Summary of findings for the main comparison. Evidence‐based psychological interventions versus any comparator for depression diagnosis at the medium‐term follow‐up.
| Evidence‐based psychological interventions compared to any comparator for depression diagnosis at the medium‐term follow‐up | |||||
| Patient or population: children and adolescents Settings: various Intervention: evidence‐based psychological interventions (targeted and universal) Comparison: any | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | ||||
| Any comparator | Evidence‐based psychological interventions | ||||
|
Evidence‐based psychological interventions versus any comparator (Overall) ‐ effect on diagnosis of depression The assumed risk is based on control group rates of depression diagnosis at medium‐term follow‐up (from a rank ordering of control group rates of each included study). |
Study population |
RR 0.84 (0.72 to 0.97) |
⊕⊕⊕⊝ Moderate1 | — | |
| 193 per 1000 |
162 per 1000 (139 to 187) |
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| Low (0%) | |||||
|
0 per 1000 (0 to 0) |
|||||
| Moderate (18.5%) | |||||
| 185 per 1000 |
155 per 1000 (133 to 180) |
||||
| High (70.7%) | |||||
| 707 per 1000 |
594 per 1000 (509 to 685) |
||||
|
Evidence‐based psychological interventions versus any comparator (Targeted programmes) ‐ effect on diagnosis of depression The assumed risk is based on control group rates of depression diagnosis at medium‐term follow‐up (from a rank ordering of control group rates of each included study). |
Study population | RR 0.82 (0.68 to 0.99) | ⊕⊝⊝⊝ Very low1,2,3 | — | |
| 243 per 1000 | 199 per 1000 (165 to 240) | ||||
| Low (0%) | |||||
|
0 per 1000 (0 to 0) |
|||||
| Moderate (20.4%) | |||||
| 204 per 1000 |
167 per 1000 (139 to 202) |
||||
| High (76.7%) | |||||
| 767 per 1000 |
629 per 1000 (521 to 759) |
||||
|
Evidence‐based psychological interventions versus any comparator (Universal programmes) ‐ effect on diagnosis of depression The assumed risk is based on control group rates of depression diagnosis at medium‐term follow‐up (from a rank ordering of control group rates of each included study). |
Study population | RR 0.87 (0.66 to 1.14) | ⊕⊕⊕⊝ Moderate4 | — | |
| 99 per 1000 | 86 per 1000 (65 to 113) | ||||
| Low (1.0%) | |||||
| 10 per 1000 |
9 per 1000 (7 to 12) |
||||
| Moderate (14.5%) | |||||
| 144 per 1000 |
125 per 1000 (95 to 164) |
||||
| High (30.8%) | |||||
| 308 per 1000 |
268 per 1000 (203 to 351) |
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| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (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; RR: risk ratio | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
1We downgraded quality owing to lack of clarity over allocation concealment and presence of other bias. 2Heterogeneity (I2 = 53%). 3Omitting trials in which the outcome was measured indirectly (i.e. using cut‐points from self‐rated depression symptom inventories) caused the treatment effect for targeted depression prevention programmes to become non‐significant (RD ‐0.04, 95% CI ‐0.08 to 0.00; k = 15; n = 2783). 4We downgraded quality owing to a lack of clarity over random sequence generation and allocation concealment.