Estimated Prevalence of Depressive Disorders in Children From 2004 to 2019

 Michael J. Spoelma, BPsych^1,2; Gemma L. Sicouri, DCP, PhD^1,3,4; Deanna A. Francis, MClinNeuro, PhD^1,4; et al

 doi:10.1001/jamapediatrics.2023.3221

Key Points

Question  What were the prevalence rates of depressive disorders in childhood (ie, age <13 years) between 2004 and 2019?

Findings  In this systematic review and meta-analyses of 41 studies, pooled prevalence estimates were noted for major depressive disorder (0.71%), dysthymia (0.30%), disruptive mood dysregulation disorder (1.60%), and 1.07% overall. These estimates did not differ significantly between males and females or high-income and low- and-middle-income countries and did not appear to increase over a 15-year period.

Meaning  These findings suggest that depression in childhood between 2004 and 2019 was uncommon and did not increase over time, but the lack of data beyond the COVID-19 pandemic is yet to be accounted for.

Abstract

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.

https://jamanetwork.com/journals/jamapediatrics/fullarticle/2808878