Trajectories of Chinese adolescent depression before and after COVID-19: A cross-temporal meta-analysis with segmented regression.

Background: The COVID-19 pandemic has had a profound impact on adolescent mental health, particularly in China. However, there is a lack of research examining the trends in depressive symptom levels among Chinese adolescents before and after the pandemic. This study aims to investigate the changes in depressive symptom levels among Chinese adolescents pre- and post-pandemic and to identify the factors influencing these changes.

Methods: English-language databases (Web of Science, PubMed, Scopus, ProQuest, and Wiley) and Chinese-language databases (CNKI, VIP, and Wanfang) were searched for relevant studies. A total of 90 articles (91 studies) were included in the cross-temporal meta-analysis (N = 473,781), all of which used the Patient Health Questionnaire-9 (PHQ-9) to measure depressive symptoms in Chinese adolescents. The data for these studies were collected over the period from 2010 to 2023.

Results: Findings indicated that: (1) From 2010 to 2020, year was not a significant predictor of adolescent depressive symptom levels, whereas from 2021 to 2023, year became a significant positive predictor. (2) From 2010 to 2020, females exhibited a more pronounced decrease in depressive symptom levels compared to males; however, from 2021 to 2023, gender differences were not significant. (3) From 2010 to 2020, previous social connectedness, including family size three years prior, divorce rate one year prior, and urbanization level three years prior, significantly and negatively predicted the current year's adolescent depressive symptom levels; however, from 2021 to 2023, the predictive effect of all social indicators was not significant.

Conclusions: This study enhances the understanding of the mechanisms underlying depression among Chinese adolescents and provides a foundation for decision-making in prevention and intervention strategies.