RISING PAEDIATRIC DEPRESSION IN SOUTHERN EUROPE: TEMPORAL TRENDS AND THE ROLE OF COVID-19 - A THIN-BASED COHORT STUDY (2018-2025) IN ITALY AND SPAIN
Author(s)
Caroline Eteve-Pitsaer, MSc1, Elena Zanzottera Ferrari, MSc2, Carlos Iglesias, MD3, Samuel Brouyere, MSc4.
1RWD-E Project Director, Clinityx by Gers Data, Boulogne-Billancourt, France, 2GERS/Cegedim Health Data, Milano, Italy, 3CEGEDIM HEALTH DATA, Sant Cugat del Vallès, Spain, 4GERS/Cegedim Health Data, Anderlecht, Belgium.
1RWD-E Project Director, Clinityx by Gers Data, Boulogne-Billancourt, France, 2GERS/Cegedim Health Data, Milano, Italy, 3CEGEDIM HEALTH DATA, Sant Cugat del Vallès, Spain, 4GERS/Cegedim Health Data, Anderlecht, Belgium.
OBJECTIVES: Paediatric depression is a growing public health concern with significant long-term consequences, further amplified by the COVID-19 pandemic. This study aimed to describe the temporal evolution of depression incidence and prevalence across three developmental age groups (3-5, 6-9, and 10-16 years) in Spain (ES) and Italy (IT), and to quantify the proportion of incident cases with prior documented COVID-19 infection in Spain.
METHODS: Retrospective cohort study using THIN longitudinal primary care records (2018-2025). Depression was identified via ICD-9 codes or antidepressant initiation. Annual prevalence was calculated as prevalent cases divided by the active population (≥1 consultation/year). Incidence was estimated in patients with no prior depression diagnosis or antidepressant use and ≥12 months of back data. For 2020-2025, the proportion of incident cases with a prior COVID-19 diagnosis was assessed in Spain.
RESULTS: Over 1.1 million active paediatric patient-years were analysed in ES and nearly 1.0 million in IT. In ES, overall prevalence rose from 0.65% (2018) to 1.21% (2025), with the sharpest increase in the 10-16 age group (1.23% to 2.21%). Incidence in ES adolescents peaked in 2021 at 0.92%, coinciding with post-lockdown return to healthcare. In IT, overall prevalence increased more modestly from 0.14% to 0.17%, with adolescent prevalence peaking at 0.50% in 2023. In ES, the proportion of incident adolescent cases (10-16 years) with prior COVID-19 rose from 8.1% (2020) to 50.7% (2024), suggesting a potential contribution of SARS-CoV-2 infection to new-onset depression
CONCLUSIONS: This study confirms, consistent with the literature, a sustained rise in paediatric depression in Southern Europe, predominantly affecting adolescents aged 10-16, with an acceleration following the COVID-19 pandemic. The growing proportion of post-COVID incident cases in Spain supports the hypothesis of SARS-CoV-2 as a potential risk factor for subsequent depressive disorders in youth, reinforcing the need for targeted mental health screening in paediatric primary care.
METHODS: Retrospective cohort study using THIN longitudinal primary care records (2018-2025). Depression was identified via ICD-9 codes or antidepressant initiation. Annual prevalence was calculated as prevalent cases divided by the active population (≥1 consultation/year). Incidence was estimated in patients with no prior depression diagnosis or antidepressant use and ≥12 months of back data. For 2020-2025, the proportion of incident cases with a prior COVID-19 diagnosis was assessed in Spain.
RESULTS: Over 1.1 million active paediatric patient-years were analysed in ES and nearly 1.0 million in IT. In ES, overall prevalence rose from 0.65% (2018) to 1.21% (2025), with the sharpest increase in the 10-16 age group (1.23% to 2.21%). Incidence in ES adolescents peaked in 2021 at 0.92%, coinciding with post-lockdown return to healthcare. In IT, overall prevalence increased more modestly from 0.14% to 0.17%, with adolescent prevalence peaking at 0.50% in 2023. In ES, the proportion of incident adolescent cases (10-16 years) with prior COVID-19 rose from 8.1% (2020) to 50.7% (2024), suggesting a potential contribution of SARS-CoV-2 infection to new-onset depression
CONCLUSIONS: This study confirms, consistent with the literature, a sustained rise in paediatric depression in Southern Europe, predominantly affecting adolescents aged 10-16, with an acceleration following the COVID-19 pandemic. The growing proportion of post-COVID incident cases in Spain supports the hypothesis of SARS-CoV-2 as a potential risk factor for subsequent depressive disorders in youth, reinforcing the need for targeted mental health screening in paediatric primary care.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH174
Topic
Epidemiology & Public Health
Disease
Infectious Disease (non-vaccine), Mental Health (including addiction)