Abstract
Background: The incidence of depression, anxiety, and post-traumatic stress disorder (PTSD) among children and adolescents residing in low- and middle-income countries (LMICs) poses a significant public health concern. However, there is variation in the evidence of effective psychological interventions. This meta-analysis aims to provide a complete overview of the current body of evidence in this rapidly evolving field. Methods: We conducted searches on PubMed, Embase.com, and EBSCO/APA PsycInfo databases up to June 23, 2022, identify randomized controlled trials (RCTs) investigating the effectiveness of psychological interventions in LMICs that targeted children and adolescents with elevated symptoms above a cut-off score for depression, anxiety, and PTSD, comparing a psychological or psychosocial intervention with other control conditions. We conducted random effects meta-analyses for depression, anxiety, and PTSD symptoms. Sensitivity analysis for outliers and high-risk studies, and analyses for the publication bias were carried out. Subgroup analyses investigated how the intervention type, intervention format, the facilitator, study design, and age group of the participant predicted effect sizes. Results: Thirty-one RCTs (6,123 participants) were included. We found a moderate effect of interventions on depression outcomes compared to the control conditions (g = 0.53; 95% CI: 0.06–0.99; NNT = 6.09) with a broad prediction interval (PI) (−1.8 to 2.86). We found a moderate to large effect for interventions on anxiety outcomes (g = 0.88; 95% CI: −0.03 to 1.79; NNT = 3.32) with a broad PI (−3.14 to 4.9). Additionally, a moderate effect was observed on PTSD outcomes (g = 0.54; 95% CI: 0.19–0.9; NNT = 5.86) with a broad PI (−0.64 to 1.72). Conclusions: Psychological and psychosocial interventions aimed at addressing depression, anxiety, and PTSD among children and adolescents in LMICs have demonstrated promising results. However, future studies should consider the variation in evidence and incorporate long-term outcomes to better understand the effectiveness of these interventions.
| Original language | English |
|---|---|
| Pages (from-to) | 1776-1788 |
| Number of pages | 13 |
| Journal | Journal of Child Psychology and Psychiatry and Allied Disciplines |
| Volume | 64 |
| Issue number | 12 |
| Early online date | 2 Oct 2023 |
| DOIs | |
| Publication status | Published - Dec 2023 |
Bibliographical note
Special Issue: Innovation in Child and Adolescent Mental Health Interventions============================================
Funding Information:
The authors thank to all researchers whose studies are included in this meta‐analysis. The authors also thank Yagmur Amanvermez and Clara Miguel Sanz for providing support and advice. The authors have declared that they have no competing or potential conflicts of interest, and funding was provided by Swedish Research Council (Grant no. 2018‐05783).
Publisher Copyright:
© 2023 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.
Funding
The authors thank to all researchers whose studies are included in this meta‐analysis. The authors also thank Yagmur Amanvermez and Clara Miguel Sanz for providing support and advice. The authors have declared that they have no competing or potential conflicts of interest, and funding was provided by Swedish Research Council (Grant no. 2018‐05783).
| Funders | Funder number |
|---|---|
| Vetenskapsrådet | 2018‐05783 |
| Vetenskapsrådet |
Keywords
- adolescents
- anxiety
- Children
- depression
- low- and middle-income countries (LMICs)
- meta-analysis
- post-traumatic stress disorder (PTSD)
- psychological interventions