Prevalence of Anxiety and Depression Among Children and Adolescents in Low- and Middle-Income Countries-A Systematic Review

低收入和中等收入国家儿童和青少年焦虑和抑郁患病率的系统评价

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Abstract

BACKGROUND: This study reviews literature examining the prevalence of emotional problems (i.e., anxiety and depressive symptoms) among child and adolescent populations living in low- and middle-income countries (LMICs). METHOD: Following recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, PsycINFO (EBSCO), and MEDLINE (PubMed) databases were searched for articles published from January 1, 2000 to April 30, 2024. Quantitative studies reporting epidemiological/prevalence data were included in the review. RESULTS: Fifty-one studies (N = 208,842) across 23 LMICs were included in a qualitative synthesis. Measures used in studies on LMIC samples were comparable to those used in high-income countries (HICs). The prevalence of emotional problems among children and adolescents in LMICs appears to be higher than in HICs. The synthesis showed an estimated prevalence ranging from 1% to 58% for depression, 1% to 30% for anxiety, and 1% to 41% for overall emotional problems (i.e., both anxiety and depression). The review indicates that types of anxiety problems with the highest prevalence estimates related to symptoms of generalized anxiety (18.2%), separation anxiety (14.0%), posttraumatic stress (32.0%), specific phobia (20.9%), and social phobia/social anxiety (20.2%). CONCLUSIONS: There are a number of potential risk factors for child and adolescent populations living in LMICs, which could explain the elevated prevalence: an increased vulnerability related to being left-behind by one or both migrant parents, orphaned status due to high rates of mortality from poor health conditions, experiences of war conflict and violence, childhood maltreatment, and poverty. These findings highlight the urgent need for scalable, culturally sensitive mental health screening, prevention, and intervention programs tailored to LMIC contexts. They also have important implications for global child and adolescent mental health policy, funding priorities, and capacity-building efforts.

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