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Prevalence of mental health symptoms in children and adolescents during the COVID-19 pandemic: a meta-analysis
Open accessAbstract
The COVID-19 pandemic and its accompanying infection control measures introduced sudden and significant disruptions to the lives of children and adolescents around the world. Given the potential for negative impacts on the mental health of youths as a result of these changes, we conducted a systematic review and meta-analysis to examine the prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances in children and adolescents during the pandemic. We searched major literature databases for relevant cross-sectional or longitudinal studies that included primary and secondary school students or children and adolescents ≤18 years of age. Prevalence values were extracted, logit-transformed, and pooled. Based on 191 included studies with 1,389,447 children and adolescents, we found the pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances to be 31%, 31%, and 42%, respectively. Age, grade levels, education levels, gender, geographical regions, and electronics use were correlated with the prevalence of mental health symptoms. The prevalence of mental health symptoms also increased with time, although signs of recovery and stabilization were also observed. Overall, the results from this review demonstrate the need for increased mental health research, monitoring, and intervention for children and adolescents during the current and future pandemics.
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“women have higher prevalence rates of both depression and anxiety problems (Deng et al., 2023; Shorey et al., 2022)”
From Process of change and efficacy of acceptance and commitment therapy (ACT) for anxiety and depression symptoms in adolescents: A meta-analysis of randomized controlled trials. (2025) · cites this paper as Deng et al., 2023
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Review of Child and Adolescent Mental Health (CAMH) Policy in Mainland China
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Gaspar, T., Carvalho, M., Guedes, F. B., Cerqueira, A., & de Matos, M. G. (2023) · Child Indicators Research · doi:10.1007/s12187-023-10092-4 · Cited by 8
“The pandemic has further increased the differences between these higher-risk groups (Deng et al., 2022; World Health Organization, 2023a, 2023b).”
Kaniasty, K. Z., & van der Meulen, E. (2024) · PLoS ONE · doi:10.1371/journal.pone.0310734 · Cited by 10
Adolescents' Reflections on Mental Health: Key Findings From a 13-Country Qualitative Study
Fine, S. L., Lai, J., Martinez-Baack, M., Oliveira, J. D. D., & Blum, R. W. (2025) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2024.09.005 · Cited by 10
Viewpoint: Supporting mental health in the current management of rheumatoid arthritis: time to act!
Doumen, M., Pazmiño, S., Verschueren, P., & Westhovens, R. (2023) · Lara D. Veeken · doi:10.1093/rheumatology/kead248 · Cited by 7
Ang, B. H., Gollapalli, S. D., Du, M., & Ng, S.-K. (2025) · Journal of Medical Internet Research · doi:10.2196/59524 · Cited by 6
Lee, H., Fosco, G. M., & Feinberg, M. E. (2024) · Child Development · doi:10.1111/cdev.14179 · Cited by 6
Wu, H., Lin, Y., Yang, L., Lai, W., Li, Y., Xu, Y., Wang, W., Yang, L., Lu, C., & Yan, B. (2024) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-024-00836-7 · Cited by 6
Tran, S. T., Bieniak, K. H., Bedree, H., Adler, M. J., Ogunmona, S., Kovar-Gough, I., Ma, W., Thabrew, H., & Cunningham, N. R. (2024) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsae097 · Cited by 6
Habermann, K., Napp, A.-K., Reiß, F., Kaman, A., Erhart, M., & Ravens‐Sieberer, U. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1510355 · Cited by 7
Lekamge, R. B., Jain, R., Sheen, J., Solanki, P., Zhou, Y., Romero, L., Barry, M. M., Chen, L., Karim, M. N., & Ilić, D. (2025) · Campbell Systematic Reviews · doi:10.1002/cl2.70024 · Cited by 10
Breath-Focused Mindfulness and Compassion Training in Parent-Child Dyads: Pilot Intervention Study
Jaiswal, S., Nan, J., Dizon, S., Young, J. O., Purpura, S. R., Manchanda, J. K., Ramanathan, D., Kuo, D. J., & Mishra, J. (2025) · JMIR Formative Research · doi:10.2196/69607 · Cited by 7
Moro, G. L., Scaioli, G., Conrado, F., Lusiani, L., Pinto, S., Rolfini, E., Bert, F., & Siliquini, R. (2024) · Journal of School Health · doi:10.1111/josh.13449 · Cited by 6
“…recent relevant reviews highlighted a substantial impact of the pandemic and related restrictive measures on children and adolescents’ mental health (Deng et al., 2022; K. Jones et al., 2023; Ludwig-Walz et al., 2022; Saulle et al., 2022), suggesting that the prevalence of symptoms may increase…”
InfluentialKhudair, S. A., Khader, Y. S., Nsour, M. A., & Tanaka, E. (2024) · Journal of School Health · doi:10.1111/josh.13459 · Cited by 6
Xiao, H., Wu, Y., Chen, Z., & Nie, Y. (2024) · Children and Youth Services Review · doi:10.1016/j.childyouth.2024.107779 · Cited by 6
A bibliometric analysis of anxiety and depression among primary school students
Jian, F., Yu, W. B., Li, S., & Sun, W. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1431215 · Cited by 10
Exploring teen well-being and social media use during the pandemic summer of 2020
Rutledge, S. A., Bunn, S., Paul, M., Dennen, V. P., & Park-Gaghan, T. J. (2025) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2024.2447464 · Cited by 9
“Likewise, Ravens-Sieberer et al. (2021), Deng et al. (2023) and Kauhanen et al. (2023) all found that adolescents felt burdened by COVID-19 and reported significantly lower health-related quality of life, more mental health issues and higher levels of anxiety.”
Xiao, H., Chen, P., Xiao, H., Zhong, P., He, J., & Nie, Y. (2025) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-025-00943-z · Cited by 5
“Emerging literature [1–4] has documented a troubling decline in mental health outcomes among young populations, with maladjustment manifesting across behavioral, psychological, social, and academic domains [5, 6].”
Hon, K., Hamamura, T., Hasking, P. A., Lim, E., Hon, K., & Boyes, M. E. (2025) · Clinical Psychology Review · doi:10.1016/j.cpr.2025.102685 · Cited by 6
Exploring reciprocal links between early adolescent coping and internalizing symptoms
Mytelka, C., Narendorf, S. C., Baumler, E. R., Acquati, C., & Temple, J. R. (2024) · Journal of Adolescence · doi:10.1002/jad.12429 · Cited by 4
de Bruijn, A. G. M., Ehren, M., Meeter, M., & Kortekaas-Rijlaarsdam, A. F. (2025) · Frontiers in Education · doi:10.3389/feduc.2025.1514895 · Cited by 9
Ahufinger, N., Aguilera, M., Guerra, E., Giberga, A., Verdaguer-Ribas, O., Balboa-Castells, R., Andreu, L., Esteve‐Gibert, N., & Sanz‐Torrent, M. (2025) · Acta Psychologica · doi:10.1016/j.actpsy.2025.104927 · Cited by 10
Machlin, L., & McLaughlin, K. A. (2023) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2023.101647 · Cited by 5
Francisco, R., Raposo, B., Hormigo, M., Sesifredo, M., Carvalho, Á., Justo, A., & Godinho, C. I. A. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1213293 · Cited by 10
Baiden, P., Azasu, E., LaBrenz, C. A., Baiden, J. F., Gobodzo, E. C., Mets, V. E., & Broni, M. N. (2023) · Children and Youth Services Review · doi:10.1016/j.childyouth.2023.107351 · Cited by 6
Jin, J., Yuan, G. F., An, Y., & Li, X. S. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-023-01650-6 · Cited by 6
Owens, J. S., Exner‐Cortens, D., Cappella, E., DeShazer, M., May, N., Seipp, J. W., Claussen, C., Zieg, N., & Garcia, M. (2024) · School Mental Health · doi:10.1007/s12310-024-09653-x · Cited by 6
“These behaviors may manifest as a function of student mental health challenges and/or student stress related to inequities facing their communities, which have been exacerbated by the COVID-19 pandemic (Deng et al., 2023; Institute of Education Sciences, n.d.).”
Understanding Adolescent Mental Health in the COVID-19 Era: A Psychodynamic Approach
Akın, A., & Sarrar, L. (2024) · Children · doi:10.3390/children11070772 · Cited by 7
“The discovered prevalence of mental health issues during the COVID-19 pandemic aligns with other studies [32–34], supporting the generalizability of the study results discussed below.”
ResultMayman, Y. R., Crowley, T., & van Wyk, B. E. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21111517 · Cited by 5
“The COVID-19 pandemic and its subsequent lockdown measures also introduced significant disruptions to the daily lives of children and adolescents around the world and affected the treatment and adherence of ALHIV to ART [21].”
Li, M., Beckwith, S., Fine, S. L., Mafuta, E. M., Lian, Q., Martinez-Baack, M., & Moreau, C. (2024) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2024.09.012 · Cited by 7
Ahmed, S. K., Dabrowski, A., Dix, K., & Carslake, T. (2023) · ACEReSearch Repository (Australian Council for Educational Research) · doi:10.37517/978-1-74286-714-4 · Cited by 6
Norouzi, E., & Shojaei, B. (2025) · BMC Psychology · doi:10.1186/s40359-025-03118-9 · Cited by 6
“The results of the present study indicate that adolescent athletes in Tehran experience high levels of mental health problems, perceived stress, and sleep disturbances, which aligns with previous research [39–41].”
Sourander, A., Zhang, X., Dadras, O., Abio, A., Mishina, K. E., Ståhlberg, T., Mori, Y., Gilbert, S., Heinonen, E., & Gyllenberg, D. (2025) · Child and Adolescent Mental Health · doi:10.1111/camh.70040 · Cited by 5
“…difference highlights a critical area of concern that the pandemic ’ s role in exacerbating pre-existing gender disparities in mental health is consistent with prepandemic fi ndings of greater internalizing symptoms among females (Deng et al., 2023; Kauhanen et al., 2023; Keyes & Platt, 2024).”
Dimova, E. D., Roddick, K., Hunter, S. C., Delfmann, L. R., Morgan, A., McPherson, K. E., Currie, C. E., McAloney‐Kocaman, K., McCann, B., & McKendrick, J. H. (2026) · Child Psychiatry & Human Development · doi:10.1007/s10578-026-02019-1 · Cited by 6
Global economic burden of depression in 154 countries from 2025 to 2050
Cao, Z., Luo, Y., Jiao, L., Chen, W., Klaus Prettner, A., Kühn, M., Bloom, D. E., Jamison, D. T. T., Bärnighausen, T., & Chen, S. (2026) · Nature Medicine · doi:10.1038/s41591-026-04548-7 · Cited by 6
Rahmon, I. J., Bosmans, M. W. G., Baliatsas, C., Hooiveld, M., Marra, E., & Dückers, M. (2024) · JMIR Public Health and Surveillance · doi:10.2196/53368 · Cited by 4
Milewczyk, C. M. K., Holtmann, M., Legenbauer, T., & Derks, L. M. (2025) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-025-00899-0 · Cited by 4
“Analyses found a pooled 31% prevalence of both depressive and anxiety symptoms in children and adolescents [9].”
Du, X., Jia, J., Duan, T., Tao, X., Li, J., Yalikun, S., Wu, H., Zhou, Z., & Ren, Z. (2025) · Journal of Research on Adolescence · doi:10.1111/jora.70046 · Cited by 4
Kara, B., Scharf, N., McCormick, K. C., Bhreathnach, L., Currie, C. E., & Symonds, J. E. (2025) · Journal of Adolescence · doi:10.1002/jad.70038 · Cited by 9
Fehkührer, S., Humer, E. C., Kaltschik, S., Pieh, C., Probst, T., Diestler, G., & Jesser, A. (2023) · Healthcare · doi:10.3390/healthcare11162242 · Cited by 4
Usami, M., Satake, N., Katsuyama, H., Okudera, K., Uchiyama, Y., Imamura, M., Hayakawa, T., Yanai, H., & Aoyanagi, N. (2024) · Psychiatry and Clinical Neurosciences Reports · doi:10.1002/pcn5.175 · Cited by 4
Metadata
- Authors
- Deng, J., Zhou, F., Hou, W., Heybati, K., Lohit, S., Abbas, U., Silver, Z., Wong, C. Y., Chang, O., Huang, E., Zuo, Q. K., Moskalyk, M., Ramaraju, H. B., & Heybati, S.
- Affiliations
- University of Toronto (CA)
- McMaster University (CA)
- Western University (CA)
- Mayo Clinic (US)
- Carleton University (CA)
- University of Ottawa (CA)
- Rutgers New Jersey Medical School (US)
- Virginia Commonwealth University (US)
- Queen's University (CA)
- Corresponding author
- Deng, Jiawen
- ORCID
- Venue
- Annals of the New York Academy of Sciences
- Publisher
- Wiley
- Published
- 2022-12-20
- Volume
- 1520
- Issue
- 1
- Pages
- 53-73
- ISSN
- 0077-8923 (ISSN-L)
- 1749-6632
- PMC
- PMC9880764
- OpenAlex
- W4312019441
- Cited by
- 283
- References
- 252
- Citations by year
- 2026: 43 · 2025: 91 · 2024: 105 · 2023: 43 · 2022: 1
- FWCI
- 10.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of the New York Academy of Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Scholarship at UWindsor (University of Windsor) (submittedVersion)
- Funders
- McMaster University
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- COVID-19 pandemic, children and adolescents, psychiatric symptoms, depressive symptoms, anxiety symptoms, sleep disorders, prevalence, school students, digital technology use, gender differences, post-pandemic recovery
- MeSH terms
- COVID-19, Adolescent, Anxiety, Child, Cross-Sectional Studies, Depression, Humans, Mental Health, Sleep Wake Disorders, Prevalence, Pandemics
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