Effects of COVID-19 Mental Health Interventions among Community-based Children, Adolescents, and Adults: A Living Systematic Review of Randomised Controlled Trials

Abstract

Background: Scalable interventions to address COVID-19 mental health are needed. Our objective was to assess effects of mental health interventions for community-based children, adolescents, and adults. Methods: We searched 9 databases (2 Chinese-language) from December 31, 2019 to March 22, 2021. We included randomised controlled trials with non-hospitalised, non-quarantined participants of interventions to address COVID-19 mental health challenges. We synthesized results descriptively but did not pool quantitatively due to substantial heterogeneity of populations and interventions and concerns about risk of bias. Findings: We identified 9 eligible trials, including 3 well-conducted, well-reported trials that tested interventions designed specifically for COVID-19 mental health challenges, plus 6 trials of standard interventions (e.g., individual or group therapy, expressive writing, mindfulness recordings) minimally adapted for COVID-19, all with risk of bias concerns. Among the 3 COVID-19-specific intervention trials, one (N = 670) found that a self-guided, internet-based cognitive-behavioural intervention targeting dysfunctional COVID-19 worry significantly reduced COVID-19 anxiety (standardized mean difference [SMD] 0.74, 95% CI 0.58 to 0.90) and depression symptoms (SMD 0.38, 95% CI 0.22 to 0.55) in Swedish general population participants. A lay-delivered telephone intervention for homebound older adults in the United States (N = 240) and a peer-moderated education and support intervention for people with a rare autoimmune condition from 12 countries (N = 172) significantly improved anxiety (SMD 0.35, 95% CI 0.09 to 0.60; SMD 0.31, 95% CI 0.03 to 0.58) and depressive symptoms (SMD 0.31, 95% CI 0.05 to 0.56; SMD 0.31, 95% CI 0.07 to 0.55) 6-weeks post-intervention, but these were not significant immediately post-intervention. No trials in children or adolescents were identified. Interpretation: Internet-based programs for the general population and lay- or peer-delivered interventions for vulnerable groups may be effective, scalable options for public mental health in COVID-19. More well-conducted trials, including for children and adolescents, are needed.

COVID-19-related mental health difficulties among marginalised populations: A literature review

“…Bonardi et al ( 2021 ) performed a review of nine randomised controlled trials (RCTs). Three were designed during the COVID-19 pandemic and included a racially and ethnically diverse sample.…”

Mental Wellbeing and Boosting Resilience to Mitigate the Adverse Consequences of the COVID-19 Pandemic: A Critical Narrative Review

“…Further theoretical and empirical research on how to foster resilience have been formulated (He et al, 2020; Rieckert et al, 2021; Sakurai & Chughtai, 2020). A wide spectrum of evidence-based interventions has been shown effective in improving emotional coping and social support and reducing mental health problems for individuals and communities (Bonardi et al, 2021; Shaygan et al, 2021). However, other interventions have been found to be harmful, so it becomes ever more pertinent to ensure there is appropriate evidence for an intervention’s effectiveness in the context of the pandemic prior to recommending it (Vukčević Marković et al, 2020).…”

Telephone-based cognitive behavioural therapy for patients with postoperative bariatric surgery to manage COVID-19 pandemic-related mental health issues and distress (TELE-BARICARE): a protocol for a randomised controlled trial

“…Currently, high quality studies on the impact of virtual psychosocial interventions to prevent or treat mental health distress and eating disorders in patients with obesity during COVID-19 remain limited. Reviews to date, including a living systematic review of randomised controlled trials (RCTs), identified that self-guided internet-based cognitive behavioural therapy (CBT) and a layperson supportive telephone intervention improved mental health distress in non-bariatric populations 15 16. Despite this preliminary evidence for virtual mental health interventions during COVID-19 in general and non-bariatric specific populations, these reviews did not identify any interventions that specifically addressed psychological distress or disordered eating in patients with obesity.…”