School-based depression and anxiety prevention programs for young people: A systematic review and meta-analysis

Abstract

Depression and anxiety often emerge for the first time during youth. The school environment provides an ideal context to deliver prevention programs, with potential to offset the trajectory towards disorder. The aim of this review was to provide a comprehensive evaluation of randomised-controlled trials of psychological programs, designed to prevent depression and/or anxiety in children and adolescents delivered in school settings. Medline, PsycINFO and the Cochrane Library were systematically searched for articles published until February 2015. Eighty-one unique studies comprising 31,794 school students met inclusion criteria. Small effect sizes for both depression (g=0.23) and anxiety (g=0.20) prevention programs immediately post-intervention were detected. Small effects were evident after 12-month follow-up for both depression (g=0.11) and anxiety (g=0.13). Overall, the quality of the included studies was poor, and heterogeneity was moderate. Subgroup analyses suggested that universal depression prevention programs had smaller effect sizes at post-test relative to targeted programs. For anxiety, effect sizes were comparable for universal and targeted programs. There was some evidence that externally-delivered interventions were superior to those delivered by school staff for depression, but not anxiety. Meta-regression confirmed that targeted programs predicted larger effect sizes for the prevention of depression. These results suggest that the refinement of school-based prevention programs have the potential to reduce mental health burden and advance public health outcomes.

Prevention of Depression: A Review of Literature

“…They are delivered by psychologist. There was no improvement in the outcome when three family sessions were added [75].…”

“…The following are the main programs that have been used in many countries and are both feasible and effective. These interventions are summarized in several recent meta-analysis and review articles of prevention programs in schools [16,38,[75][76][77].…”

Child labor and severe functioning difficulties and disability in Mexican children and adolescents 5-17 years of age

“…24 Research has yet to clarify the relationships between anxiety or depression and child labor; some authors theorize that child labor creates stress or trauma during childhood, which could lead to mental disorders at that time and later in life. 25 Systematic reviews show that improvements in depression and anxiety prevention programs (schoolbased or not) 26 as well as cognitive behavioral therapy and interpersonal psychotherapy 27 can be efficacious at reducing these important health problems. Either of these options (prevention programs or treatment) have the potential to reduce the possible contribution of these mental health issues on higher levels of child labor or of educational lag as well as their impact in adulthood.…”

What Are the Challenges Involved in the Prevention of Depression in Schools?

“…More quality research is needed to disentangle the inconsistencies (Horowitz and Garber 2006;Merry et al 2011;Werner-Seidler et al 2017;Corrieri et al 2014;Calear and Christensen 2010). Future studies should include longer follow-ups, comparisons to already existing interventions and scrupulous assessment of the fidelity of the intervention (Horowitz and Garber 2006;Merry et al 2011;Werner-Seidler et al 2017;Corrieri et al 2014;Calear and Christensen 2010).…”

“…The rising interest in schools acting as a platform for such initiatives has been reflected in growing evidence base for their effectiveness (Corrieri et al 2014;Calear and Christensen 2010;Werner-Seidler et al 2017). In this piece, we outline the challenges encountered by schools and specifically focus on whole family approaches as a way forward.…”