Summary of findings 5. Summary of findings table ‐ Selective prevention interventions compared to control group in preventing mental disorders in children.
Selective prevention interventions compared to control group in preventing mental disorders in children | ||||||
Patient or population: preventing mental disorders Setting: low‐ and middle‐income countries (Uganda (1 study), Thailand (1 study), Democratic Republic of Congo (1 study), Brazil (1 study)) Intervention: selective prevention interventions Comparison: control group | ||||||
Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
Risk with control group | Risk with selective prevention interventions | |||||
Diagnosis of mental disorders at study endpoint | No studies that measured this outcome were identified. | (0 studies) | ‐ | |||
Quality of life at study endpoint (higher score = better quality of life) | MD 1.1 higher (3.32 lower to 1.12 higher) | ‐ | 115 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b | It is uncertain whether selective prevention interventions have any effect on quality of life among children with risk factors for mental disorders/lack of protective factors (at post‐intervention) compared with usual care. [There is a small effect according to Cohen 1992]1 | |
Adverse events at study endpoint | No studies that measured this outcome were identified. | (0 studies) | ‐ | |||
Psychological functioning and impairment at study endpoint (higher score = higher disability) | MD 0.02 higher (0.09 lower to 0.05 higher) | ‐ | 479 (1 RCT) | ⊕⊕⊝⊝ Lowc,d | There is no evidence that selective prevention interventions improve functional impairment in children with risk factors for mental disorders/lack of protective factors (at post‐intervention) compared to usual care. 1 | |
Depressive symptoms at study endpoint (higher score = higher severity) | ‐ | SMD 0 SD (0.16 lower to 0.15 higher) | ‐ | 638 (2 RCTs) | ⊕⊕⊕⊝ Moderated | Scores estimated based on an SMD of 0.0 (95% CI ‐0.16 to 0.15). Selective prevention interventions for children with risk factors for mental disorders/lack of protective factors probably slightly reduce depressive symptoms (at post‐intervention)compared to usual care. [There is a small effect according to Cohen 1992]1 |
Anxiety symptoms at study endpoint (higher score = higher severity) | MD 4.5 higher (12.05 lower to 21.05 higher) | ‐ | 28 (1 RCT) | ⊕⊕⊝⊝ Lowe | Selective prevention interventions may make little or no difference to anxiety symptoms in children with risk factors for mental disorders/lack of protective factors (at post‐intervention) compared to usual care. 1 | |
Distress/PTSD symptoms at study endpoint (higher score = higher severity) | MD 2.14 lower (3.77 lower to 0.51 lower) | ‐ | 159 (1 RCT) | ⊕⊕⊕⊝ Moderateb | Selective prevention interventions for children with risk factors for mental disorders/ lack of protective factors probably slightly reduce distress/PTSD symptoms (at post‐intervention) compared to usual care. [There is a small effect according to Cohen 1992]1 | |
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference; SMD: standardised mean difference | ||||||
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
See interactive version of this table: https://gdt.gradepro.org/presentations/#/isof/isof_question_revman_web_429913697396673091. |
a Downgraded 2 levels owing to study limitations (over 30% of RCTs had high risk of bias due to deviations from intended interventions and missing outcome data, in measurement of the outcome, and in selection of the reported result) b Downgraded 1 level owing to imprecision (outcome based on a small number of participants, less than 200) c Downgraded 1 level owing to indirectness (outcome measures as proxy of psychological functioning and impairment) d Downgraded 1 level owing to imprecision (confidence interval ranged from favouring selective prevention intervention to no clinical effect) e Downgraded 2 levels owing to imprecision (outcome based on a small number of participants, less than 200, and confidence interval ranged from favouring selective prevention intervention to no clinical effect) 1 J, Cohen. A power primer. Psychological Bulletin ; 1992.