Universal and selective interventions to promote good mental health in young people: Systematic review and meta-analysis
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Date
2020-12Author
De Michell, Andrea
Nieman, Dorien H.
Correll, Christoph U.
Kessing, Lars Vedel
Pfennig, Andrea
Bechdolf, Andreas
Borgwardt, Stefan
Arango, Celso
Van Amelsvoort, Therese
Vieta, Eduard
Solmi, Marco
Oliver, Dominic
Verdino, Valeria
Di Maggio, Lucia
Bonoldi, Ilaria
Vaquerizo Serrano, Julio
Boy, Ottone Baccaredda
Provenzani, Umberto
Ruzzi, Francesca
Calorio, Federica
Nosari, Guido
Di Marco, Benedetto
Famularo, Irene
Molteni, Silvia
Filosi, Eleonora
Mensi, Martina
Balottin, Umberto
Politi, Pierluigi
Il Shin, Jae
Fusar-Poli, Paolo
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European Neuropsychopharmacology 41 : 28-39 (2020)
Abstract
Promotion of good mental health in young people is important. Our aim was to evaluate the consistency and magnitude of the efficacy of universal/selective interventions to promote good mental health. A systematic PRISMA/RIGHT-compliant meta-analysis (PROSPERO: CRD42018088708) search of Web of Science until 04/31/2019 identified original studies comparing the efficacy of universal/selective interventions for good mental health vs a control group, in samples with a mean age < 35 years. Meta-analytical random-effects model, heterogeneity statistics, assessment of publication bias, study quality and sensitivity analyses investigated the efficacy (Hedges' g = effect size, ES) of universal/selective interventions to promote 14 good mental health outcomes defined a-priori. 276 studies were included (total participants: 159,508, 79,142 interventions and 80,366 controls), mean age = 15.0 (SD = 7.4); female = 56.0%. There was a significant overall improvement in 10/13 good mental health outcome categories that could be meta-analysed: compared to controls, interventions significantly improved (in descending order of magnitude) mental health literacy (ES = 0.685, p < 0.001), emotions (ES = 0.541, p < 0.001), self-perceptions and values (ES = 0.49, p < 0.001), quality of life (ES = 0.457, p = 0.001), cognitive skills (ES = 0.428, p < 0.001), social skills (ES = 0.371, p < 0.001), physical health (ES = 0.285, p < 0.001), sexual health (ES = 0.257, p = 0.017), academic/occupational performance (ES = 0.211, p < 0.001) and attitude towards mental disorders (ES = 0.177, p = 0.006). Psychoeducation was the most effective intervention for promoting mental health literacy (ES = 0.774, p < 0.001) and cognitive skills (ES = 1.153, p = 0.03). Physical therapy, exercise and relaxation were more effective than psychoeducation and psychotherapy for promoting physical health (ES= 0.498, p<0.001). In conclusion, several universal/selective interventions can be effective to promote good mental health in young people. Future research should consolidate and extend these findings.