College of Business, Oregon State University, Corvallis, Oregon, USA.
Adelaide Business School, University of Adelaide, Adelaide, Australia.
J Glob Health. 2022 May 23;12:05011. doi: 10.7189/jogh.12.05011.
BACKGROUND: This systematic review aims to 1) summarize the prevalence of anxiety, depression, distress, insomnia, and PTSD in the adult population during the first year of the COVID pandemic in developing countries and 2) uncover and highlight the uneven distribution of research on mental health in all developing countries across regions. METHODS: Several literature databases were systemically searched for meta-analyses published by September 22, 2021, on the prevalence rates of mental health symptoms in developing countries worldwide. We meta-analysed the raw data of the individual empirical results from the previous meta-analysis papers in developing countries in different regions. RESULTS: The prevalence rates of mental health symptoms were summarized based on 341 empirical studies with a total of 1 704 072 participants from 40 out of 167 developing countries in Africa, Asia (East, Southeast, South, and West), Europe, and Latin America. Comparatively, Africa (39%) and West Asia (35%) had the worse overall mental health symptoms, followed by Latin America (32%). The prevalence rates of overall mental health symptoms of medical students (38%), general adult students (30%), and frontline health care workers (HCWs) (27%) were higher than those of general HCWs (25%) and general populations (23%). Among five mental health symptoms, distress (29%) and depression (27%) were the most prevalent. Interestingly, people in the least developing countries suffered less than those in emergent and other developing countries. The various instruments employed lead to result heterogeneity, demonstrating the importance of using the well-established instruments with the standard cut-off points (eg, GAD-7, GAD-2, and DASS-21 for anxiety, PHQ-9 and DASS-21 for depression, and ISI for insomnia). CONCLUSIONS: The research effort on mental health in developing countries during COVID-19 has been highly uneven in the scope of countries and mental health outcomes. This meta-analysis, the largest on this topic to date, shows that the mental health symptoms are highly prevalent yet differ across regions. The accumulated systematic evidence from this study can help enable the prioritization of mental health assistance efforts to allocate attention and resources across countries and regions.
背景：本系统评价旨在：1）总结在发展中国家 COVID-19 大流行的第一年中，成年人中焦虑、抑郁、痛苦、失眠和创伤后应激障碍的流行率；2）揭示并强调整个发展中国家的心理健康研究在各区域的分布不均。
方法：系统检索了截至 2021 年 9 月 22 日发表的关于全球发展中国家心理健康症状流行率的荟萃分析文献数据库。我们对来自非洲、亚洲（东亚、东南亚、南亚和西亚）、欧洲和拉丁美洲 40 个国家的 341 项实证研究的原始数据进行了荟萃分析。
结果：基于来自非洲、亚洲（东亚、东南亚、南亚和西亚）、欧洲和拉丁美洲 40 个国家的 341 项实证研究，共涉及 167 个发展中国家的 1704072 名参与者的汇总数据，总结了心理健康症状的流行率。比较而言，非洲（39%）和西亚（35%）的整体心理健康症状更为严重，其次是拉丁美洲（32%）。医学生（38%）、普通成年学生（30%）和一线卫生保健工作者（HCWs）（27%）的整体心理健康症状的流行率高于普通 HCWs（25%）和普通人群（23%）。在五种心理健康症状中，痛苦（29%）和抑郁（27%）最为常见。有趣的是，最不发达国家的人比新兴国家和其他发展中国家的人遭受的痛苦更少。所使用的各种工具导致结果存在异质性，这表明使用建立良好的工具并采用标准截断值（例如，广泛性焦虑障碍 7 项量表[GAD-7]、GAD-2 量表和抑郁症状快速筛查量表[DASS-21]用于焦虑，患者健康问卷 9 项量表[PHQ-9]和 DASS-21 用于抑郁，以及失眠严重程度指数量表[ISI]用于失眠）的重要性。
结论：在 COVID-19 期间，发展中国家对心理健康的研究在范围和心理健康结果方面存在很大的不均衡性。这项迄今为止最大规模的荟萃分析表明，心理健康症状高度流行，但在不同地区有所不同。本研究积累的系统证据可以帮助确定心理健康援助工作的优先顺序，以便在国家和地区之间分配注意力和资源。
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