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      Mental health effects prevalence in children and adolescents during the COVID‐19 pandemic: A systematic review


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          The COVID‐19 pandemic health crisis has changed household and school routines leaving children and adolescents without important anchors in life. This, in turn, can influence their mental health, changing their behavioral and psychological conditions.


          To systematically review the literature to answer the question: “What is the worldwide prevalence of mental health effects in children and adolescents during the COVID‐19 pandemic?”.


          Embase, Epistemonikos database, LILACS, PsycINFO, PubMed, Scopus, Web of Science, and World Health Organization Global literature on coronavirus disease were searched. Grey literature was searched on Google Scholar, Grey Literature Report, and Preprint server MedRxiv. Observational studies assessing the prevalence of mental health effects in children and adolescents during the COVID‐19 pandemic were included. Four authors independently collected the information and assessed the risk of bias of the included studies.


          From a total of 11,925 identified studies, 2873 remained after the removal of the duplicated records. Nineteen studies remained after the final selection process. The proportion of emotional symptoms and behavior changes varied from 5.7% to 68.5%; anxiety 17.6% to 43.7%, depression 6.3% to 71.5%, and stress 7% to 25%. Other outcomes such as the prevalence of post‐traumatic stress disorder (85.5%) and suicidal ideation (29.7% to 31.3%) were also evaluated.

          Linking Evidence to Action

          Overall findings showed that the proportion of children and adolescents presenting mental health effects during the COVID‐19 pandemic showed a wide variation in different countries. However, there was a trend toward mental health issues. Therefore, policymakers, healthcare planners, youth mental health services, teachers, parents, and researchers need to be prepared to deal with this demand.

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          Most cited references38

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          Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19

          Objective Disease containment of COVID-19 has necessitated widespread social isolation. We aimed to establish what is known about how loneliness and disease containment measures impact on the mental health in children and adolescents. Method For this rapid review, we searched MEDLINE, PSYCHINFO, and Web of Science for articles published between 01/01/1946 and 03/29/2020. 20% of articles were double screened using pre-defined criteria and 20% of data was double extracted for quality assurance. Results 83 articles (80 studies) met inclusion criteria. Of these, 63 studies reported on the impact of social isolation and loneliness on the mental health of previously healthy children and adolescents (n=51,576; mean age 15.3) 61 studies were observational; 18 were longitudinal and 43 cross sectional studies assessing self-reported loneliness in healthy children and adolescents. One of these studies was a retrospective investigation after a pandemic. Two studies evaluated interventions. Studies had a high risk of bias although longitudinal studies were of better methodological quality. Social isolation and loneliness increased the risk of depression, and possibly anxiety at the time loneliness was measured and between 0.25 to 9 years later. Duration of loneliness was more strongly correlated with mental health symptoms than intensity of loneliness. Conclusion Children and adolescents are probably more likely to experience high rates of depression and probably anxiety during and after enforced isolation ends. This may increase as enforced isolation continues. Clinical services should offer preventative support and early intervention where possible and be prepared for an increase in mental health problems.
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            Is Open Access

            Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline

            In systematic reviews that lack data amenable to meta-analysis, alternative synthesis methods are commonly used, but these methods are rarely reported. This lack of transparency in the methods can cast doubt on the validity of the review findings. The Synthesis Without Meta-analysis (SWiM) guideline has been developed to guide clear reporting in reviews of interventions in which alternative synthesis methods to meta-analysis of effect estimates are used. This article describes the development of the SWiM guideline for the synthesis of quantitative data of intervention effects and presents the nine SWiM reporting items with accompanying explanations and examples.
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              Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19

              Psychological health problems, especially emotional disorders, are common among adolescents. The epidemiology of emotional disorders is greatly influenced by stressful events. This study sought to assess the prevalence rate and socio-demographic correlates of depressive and anxiety symptoms among Chinese adolescents affected by the outbreak of COVID-19. We conducted a cross-sectional study among Chinese students aged 12–18 years during the COVID-19 epidemic period. An online survey was used to conduct rapid assessment. A total of 8079 participants were involved in the study. An online survey was used to collect demographic data, assess students’ awareness of COVID-19, and assess depressive and anxiety symptoms with the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) questionnaire, respectively. The prevalence of depressive symptoms, anxiety symptoms, and a combination of depressive and anxiety symptoms was 43.7%, 37.4%, and 31.3%, respectively, among Chinese high school students during the COVID-19 outbreak. Multivariable logistic regression analysis revealed that female gender was the higher risk factor for depressive and anxiety symptoms. In terms of grades, senior high school was a risk factor for depressive and anxiety symptoms; the higher the grade, the greater the prevalence of depressive and anxiety symptoms. Our findings show there is a high prevalence of psychological health problems among adolescents, which are negatively associated with the level of awareness of COVID-19. These findings suggest that the government needs to pay more attention to psychological health among adolescents while combating COVID-19. Electronic supplementary material The online version of this article (10.1007/s00787-020-01541-4) contains supplementary material, which is available to authorized users.

                Author and article information

                Worldviews Evid Based Nurs
                Worldviews Evid Based Nurs
                Worldviews on Evidence-Based Nursing
                John Wiley and Sons Inc. (Hoboken )
                01 March 2022
                April 2022
                01 March 2022
                : 19
                : 2 ( doiID: 10.1111/wvn.v19.2 )
                : 130-137
                [ 1 ] Brazilian Centre for Evidence‐Based Research (COBE) Florianópolis Brazil
                [ 2 ] Department of Dentistry Federal University of Santa Catarina (UFSC) Florianópolis Brazil
                [ 3 ] Division of Pediatric Dentistry Faculdade São Leopoldo Mandic São Paulo Brazil
                [ 4 ] University Library Federal University of Santa Catarina (UFSC) Florianópolis Brazil
                [ 5 ] Department of Dentistry Health Sciences Faculty University of Brasília (UnB) Brasília Brazil
                [ 6 ] ringgold 3158; Department of Anesthesiology and Pain Medicine University of Alberta Edmonton Alberta Canada
                Author notes
                [*] [* ] Correspondence

                Carla Massignan, Department of Dentistry, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasília‐DF, CEP 70910‐900, Brazil.

                Email: carla.massignan@ 123456unb.br

                © 2022 Sigma Theta Tau International

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                Page count
                Figures: 1, Tables: 1, Pages: 8, Words: 6131
                Funded by: Universidade de Brasília , doi 10.13039/100008994;
                Award ID: EDITAL COPEI‐DPI/DEX n.01/2020
                Evidence Review
                Evidence Review
                Custom metadata
                April 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.6 mode:remove_FC converted:18.05.2022

                adolescents,children,covid‐19,mental health,prevalence,systematic review
                adolescents, children, covid‐19, mental health, prevalence, systematic review


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