Has the prevalence of mental health problems of children and adolescents increased in recent 50 years? Systematic review and meta-analysis of repeated cross-sectional studies

Background: The treatment prevalence of mental health problems among children and adolescents has risen significantly in recent decades. It is unclear whether the increase in treatment prevalence is caused by changes in epidemiological prevalence.Method: A systematic review and meta-analysis of repeated cross-sectional studies involving children and adolescents up to the age of 18 was conducted. The review included studies from around the world that were carried out using identical study designs at least twice in the same region.Results: 58 publications were included, with data collected between 1973 and 2023. The overall odds ratio for changes in prevalence was 1.38 (95% confidence interval 1.26–1.52). This corresponds to a risk ratio of 1.32. The odds ratio for females was 1.47 (95% CI: 1.28–1.70), and the odds ratio for males was 1.25 (95% CI: 1.09–1.43). The greatest increase in prevalence was observed in the pandemic decade of 2020.Discussion: The overall result corresponds to a 3.7% increase in prevalence over the entire 50-year period. This can be interpreted as a minor increase.Conclusion: The rise in psychiatric treatment for children and adolescents is not primarily due to an increase in epidemiological prevalence.