Anxiety symptoms and disorders during the COVID-19 pandemic in children and adolescents: Systematic review and meta-analysis

• Urvashi Panchal ^[4] ; Julio David Vaquerizo-Serrano ^[5] ; Ileana Conde-Ghigliazza ^[5] ; Herdem Aslan Genc ^[1] ; Simone Marchini ^[6] ; Kamile Pociute ^[2] ; Binay Kayan Ocakoglu ^[7] ; Szarah Sanchez-Roman ^[8] ; Dorottya Ori ^[9] ; Ana Catalan ^[10] ; Luis Alameda ^[11] ; Samuele Cortese ^[3] ; Gonzalo Salazar de Pablo ^[12]
  1. [1] Koç University

     Koç University

     Turquía

     
  2. [2] Vilnius University

     Vilnius University

     Lituania

     
  3. [3] University of Southampton

     University of Southampton

     GB.ENG.M4.24UJ, Reino Unido

     
  4. [4] Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK; The Havens Sexual Assault Referral Centre, King’s College Hospital NHS Foundation Trust, London, UK
  5. [5] Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
  6. [6] f Department of Psychiatry for Infant, Child, Adolescent and Youth, University Hospital Brussels (HUB), Brussels, Belgium; Day care center for Adolescents, Equipe ASBL, Brussels, Belgium
  7. [7] Clinic of Child and Adolescent Psychiatry, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, University of Health Sciences, Istanbul, Turkey
  8. [8] Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
  9. [9] Department of Mental Health, Heim Pal National Pediatic Institute, Budapest, Hungary; Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
  10. [10] Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK; Biobizkaia Health Research Institute, Basurto University Hospital, OSI Bilbao-Basurto, University of the Basque Country UPV/EHU, Centro de Investigacion en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III
  11. [11] Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College of London, London, UK; Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain
  12. [12] Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK

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• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 37, Nº 4, 2023
• Idioma: inglés
• DOI: 10.1016/j.ejpsy.2023.06.003
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  • Background and Objectives: The COVID-19 pandemic and its associated factors have been shown to affect anxiety levels of young people. We meta-analytically assessed the prevalence of anxiety symptoms and anxiety disorders in children and adolescents during the pandemic, and the predictors and moderating factors influencing anxiety.

    Methods: Multiple databases and registers were searched in this PRISMA and MOOSE-compliant systematic review and meta-analysis (PROSPERO:CRD42021266695) until 27/06/2021. We included individual studies evaluating the prevalence and characteristics of anxiety symptoms or anxiety disorders in children and adolescents (mean age≤18 years), during the COVID-19 pandemic. Data extraction and quality assessment were carried out by independent authors. Random-effects meta-analyses of the prevalence of anxiety symptoms and anxiety disorders were conducted using Comprehensive Meta-Analysis (CMA) V3.

    Results: 74 articles (total participant sample=478,882) were included (mean age=13.4 years, 52.3% female). The pooled rate of children and adolescents fulfilling diagnostic criteria for anxiety disorders was 13.0% (95%CI=4.9−30.1); the pooled prevalence of anxiety symptoms was 26.5% (95%CI=20.3−33.9). Anxiety symptoms were significantly more prevalent in females than males (B = 0.103, p<.001), significantly higher during the second wave of COVID-19, following July 2020, than during the first wave, prior to June 2020, (Q= 8.136, p=.017), and during school closure (Q= 8.100, p=.014). Quality of included studies was overall moderate.

    Conclusions: There is a high prevalence of anxiety symptoms in children and adolescents during the COVID-19 pandemic, especially amongst females. This study identifies vulnerable groups, risk, and protective factors, which is crucial to developing clinical practice to prevent further mental health deterioration in young people.