Indikterte forebyggingstiltak mot angst hos barn og unge: Systematisk oversikt og metaanalyse

Indicated prevention interventions for anxiety in children and adolescents: a review and meta-analysis of school-based programs

Hugh-Jones, S. Beckett, S. Tumelty, E. Mallikarjun, P.
European Child & Adolescent Psychiatry
Anxiety disorders are among the most common youth mental health disorders. Early intervention can reduce elevated anxiety symptoms. School-based interventions exist but it is unclear how effective targeted approaches are for reducing symptoms of anxiety. This review and meta-analysis aimed to determine the effectiveness of school-based indicated interventions for symptomatic children and adolescents. The study was registered with PROSPERO [CRD42018087628]. We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Library for randomised-controlled trials comparing indicated programs for child and adolescent (5-18 years) anxiety to active or inactive control groups. Data were extracted from papers up to December 2019. The primary outcome was efficacy (mean change in anxiety symptom scores). Sub-group and sensitivity analyses explored intervention intensity and control type. We identified 20 studies with 2076 participants. Eighteen studies were suitable for meta-analysis. A small positive effect was found for indicated programs compared to controls on self-reported anxiety symptoms at post-test (g = - 0.28, CI = - 0.50, - 0.05, k = 18). This benefit was maintained at 6 (g = - 0.35, CI = - 0.58, - 0.13, k = 9) and 12 months (g = - 0.24, CI = - 0.48, 0.00, k = 4). Based on two studies, > 12 month effects were very small (g = - 0.01, CI = - 0.38, 0.36). No differences were found based on intervention intensity or control type. Risk of bias and variability between studies was high (I<sup>2</sup> = 78%). Findings show that school-based indicated programs for child and adolescent anxiety can produce small beneficial effects, enduring for up to 12 months. Future studies should include long-term diagnostic assessments.

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Type of intervention

Early Intervention

Treatment and Child Welfare Interventions


Mental Health Problems and Disorders

Anxiety Problems

Anxiety and Anxiousness


The organization of interventions

School/Preschoolbased Interventions

Age group

School Aged Children (6-12 years)

Adolescents (13-18 years)

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