ReviewChild and adolescent psychiatry and mental health2023
Anxiety increased among children and adolescents during pandemic-related school closures in Europe: a systematic review and meta-analysis.
Review in Child and adolescent psychiatry and mental health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Effects of exercise therapy on anxiety and depression in patients with COVID-19: a systematic review and meta-analysis.Frontiers in public health · 2024Pooled it
- How the COVID-19 pandemic and related school closures reduce physical activity among children and adolescents in the WHO European Region: a systematic review and meta-analysis.The international journal of behavioral nutrition and physical activity · 2023Pooled it
- Mental health and quality of life in children and adolescents during the COVID-19 pandemic: a systematic review of longitudinal studies.Frontiers in public health · 2023Pooled it
- Prevalence and Sociodemographic Correlates of Mental Health Symptoms Among Canadian Youth: A Cross-Sectional Study.Clinical child psychology and psychiatry · 2026Article
- Article
- Trends in Mental Health Diagnoses Among Children and Adolescents Before and During the COVID-19 Pandemic in a Large German State.Children (Basel, Switzerland) · 2026Article
- Elevated depression and anxiety symptoms among younger adults in Germany during the post-pandemic period.BMC public health · 2026Article
- Parallel Increase in Childhood Anorexia Nervosa and Early Puberty During the COVID-19 Pandemic.The International journal of eating disorders · 2026Article
- Trends in physical fitness among children and adolescents in Europe: A systematic review and meta-analyses during and after the COVID-19 pandemic.Journal of sport and health science · 2025Review
- The impact of the SARS-CoV2 pandemic on the mental health of scoliosis patients in Germany.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Mental health changes during and after the COVID-19 pandemic in children and adolescents with mental disorders.European child & adolescent psychiatry · 2025Article
- Child and adolescent mental health during the Covid-19 pandemic: an overview of key findings from a thematic series.Child and adolescent psychiatry and mental health · 2025Review
- Article
- Investigating the Magnitude and Persistence of COVID-19-Related Impacts on Affect and GPS-Derived Daily Mobility Patterns in Adolescence and Emerging Adulthood: Insights From a Smartphone-Based Intensive Longitudinal Study of Colorado-Based Youths From June 2016 to April 2022.Journal of medical Internet research · 2025Article
- Integrating European contexts and needs into WHO guiding principles on online mental health content for young people: five recommendations.European child & adolescent psychiatry · 2025Article
- When normality collapses from one moment to the next. A sociological theory of singular crisis.Frontiers in sociology · 2025Review
- Professional mental health aid for children, adolescents, and young adults during COVID-19 in Flanders, Belgium.Frontiers in public health · 2025Article
- Pediatric healthcare service utilization after the end of COVID-19 state of emergency in Northern Italy: a 6-year quasi-experimental study using interrupted time-series analysis.Frontiers in public health · 2025Article
- Trends in changes of family functioning during different phases of the pandemic - findings across four population-based surveys between 2020 to 2023 in Germany.BMC public health · 2024Article
- A never-ending story: The COVID-19 pandemic and the increase of hospital admissions for typical and atypical anorexia nervosa in children, adolescents and young adults in the post-pandemic era in Germany.European psychiatry : the journal of the Association of European Psychiatrists · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConsidering the heterogenous evidence, a systematic review of the change in anxiety in European children and adolescents associated with the COVID-19 pandemic is lacking. We therefore assessed the change compared with pre-pandemic baselines stratified by gender and age as well as evaluated the impact of country-specific restriction policies.
methodsA registration on the 'International Prospective Register of Systematic Reviews' (PROSPERO) occurred and an a priori protocol was published. We searched six databases (PubMed, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, WHO COVID-19) using a peer-reviewed search string with citation tracking and grey literature screening. Primary outcomes were: (1) general anxiety symptoms; and (2) clinically relevant anxiety rates. We used the Oxford COVID-19 Stringency Index as an indicator of pandemic-related restrictions. Screening of title/abstract and full text as well as assessing risk of bias (using the 'Risk of Bias in Non-randomized Studies of Exposure' [ROBINS-E]) and certainty of evidence (using the 'Grading of Recommendations Assessment, Development and Evaluation' [GRADE]) was done in duplicate. We pooled data using a random effects model. Reporting is in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement.
resultsOf 7,422 non-duplicate records, 18 studies with data from 752,532 pre-pandemic and 763,582 pandemic participants met full inclusion criteria. For general anxiety symptoms the total change effect estimate yielded a standardised mean difference (SMD) of 0.34 (95% confidence interval [CI], 0.17-0.51) and for clinically relevant anxiety rates we observed an odds ratio of 1.08 (95%-CI, 0.98-1.19). Increase in general anxiety symptoms was highest in the 11-15 years age group. Effect estimates were higher when pandemic-related restrictions were more stringent (Oxford Stringency Index > 60: SMD, 0.52 [95%-CI, 0.30-0.73]) and when school closures (School Closure Index ≥ 2: SMD, 0.44 [95%-CI, 0.23-0.65]) occurred.
conclusionGeneral anxiety symptoms among children and adolescents in Europe increased in a pre/during comparison of the COVID-19 pandemic; particularly for males aged 11-15 years. In periods of stringent pandemic-related restrictions and/or school closures a considerable increase in general anxiety symptoms could be documented. PROSPERO registration: CRD42022303714.
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