BACKGROUND: Targeted interventions are needed to prevent depression in at-risk children and adolescents. Children and adolescents are commonly at risk of depression due to subsyndromal depressive symptoms or problems in their social environment.
METHODS: This review was conducted according to the Cochrane guidelines (2023) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was done in December 2023 using three electronic databases and a manual search. The methodological quality of all eligible studies was assessed using the Cochrane Collaboration's tool for assessing the risk of bias.
RESULTS: This review includes 77 intervention studies of which 13 are follow-ups. Of the 64 identified main studies (n = 11,808), 19 were selective interventions targeting the problems in a social environment. Of the participants 63.6 % were girls and the mean age ranged between 9 and 17. Most of the studies were conducted in a Western school setting using psychological interventions, with the majority being CBT (cognitive behavioral therapy) based programs. Targeted interventions reduced the symptoms of depression statistically significantly at postintervention (SMD 0.27, 95 % confidence interval 0.16-0.37) and 6-month follow-up (SMD 0.32, 0.18-0.45) compared to any comparator. Intervention effects were not statistically significant at the 12-month follow-up.
CONCLUSION: Indicated and selective interventions targeted to children and adolescents at risk of depression due to their social environment have a small effect on depressive symptoms. Interventions should be delivered by mental health experts.
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