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Estimated Prevalence of Depressive Disorders in Children From 2004 to 2019: A Systematic Review and Meta-Analysis
Michael J Spoelma1,2, Gemma L Sicouri1,3,4, Deanna A Francis1,4
1Black Dog Institute, University of New South Wales, Sydney, Australia.
Insights
Childhood depression is uncommon, with prevalence rates for major depressive disorder and other forms remaining stable between 2004 and 2019. Further research is needed to monitor trends post-pandemic.
Area of Science:
- Child and Adolescent Psychiatry
- Epidemiology
- Mental Health Research
Background:
- Childhood depression represents a significant public health concern.
- Environmental and lifestyle changes may increase children's risk for mental health issues, but evidence for depression specifically is limited.
Purpose of the Study:
- To determine the prevalence of depressive disorders in children under 13 years.
- To assess changes in childhood depression prevalence over time.
Main Methods:
- Systematic search of multiple databases (MEDLINE, PsycINFO, Embase, Scopus, Web of Science) and gray literature.
- Inclusion of studies with population prevalence estimates, standardized diagnostic interviews, and birth year information for children under 13.
- Meta-analysis and meta-regression of data from 41 studies published between 2004 and 2023.
Main Results:
- Pooled prevalence: 1.07% for overall depressive disorders, 0.71% for major depressive disorder (MDD), 0.30% for dysthymia, and 1.60% for disruptive mood dysregulation disorder (DMDD).
- No significant differences in prevalence were found between sexes or between high-income and low/middle-income countries.
- No significant association with birth cohort was detected; prevalence remained stable from 2004 to 2019.
Conclusions:
- Childhood depression appears uncommon and has not substantially increased between 2004 and 2019.
- Further epidemiologic studies are essential to track trends, especially in the context of the COVID-19 pandemic.
- The low number of studies for DMDD highlights a need for more research in this specific area.
Importance:
Depression during childhood (ie, age <13 years) poses a major health burden. Recent changes in environmental and lifestyle factors may increase children's risk of mental health problems. This has been reported for anxiety disorders, but it is unclear whether this occurs for depressive disorders.
Objective:
To provide prevalence estimates for the depressive disorders (ie, major depressive disorder [MDD], dysthymia, disruptive mood dysregulation disorder [DMDD], and overall) in children, and whether they have changed over time.
Data Sources:
The MEDLINE, PsycINFO, Embase, Scopus, and Web of Science databases were searched using terms related to depressive disorders, children, and prevalence. This was supplemented by a systematic gray literature search.
Study Selection:
Studies were required to provide population prevalence estimates of depressive disorder diagnoses (according to an established taxonomy and standardized interviews) for children younger than 13 years, information about participants' year of birth, and be published in English.
Data Extraction And Synthesis:
Data extraction was compliant with the Meta-Analysis of Observational Studies in Epidemiology guidelines. A total of 12 985 nonduplicate records were retrieved, and 154 full texts were reviewed. Data were analyzed from 2004 (the upper limit of a previous review) to May 27, 2023. Multiple proportional random-effects meta-analytic and mixed-effects meta-regression models were fit.
Main Outcomes And Measures:
Pooled prevalence rates of depressive disorders, prevalence rate differences between males vs females and high-income countries (HICs) vs low-and middle-income countries (LMICs), and moderating effects of time or birth cohort.
Results:
A total of 41 studies were found to meet the inclusion criteria. Pooled prevalence estimates were obtained for 1.07% (95% CI, 0.62%-1.63%) for depressive disorders overall, 0.71% (95% CI, 0.48%-0.99%) for MDD, 0.30% (95% CI, 0.08%-0.62%) for dysthymia, and 1.60% (95% CI, 0.28%-3.90%) for DMDD. The meta-regressions found no significant evidence of an association with birth cohort, and prevalence rates did not differ significantly between males and females or between HICs and LMICs. There was a low risk of bias overall, except for DMDD, which was hindered by a lack of studies.
Conclusions And Relevance:
In this systematic review and meta-analysis, depression in children was uncommon and did not increase substantially between 2004 and 2019. Future epidemiologic studies using standardized interviews will be necessary to determine whether this trend will continue into and beyond the COVID-19 pandemic.
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