Interventions to reduce stress, anxiety and depression symptoms in teenagers – a systematic review

Introduction

Stress, anxiety and depression symptoms are frequent in teenagers. Objectives: To identify the interventions effectively able to prevent or reduce anxiety, depression and psychological stress in adolescents; to assess the effectiveness, feasibility and transferability of the interventions.

Methods

Comprehensive systematic review was performed. Three steps searching strategy using the databases: PsycINFO, PubMed, SCOPUS, Cochrane Library, and Google Scholar identified 679 studies and reviews. Critical appraisal was performed by 2 reviewers, data extraction performed on finally selected 59 reviews, RCT, cohort studies focused on sample size, geographical context, setting, description of intervention, measures of primary and secondary outcomes.

Results

The considered interventions are: Internet-based multifaceted cognitive bias modification training (CBM), Internet (iCBT) or school-based cognitive behavioral group training (CBT), Social skills training (SST), Metacognitive therapy, Psychosocial Support Intervention, organized sports participation and voluntary outdoor play, school-based resilience-focused intervention, assertiveness group training, short-term psychoanalytic psychotherapy (STPP), brief psychosocial intervention (BPI), Guided Parent-Delivered Cognitive Behaviour Therapy (GPD-CBT), Internet-based self-support method.

Conclusions

Interventions for promoting mental health in adolescents have to combine parenting programs with leisure activities and balanced curriculum; various approaches (physical activity, music, sports participation) should be tailored into the national, community and school contexts. Resilience factors (relationship with parents, communications with peers), development of help-seeking behaviours and available self-help programs could support early detection and assistance. Most interventions showed positive effects on short and medium term and potential transferability.

Key messages

Regular screening for childhood adversities and traumas and screening of symptoms as feeling sad, hopeless, worried should be performed in adolescents as they get older. Besides mental health risk factors, interventions should target developmental risk factors in transitional stages from childhood to adolescence and from adolescence to young adulthood.

Appropriate approaches for improving health promotion literacy in adolescents – a systematic review

Background

Adolescents are exposed to various risks for their health: substance use, Internet overuse, video game addiction, unhealthy diet (reduced intake of fruits and vegetables, fast food culture), low physical activity, overweight, stress, violence, unsafe sexual behaviours, self-medication. Health literacy is defined as the knowledge, motivation and competence to access, understand, appraise and apply right information to make decisions in terms of healthcare, disease prevention and health promotion. Despite the advancement of theoretical models, many national and international health promotion programs, the percentage of unhealthy behaviours still persist in young age. Objective: Current review proposes to assess the implementation and effectiveness of various interventions in order to identify possible success or failure factors.

Methods

Comprehensive Systematic review was performed. After three steps data searching (in PubMed, SCOPUS, Cochrane, PsycINFO, Google Scholar) and critical appraisal, 63 studies out of 739 were fully retrieved.

Results

Implementation aspects as intervention types (single or combined targeted risk factors), type of audience (students, parents, school staff, communities), settings (home, school or outdoor), type of organization (face to face, groups, online), professional or peer-led, communication type (written materials as brochures, posters or videoconferencing) or effectiveness measures were extracted and synthesized. Important features of context such as funding, European or government programs were used for clustering the studies.

Conclusions

Health literacy interventions in adolescents need the involvement of education staff and parents participation. Health literacy for adolescents has to take into account cultural context, language, psychological features of each age; either digital or non-digital interventions cannot elude face to face communication between adolescents and their parents, academics or peers.

Key messages

Health literacy school-based interventions are effective but the content for adolescents audience should rely on guidelines provided by interdisciplinary teams of experts. Health Literacy interventions in adolescents should be age-appropriate and do-not-harm precautions must always be taken in order to avoid prejudices, body-image or self-esteem concerns.

Barriers to mental health treatment: results from the WHO World Mental Health surveys

BACKGROUND

To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders.

METHOD

Data were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 63,678) and analyzed at different levels of clinical severity.

RESULTS

Among those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders).

CONCLUSIONS

Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.

Barriers to mental health treatment: results from the WHO World Mental Health surveys

BACKGROUND

To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders.

METHOD

Data were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 63,678) and analyzed at different levels of clinical severity.

RESULTS

Among those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders).

CONCLUSIONS

Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.