Prevalence and Correlates of Depressive Symptoms in Canada During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis Based on 144 Studies Including 406,043 Participants: Prévalence et corrélats des symptômes dépressifs au Canada pendant la pandémie de COVID-19 : revue systématique et méta-analyse de 144 études comprenant 406 043 participants.

BackgroundThe COVID-19 pandemic and associated public health measures, including lockdowns, school closures, quarantine, and social restrictions, substantially disrupted social and economic life in Canada. These conditions intensified risk factors for depressive symptoms. However, reported prevalence estimates vary widely across studies, highlighting the need for comprehensive syntheses of evidence specific to the Canadian context. The present study aimed to estimate the pooled prevalence of depressive symptoms and examine key demographic, geographic, and methodological sources of variability.MethodsA systematic review and meta-analysis were conducted following a PROSPERO-registered protocol (CRD42024552536). Five databases were searched for studies published since 2020 assessing depressive symptoms in Canada during COVID-19. Methodological quality was evaluated using Joanna Briggs Institute (JBI) appraisal checklists. Random-effects meta-analyses estimated pooled prevalence, with subgroup analyses and meta-regressions.ResultsA total of 144 studies including 406,043 participants were analysed. The pooled prevalence of depressive symptoms in Canada during the COVID-19 pandemic was 31.1% (95% confidence interval [CI], 28.4%-33.9%), with substantial heterogeneity (I2 = 99.71). Prevalence was higher among women (29.2% [95% CI, 25.8%-32.7%]) than men (21.1% [95% CI, 18.5%-23.8%]) (p = .0003) and varied significantly across provinces (p = .0001), measurement tools (p < .0001), evaluation periods (p = .017), and study designs (p = .041). No significant publication bias was detected (Egger's test: z = 1.05, p = .295).ConclusionsThese findings underscore the critical need for a comprehensive and coordinated national mental health strategy in Canada. Such a strategy should expand the mental health workforce, implement large-scale promotion and early intervention program across schools, workplaces, and community settings, and provide gender-responsive support. Future research should focus on standardizing depressive assessment measurements and prioritizing studies and interventions targeting healthcare workers, as well as racialized and Indigenous populations, to promote equitable access, strengthen resilience, and enhance preparedness for future public health crises.