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Table 2 Summary of findings

From: Increase of depression among children and adolescents after the onset of the COVID-19 pandemic in Europe: a systematic review and meta-analysis

Outcome

Number of studies

Standardized mean difference, 95% CI

Odds Ratio, 95% CI

Summary of findings

Certainty of evidence

(GRADE)

General depression symptoms

17 studies

[21, 27, 29,30,31,32, 35,36,37, 39,40,41,42,43,44,45, 47]

Low-risk-of-bias studies:

0.21, 0.12 to 0.30

All studies:

0.16, 0.07 to 0.25

Low-risk-of-bias studies:

1.46, 1.24 to 1.72 (converteda)

All studies:

1.34, 1.14 to 1.57

(converteda)

Low risk of bias studies predicted an increase of general depression symptoms in the total population, female and male children and adolescents with a dose response-relationship

      

Moderateb,c,d

Clinically relevant depressive rates

5 studies

[29, 30, 38, 41, 46]

 

Low-risk-of-bias studies:

1.36, 1.05 to 1.76

All studies:

1.19, 0.93 to 1.53

Low risk of bias studies predicted an increase of clinically relevant depressive symptoms in the total population and female children and adolescents; however, with partly moderate confidence intervals

      

Lowc,e

  1. aConversion in odds ratio with 95% confidence interval according to the Hasselblad and Hedges’ method [10]
  2. bDowngraded − 1 for risk of bias due to some concerns about bias due to confounding (e.g. no appropriate controlling for important confounding domains) and bias due to missing data (e.g. no sufficient documented handling of missing data)
  3. cDowngraded − 1 for inconsistency due to a significant chi2 test and a substantial high I2 test (> 50%), further analysis via subgroup analysis, sensitivity analysis and meta-regression analysis were conducted
  4. dUpgraded + 1 because the dose–response relation shows significant higher effect estimates when the Stringency Index was > 60 or the School Closure Index ≥ 2
  5. eDowngraded − 1 for indirectness due to moderate confidence intervals and overlap of the line of no effect of the 95% confidence interval in total effect estimate, although a large sample size