Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children
Abstract
Worldwide, millions of children are affected by armed conflict. However, data on the prevalence of mental disorders among these children is sparse. We aimed to determine the prevalence of mental disorders among children affected by war using a systematic review and meta-regression analysis. We systematically reviewed existing literature to identify studies on prevalence of post-traumatic stress disorder (PTSD), anxiety, depression and psychosis among children exposed to armed conflict. We searched electronic databases and references listed in studies to obtain eligible studies. We pooled studies using the random-effects method and explored heterogeneity using meta-regression analysis. Seventeen studies met our inclusion criteria. Studies included 7,920 children. Sample sizes ranged from 22 to 2,976. Four studies were conducted during a conflict and others during post-conflict. All the studies reported PTSD as the primary outcome ranging from 4.5 to 89.3%, with an overall pooled estimate of 47% (9% CI: 35-60%, I2 = 98%). Meta-analysis heterogeneity was attributable to study location (OR 1.33, 95% CI: 1.27-1.41), method of measurement (OR 1.36, 95% CI: 1.29-1.44) and duration since exposure to war (coefficient 0.17, 95% CI: 0.94-0.25). In addition, four studies reported elevated depression that allowed pooling (43%, 95% CI: 31-55%) and three studies reported elevated anxiety disorders allowing pooling (27%, 95% CI: 21-33%). Our systematic review suggests a higher prevalence rate of mental disorders among children exposed to conflict than among the general population. Given the number of current conflicts, there is a paucity of information regarding mental disorders among children affected by war.
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Children and adolescents exposed to armed conflict face an elevated risk of mental health problems.
“Inadequate responsiveness to these issues is especially concerning in view of the body of research documenting increased risk of mental health problems in war-affected children and families.1,3–8”
From Interventions for Children Affected by War: An Ecological Perspective on Psychosocial Support and Mental Health Care (2013) · cites this paper as [4]
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- Authors
- Attanayake, V., McKay, R., Joffres, M., Singh, S., Burkle, F., & Mills, E.
- Affiliations
- Simon Fraser University (CA)
- Johns Hopkins University (US)
- Harvard University (US)
- McMaster University (CA)
- Corresponding author
- Mills, Edward
- Venue
- Medicine, Conflict and Survival
- Publisher
- Informa UK Limited
- Published
- 2009-01
- Volume
- 25
- Issue
- 1
- Pages
- 4-19
- ISSN
- 1362-3699 (ISSN-L)
- 1743-9396
- OpenAlex
- W2076797897
- Cited by
- 362
- References
- 3
- Citations by year
- 2026: 29 · 2025: 34 · 2024: 27 · 2023: 26 · 2022: 32 · 2021: 23 · 2020: 23 · 2019: 26 · 2018: 31 · 2017: 19 · 2016: 21 · 2015: 18 · 2014: 17 · 2013: 13 · 2012: 7
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medicine Conflict & Survival (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- child psychopathology, war exposure, armed conflict, post-traumatic stress disorder, depression, anxiety disorders, psychosis, prevalence, child mental health
- MeSH terms
- Mental Disorders, Child, Child Welfare, Humans, Warfare
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