2025

Luttinen, Johanna; Watroba, Anni; Niemelä, Mika; Miettunen, Jouko; Ruotsalainen, Heidi

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.