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中国儿童和青少年抑郁症状的患病率:一项系统评价和荟萃分析。

Prevalence of depressive symptoms among children and adolescents in china: a systematic review and meta-analysis.

作者信息

Zhou Jia, Liu Yiang, Ma Jingyao, Feng Zizhao, Hu Jie, Hu Jia, Dong Bin

机构信息

The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.

Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China.

出版信息

Child Adolesc Psychiatry Ment Health. 2024 Nov 19;18(1):150. doi: 10.1186/s13034-024-00841-w.

Abstract

BACKGROUND

Depression is a significant health concern among children and adolescents. Previous epidemiological studies on depressive symptoms in this population have yielded inconsistent findings. This study aims to systematically estimate the prevalence of depressive symptoms among Chinese children and adolescents.

METHOD

A comprehensive literature search was conducted in both English (PubMed, EMBASE) and Chinese (China National Knowledge Infrastructure, WANFANG) databases from their inception until October 15, 2024. This meta-analysis employed a random-effects model to estimate the pooled prevalence of depressive symptoms.

RESULTS

A total of 439 eligible studies, comprising 1,497,524 participants, were included in the analysis. The pooled point prevalence of depressive symptoms among children and adolescents was found to be 26.17% (95% CI 25.00-27.41%), with significant heterogeneity among studies (I = 100%, p < 0.001). The most commonly used scales were the SDS and CES-D; the SDS reported a higher prevalence (28.80%, 95% CI 26.88-30.85%) compared to the CES-D (24.50%, 95% CI 22.49-26.68%). There was no clear temporal trend in the prevalence of depressive symptoms over time (r = 0.03, P = 0.74). The highest pooled prevalence was observed in high school students (28.23%, 95% CI 25.58-31.15%), followed by undergraduate students (27.72%, 95% CI 25.79-29.79%) and middle school students (24.15%, 95% CI 21.61-27.00%). Among the provinces, Inner Mongolia exhibited the lowest prevalence (18.43%, 95% CI 11.98-28.36%), while Qinghai and Tibet had the highest rates at 54.19% and 47.50%, respectively, although only two and one study were included for these regions.

CONCLUSIONS

The detection rate of depressive symptoms in this study aligns closely with global rates for children and adolescents. High school students exhibit a higher prevalence of depressive symptoms compared to other age groups, highlighting the need for effective interventions targeted at this population. There was no clear temporal trend in the prevalence of depressive symptoms. Additionally, the choice of measurement tool is a critical aspect of epidemiological research; standardizing these measurements is essential for enhancing data comparability across studies. Trial Registration International Prospective Register of Systematic Reviews: No. CRD42023455604.

摘要

背景

抑郁症是儿童和青少年中一个重要的健康问题。此前关于该人群抑郁症状的流行病学研究结果并不一致。本研究旨在系统评估中国儿童和青少年抑郁症状的患病率。

方法

从数据库创建至2024年10月15日,在英文数据库(PubMed、EMBASE)和中文数据库(中国知网、万方)中进行了全面的文献检索。本荟萃分析采用随机效应模型来估计抑郁症状的合并患病率。

结果

共纳入439项符合条件的研究,涉及1,497,524名参与者。儿童和青少年抑郁症状的合并点患病率为26.17%(95%置信区间25.00 - 27.41%),各研究间存在显著异质性(I = 100%,p < 0.001)。最常用的量表是SDS和CES - D;SDS报告的患病率(28.80%,95%置信区间26.88 - 30.85%)高于CES - D(24.50%,95%置信区间22.49 - 26.68%)。抑郁症状患病率随时间没有明显的时间趋势(r = 0.03,P = 0.74)。合并患病率最高的是高中生(28.23%,95%置信区间25.58 - 31.15%),其次是大学生(27.72%,95%置信区间2`5.79 - 29.79%)和初中生(24.15%,95%置信区间21.61 - 27.00%)。在各省中,内蒙古的患病率最低(18.43%,95%置信区间11.98 - 28.36%),而青海和西藏的患病率最高,分别为54.19%和47.50%,不过这两个地区分别仅纳入了两项和一项研究。

结论

本研究中抑郁症状的检出率与全球儿童和青少年的检出率相近。高中生的抑郁症状患病率高于其他年龄组,这凸显了针对该人群进行有效干预的必要性。抑郁症状患病率没有明显的时间趋势。此外,测量工具的选择是流行病学研究的一个关键方面;规范这些测量对于提高各研究数据的可比性至关重要。试验注册国际前瞻性系统评价注册库:编号CRD42023455604。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67ad/11577650/5b0d48e37027/13034_2024_841_Fig1_HTML.jpg

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