Preventing depression and anxiety in young people: a review of the joint efficacy of universal, selective and indicated prevention

Stockings, E. A., Degenhardt, L., Dobbins, T., Lee, Y. Y., Erskine, H. E., Whiteford, H. A. and Patton, G. 2016, Preventing depression and anxiety in young people: a review of the joint efficacy of universal, selective and indicated prevention, Psychological medicine, vol. 46, no. 1, pp. 11-26, doi: 10.1017/S0033291715001725.

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Title Preventing depression and anxiety in young people: a review of the joint efficacy of universal, selective and indicated prevention
Author(s) Stockings, E. A.
Degenhardt, L.
Dobbins, T.
Lee, Y. Y.
Erskine, H. E.
Whiteford, H. A.
Patton, G.
Journal name Psychological medicine
Volume number 46
Issue number 1
Start page 11
End page 26
Total pages 16
Publisher Cambridge University Press
Place of publication Cambridge, Eng.
Publication date 2016-01
ISSN 0033-2917
Keyword(s) Social Sciences
Science & Technology
Life Sciences & Biomedicine
Psychology, Clinical
child and adolescent
early intervention
Summary Depression and anxiety (internalizing disorders) are the largest contributors to the non-fatal health burden among young people. This is the first meta-analysis to examine the joint efficacy of universal, selective, and indicated preventive interventions upon both depression and anxiety among children and adolescents (5-18 years) while accounting for their co-morbidity. We conducted a systematic review of reviews in Medline, PsycINFO and the Cochrane Library of Systematic Reviews, from 1980 to August 2014. Multivariate meta-analysis examined the efficacy of preventive interventions on depression and anxiety outcomes separately, and the joint efficacy on both disorders combined. Meta-regressions examined heterogeneity of effect according to a range of study variables. Outcomes were relative risks (RR) for disorder, and standardized mean differences (Cohen's d) for symptoms. One hundred and forty-six randomized controlled trials (46 072 participants) evaluated universal (children with no identified risk, n = 54) selective (population subgroups of children who have an increased risk of developing internalizing disorders due to shared risk factors, n = 45) and indicated prevention (children with minimal but detectable symptoms of an internalizing disorder, n = 47), mostly using psychological-only strategies (n = 105). Reductions in internalizing disorder onset occurred up to 9 months post-intervention, whether universal [RR 0.47, 95% confidence interval (CI) 0.37-0.60], selective (RR 0.61, 95% CI 0.43-0.85) or indicated (RR 0.48, 95% CI 0.29-0.78). Reductions in internalizing symptoms occurred up to 12 months post-intervention for universal prevention; however, reductions only occurred in the shorter term for selective and indicated prevention. Universal, selective and indicated prevention interventions are efficacious in reducing internalizing disorders and symptoms in the short term. They might be considered as repeated exposures in school settings across childhood and adolescence. (PROSPERO registration: CRD42014013990.)
Language eng
DOI 10.1017/S0033291715001725
Indigenous content off
Field of Research 1701 Psychology
1117 Public Health and Health Services
1109 Neurosciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, Cambridge University Press
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Document type: Journal Article
Collections: Faculty of Health
School of Health and Social Development
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