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Cited by 148Child Abuse and TraumaPosttraumatic Stress Disorder ResearchChild and Adolescent Psychosocial and Emotional Development

A systematic review and meta-analysis on the prevalence of depression in children and adolescents after exposure to trauma

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Vibhakar, Viktoria, Allen, Leila R., Gee, Brioney, Meiser-Stedman, Richard·2019·Journal of Affective Disorders
DOI 10.1016/j.jad.2019.05.005
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Abstract

Background Depression is often reported as co-occurring with post-traumatic stress disorder in children and adolescents, but its prevalence within trauma-exposed child and adolescent samples is not well understood.Methods Our meta-analyses addressed two questions: I. What is the prevalence of depression (either based on structured interview or cut-off on a self-report measure) in children and adolescents after exposure to trauma? II. Does trauma exposure increase the severity or rates of depression comparative to another comparison group of children and adolescents with milder exposure or no exposure to trauma?Results Fifty-six studies reported depression prevalence. A random effects meta-analysis suggested that 24.2% [95% CI 20.6-28.0] of children and adolescents exposed to a traumatic event met criteria for depression. Our second meta-analysis across 30 studies found that the effect of trauma exposure (relative to unexposed or less exposed children and adolescents) on depression scores was medium in size (d = 0.51, 95% CI 0.41-0.61). The odds of a diagnosis of depression were 2.6 times greater [95% CI 2.0-3.3] for children and adolescents exposed to trauma as compared to those unexposed or less exposed. Participants exposed to interpersonal violence (IPV) had a higher prevalence and level of depression compared with those exposed to non-IPV trauma.Limitations Results should be interpreted with caution due to high levels of heterogeneity.Conclusion Depression in trauma-exposed children and adolescents is a common response to trauma that is not solely reflective of pre-traumatic difficulties. Post-traumatic depression merits serious consideration in trauma-exposed children and adolescents.

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  • Post-injury depression and PTSD may lead to functional impairment and other poor outcomes.

    “Traumatically injured patients, especially due to violence, have a significantly increased risk of developing depression and PTSD after injury compared to those who do not experience injury, and this may lead to functional impairment and other poor outcomes [45–47].”

    From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [45]

    The Introduction describes depression in children and adolescents as a leading cause of disability and a risk factor for long-term adverse outcomes. The Limitations section discusses functional impairment as a criterion for depression. The paper does not establish that PTSD leads to those outcomes, and its focus is trauma-exposed youth rather than injured patients generally. (LLM, conf=0.86)

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  • Traumatically injured patients, especially those injured by violence, have a significantly increased risk of developing depression and PTSD after injury compared to those who do not experience injury.

    “Traumatically injured patients, especially due to violence, have a significantly increased risk of developing depression and PTSD after injury compared to those who do not experience injury, and this may lead to functional impairment and other poor outcomes [45–47].”

    From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [45]

    The Results (manuscript p. 17) report higher depression scores in trauma-exposed children and adolescents than in unexposed or less-exposed groups. The Discussion (manuscript pp. 20–21) reports higher depression rates after interpersonal violence than after other trauma, but cites prior research for the PTSD finding. This review does not establish the stated depression-and-PTSD risk comparison for traumatically injured patients versus people without injury; its population is children and adolescents exposed to varied traumas. (LLM, conf=0.88)

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  1. [25]25. Tukey, J. W. (1977). Exploratory data analysis (Vol. 2). Reading, Mass.: Addison-Wesley.

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Authors
Vibhakar, V., Allen, L. R., Gee, B., & Meiser-Stedman, R.
Affiliations
  • University of East Anglia (GB)
  • Norfolk and Suffolk NHS Foundation Trust (GB)
Corresponding author
Vibhakar, Viktoria
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2019-08
Volume
255
Pages
77-89
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2019.05.005
OpenAlex
W2944107780
Cited by
148
References
99
Citations by year
2026: 24 · 2025: 21 · 2024: 32 · 2023: 26 · 2022: 19 · 2021: 15 · 2020: 10 · 2019: 1
FWCI
1.77
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • UEA Digital Repository (University of East Anglia) (submittedVersion)
Funders
University of Queensland
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
depression, children, adolescents, trauma exposure, post-traumatic depression, interpersonal violence, post-traumatic stress disorder, depression prevalence, injury severity
MeSH terms
Adolescent, Child, Depression, Depressive Disorder, Female, Humans, Male, Stress Disorders, Post-Traumatic, Violence, Prevalence

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