Table 3.
Summary estimates for adolescent mental health interventions
| Interventions (number of reviews) | Comparison | Outcomes and estimates |
|---|---|---|
| School-based interventions (n = 12) | School-based CBT | Symptoms of depression: effect size range: .21 to 1.40 |
| CBT in secondary schools | Depression (SMD: −.16; 95% CI: −.26 to −.05) | |
| Anxiety (SMD: −.33; 95% CI: −.59 to −.06) | ||
| Classroom instructions | Knowledge of suicide (SMD: 1.51; 95% CI: .57 to 2.45) | |
| Knowledge of suicide prevention (SMD: .72; 95% CI: .36 to 1.07) | ||
| Community-based interventions (n = 6) | Person-centered programs | Social acceptance at 3-month follow-up (SMD: −.03; 95% CI: −.10 to .04) |
| Affective education (SMD: .33; 95% CI: .18 to .48) | ||
| Aggregate of positive mental health outcome (SMD: .03; 95% CI: −.19 to .25) | ||
| Person plus environment interventions | Aggregate of positive mental health outcome (SMD: .27; 95% CI: .16 to .37) | |
| Environment-only interventions | Aggregate of positive mental health outcome (SMD: .38; 95% CI: .15 to .60) | |
| Digital platforms (n = 8) | Mass media | Discrimination: effect size range: SMD −.85 to −.17 |
| Prejudice: effect size range: SMD −2.94 to 2.40 | ||
| Individual-/family-based interventions (n = 12) | Media literacy and advocacy approach | Internalization or acceptance of societal ideals relating to appearance at a 3- to 6-month follow-up (SMD: −.28; 95% CI: −.51 to −.05) |
| Eating attitudes and behaviors and adolescent issues | BMI at 12- to 14-month follow-up (SMD: −.10; 95% CI: −.45 to .25) | |
| Eating Attitude Test at 6- to 12-month follow-up (SMD: .01; 95% CI: −.13 to .15) | ||
| Eating Disorder Inventory “bulimia” at 12- to 14-month follow-up (SMD: −.03; 95% CI: −.16 to .10) | ||
| Self-esteem approach | Close friendship at 3-month follow-up (SMD: −.01; 95% CI: −.09 to .06) | |
| Exercise alone | Self-esteem (SMD: .49; 95% CI: .16 to .81) | |
| Exercise as a part of a comprehensive intervention | Self-esteem (SMD: .51; 95% CI: .15 to .88) | |
| Exercise compared to control | Depression (SMD: −.62; 95% CI: −.81 to −.42) | |
| Dropouts (RR: 1.00; 95% CI: .97 to 1.04) | ||
| Exercise compared to psychological therapies | Depression (SMD: −.03; 95%CI −.32 to .26) | |
| Exercise compared to antidepressant | Depression (SMD: −.11; 95% CI: −.34 to .12) | |
| Vigorous exercise versus no intervention | Anxiety scores (SMD: −.48; 95% CI: −.97 to .01) | |
| Depression score (SMD: −.66; 95% CI: −1.25 to −.08) | ||
| Vigorous exercise to low intensity exercise | Anxiety scores (SMD: −.14; 95% CI: −.41 to .13) | |
| Depression scores (SMD: −.15; 95% CI: −.44 to .14) | ||
| Exercise with psychosocial interventions | Anxiety scores (SMD: −.13; 95% CI: −.43 to .17) | |
| Depression scores (SMD: .10; 95% CI: −.21 to .41) | ||
| Waitlist versus CBT for anxiety | Anxiety remission (OR: 7.85; 95% CI: 5.31 to 11.6) | |
| Participants lost to follow-up: (OR: .93; 95% CI: .58 to 1.51) | ||
| Psychological therapy versus antidepressant medications for depression | Remission (OR: .62; 95% CI: .28 to 1.35) | |
| Dropouts (OR: .61; 95% CI: .11 to 3.28) | ||
| Suicidal ideation (SMD: −3.12; 95% CI: −5.91 to −.33) | ||
| Depression symptoms (SMD: .16; 95% CI: −.69 to 1.01) | ||
| Combination therapy versus antidepressant medication for depression | Remission (OR: 1.50; 95% CI: .99 to 2.27) | |
| Dropouts (OR: .84; 95% CI: .51 to 1.39) | ||
| Suicidal ideation (OR: .75; 95% CI: .26 to 2.16) | ||
| Depression symptoms (SMD: −.27; 95% CI: −4.95 to 4.41) | ||
| Functioning (SMD: .09; 95% CI: −.11 to .28) | ||
| Combination therapy versus psychological therapy | Remission (OR: 1.61; 95% CI: .38 to 6.90) | |
| Dropouts (OR: 1.23; 95% CI: .12 to 12.71) | ||
| Suicidal ideation (SMD: .60; 95% CI: −2.25 to 3.45) | ||
| Depression symptoms (SMD: −.28; 95% CI: −1.41 to .84) | ||
| Combination therapy versus psychological therapy plus placebo | Dropouts (OR: .98; 95% CI: .42 to 2.28) | |
| Remission (OR: 2.15; 95% CI: 1.15 to 4.02) | ||
| Depression symptoms (SMD: −.52; 95% CI: −.78 to −.26) | ||
| Antidepressants compared to placebo to relapse and recurrence | Number of relapsed recurred (OR: .34; 95% CI: .18 to .64) | |
| Suicide-related behaviors (OR: 1.02; 95% CI: .14 to 7.39) | ||
| Dropouts (OR: 1.02; 95% CI: .38 to 2.79) | ||
| Behavioral therapy compared to all other psychological therapies | Response (RR: .97; 95% CI: .86 to 1.09) | |
| Remission (RR: .91; 95% CI: .8 to 1.04) | ||
| Response at follow-up (RR: .77; 95% CI: .59 to 1.01) | ||
| Depression severity (SMD: −.03; 95% CI: −.2 to .15) | ||
| Dropouts (RR: 1.02; 95% CI: .65 to 1.61) | ||
| Evidence-based youth-focused psychotherapy versus usual clinical care | Effect size (SMD: .31; 95% CI: .16 to .44) | |
| Evidence-based parent-/family-focused psychotherapy versus usual clinical care | Effect size (SMD: .16; 95% CI: −.01 to .33) | |
| Multisystem approaches | Effect size (SMD: .35; 95% CI: .19 to .52) | |
| Combinations | Effect size (SMD: .29; 95% CI: .06 to .52) |
Bold indicates significant impact. Italics indicate nonsignificant impact.
BMI = body mass index; CBT, cognitive behavioral therapy; CI = confidence interval; OR = odds ratio; RR = relative risk; SMD = standard mean difference.