历临床上升高的抑郁症状，而五分之一的年轻人正在经历临床上升高的焦虑症状。这些汇总估计值随着时间的推移而增加，是大流行前估计值的两倍。预计会有大量的精神卫生保健使用，分配资源以解决儿童和青少年的精神卫生问题至关重要。