Mental health of Canadian youth: A systematic review and meta-analysis of studies examining changes in depression, anxiety, and suicide-related outcomes during the COVID-19 pandemic

ObjectivesThis systematic review and meta-analysis aims to describe Canadian youth mental health during the COVID-19 pandemic, focusing on changes in anxiety and depressive symptoms and suicidality.MethodsWe searched four databases up to February 2023 for longitudinal or repeated cross-sectional studies reporting on changes in depressive and anxiety symptoms, suicidality, or related services utilization among young people under 25 years old residing in Canada during the COVID-19 pandemic. Random-effects meta-analyses were performed for studies comparing depressive and anxiety symptoms from before to during the first, second, and third COVID-19 waves (up to June 2021), and between COVID-19 waves. Other studies were described narratively. Risk of bias was assessed using an adapted Joanna Briggs Institute Checklist.SynthesisOf the 7916 records screened, 35 articles met inclusion criteria for this review. Included studies were highly heterogeneous in design, population, and type of change investigated, and many had a high risk of bias. The meta-analyses found that depressive symptoms worsened minimally from pre-pandemic to wave 1 but returned to pre-pandemic levels by wave 2. Anxiety symptoms were broadly comparable from pre-pandemic to waves 1 and 2 but worsened from waves 1 to 3 and from pre-pandemic to wave 1 for girls. The narrative review included several studies that provided inconclusive evidence of increases in services utilization.ConclusionThe current evidence is limited and highly heterogeneous, making it insufficient to draw definitive conclusions regarding the short- to medium-term impact of the pandemic on youth mental health in Canada. Obtaining better mental health surveillance among Canadian youth is imperative. ObjectifsCette revue systematique et meta-analyse vise a decrire la sante mentale des jeunes Canadiens pendant la pandemie de COVID-19 en ce qui concerne les changements dans les symptomes d'anxiete et de depression et la suicidalite.MethodesNous avons cherche dans quatre bases de donnees, jusqu'en fevrier 2023, des etudes longitudinales ou transversales repetees portant sur l'evolution des symptomes depressifs et anxieux, de la suicidalite ou de l'utilisation des services en sante mentale chez les jeunes de moins de 25 ans residant au Canada pendant la pandemie de COVID-19. Des meta-analyses a effets aleatoires ont ete realisees pour les etudes comparant les symptomes depressifs et anxieux avant et pendant les premiere, deuxieme et troisieme vagues du COVID-19 (jusqu'en juin 2021), ainsi qu'entre les vagues de COVID-19. Les autres etudes ont ete decrites de maniere narrative. Le risque de biais a ete evalue a l'aide d'une liste de controle adaptee du Joanna Briggs Institute.SyntheseSur les 7 916 dossiers examines, 35 articles repondaient aux criteres d'inclusion de la presente etude. Les etudes retenues sont tres heterogenes en termes de conception, de population et de type de changement etudie, et un grand nombre d'entre elles presentent un risque eleve de biais. Les meta-analyses revelent que les symptomes depressifs se sont legerement aggraves entre la periode prepandemique et la premiere vague, mais qu'ils sont revenus aux niveaux prepandemiques lors de la deuxieme vague. Les symptomes d'anxiete sont globalement comparables entre la periode prepandemique et les vagues 1 et 2, mais se sont aggraves entre les vagues 1 et 3 et entre la periode prepandemique et la vague 1 pour les filles. La revue narrative porte sur plusieurs etudes qui ont fourni des preuves non concluantes de l'augmentation de l'utilisation des services en sante mentale.ConclusionLes donnees actuelles sont limitees et tres heterogenes, ce qui ne permet pas de tirer des conclusions definitives quant a l'impact a court et moyen terme de la pandemie sur la sante mentale des jeunes au Canada. Il est imperatif d'ameliorer la surveillance de la sante mentale des jeunes Canadiens.