CoChat
Sign Up
Cited by 104School Health and Nursing EducationChild and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and Access

Universal and selective interventions to promote good mental health in young people: Systematic review and meta-analysis

Open access
Salazar de Pablo, Gonzalo, De Micheli, Andrea, Nieman, Dorien H., Correll, Christoph U., Kessing, Lars Vedel, Pfennig, Andrea, Bechdolf, Andreas, Borgwardt, Stefan +24 more·2020·European Neuropsychopharmacology
DOI 10.1016/j.euroneuro.2020.10.007
Open this paper in CoChat — free accountOpen PDF

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.

AI snapshot

Written from the paper’s full text.

TL;DR

This PRISMA/MOOSE systematic review and meta-analysis of 295 studies (447,206 individuals, mean age 15.4) found that universal and selective preventive interventions for young people improved several poor mental health outcomes, with small effect sizes. Psychoeducation and psychotherapy were particularly promising for specific outcomes, while eating-related problems, impaired functioning, internalising behaviours, and sleep-related problems did not show significant improvement.

Key findings

  • Across 17 outcomes, interventions vs control improved interpersonal violence (ES=0.431, p=0.021), general psychological distress (ES=0.421, p<0.001), alcohol use (ES=0.401, p<0.001), anxiety features (ES=0.393, p<0.001), affective symptoms (ES=0.304, p<0.001), other emotional and behavioural problems (ES=0.304, p<0.001), consequences of alcohol use (ES=0.282, p=0.019), PTSD features (ES=0.279, p=0.017), conduct problems (ES=0.21, p<0.001), tobacco use (ES=0.208, p=0.002), externalising behaviours (ES=0.137, p=0.001), ADHD features (ES=0.132, p<0.001), and cannabis use (ES=0.07, p=0.013).
  • No statistically significant differences were found for eating-related problems (ES=0.147, p=0.589), impaired functioning (ES=0.018, p=0.929), internalising behaviour (ES=0.001 after trim-and-fill, p=0.32), or sleep-related problems (ES=0.11, p=0.078).
  • Psychoeducation had the highest effect size for ADHD features (ES=0.202, p=0.004), affective symptoms (ES=0.611, p<0.001), and interpersonal violence (ES=0.676, p=0.024); psychotherapy had the highest effect size for anxiety features (ES=0.453, p<0.001).
  • NNT ranged from 18 (95% CI=12–91) for interpersonal violence to 85 (95% CI=49–384) for cannabis use at a 10% control event rate; PIN ranged from 59 (95% CI=41–305) for interpersonal violence to 284 (95% CI=164–1278) for cannabis use in the most conservative scenario. Heterogeneity was significant (I² 57.4%–98.7%), and publication bias was detected in two outcome categories.

Methods

  • PRISMA/MOOSE-compliant systematic review and meta-analysis (PROSPERO: CRD42018102143) searching Web of Science up to 04/31/2019, plus manual reference searches; inclusion required original interventional studies comparing universal or selective prevention vs a control group, meta-analysable data, English language, and samples with mean age <35 years.
  • 295 articles were included: 447,206 individuals (234,330 intervention; 212,876 control), mean age 15.4 (SD 7.4), covering 17 poor mental health outcomes; 175 studies used selective approaches, 118 universal, and 2 both.
  • Random-effects models estimated Hedges’ g; heterogeneity was assessed with I², publication bias with Egger’s test and trim-and-fill, and meta-regressions examined study quality. Sensitivity analyses stratified by intervention type, universal vs selective approach, and age group; NNT and PIN were also calculated.

Limitations

  • Stated by the authors: limited evidence for some outcomes (sleep-related problems, impaired functioning, eating-related problems, interpersonal violence); inability to quantify differential efficacy of “other” and “combined” interventions or specific interventions within psychotherapy/psychoeducation; most studies were low quality (no blinding and/or randomisation) and the quality assessment may have been suboptimal; other potential modifiers could not be investigated due to heterogeneity; limited evidence on categorical mental disorders other than psychosis; only post-test efficacy, not long-term efficacy, was assessed; outcomes were pragmatically aligned with each study’s operationalisation.
  • Evident from the text: heterogeneity was high (I² 57.4%–98.7%) and publication bias was detected in two outcome categories; effect sizes were generally small; some sensitivity analyses could not be performed because all interventions for consequences of alcohol use were universal and all PTSD interventions were selective.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.euroneuro.2020.10.007

Cites

58 of 58 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 36 cited sources checked · 0 supported · 0 flagged

  • Findingown data
    § Abstract

    Compared to control conditions, universal and selective interventions improved externalising behaviours (ES=0.137, p=0.001).

    “externalising behaviours (ES=0.137,p=0.001)”
    Quote in the paperSubstantial claim
  • Findingown data
    § Abstract

    Compared to control conditions, universal and selective interventions improved interpersonal violence (ES=0.431, p=0.021).

    “improved (in descending magnitude order) interpersonal violence (ES=0.431,p=0.021)”
    Quote in the paperSubstantial claim
  • Findingown data
    § Number needed to treat (NNT) and population impact number (PIN) for universal and selective preventive interventions

    The NNT ranged from 18 (95% CI=12-91) for interpersonal violence to 85 (95% CI=49-384) for cannabis use when the CER was set to 10%.

    “The NNT ranged from 18 (95% CI=12-91) for interpersonal violence to 85 (95% CI=49-384) for cannabis use when the CER was set to 10%”
    Quote in the paperSubstantial claim
  • Findingown data
    § Abstract

    Psychoeducation had the highest effect size for ADHD features (ES=0.202, p=0.004).

    “Psychoeducation had the highest effect size for ADHD features (ES=0.202,p=0.004)”
    Quote in the paperNot a substantial claim
  • Findingown data
    § DISCUSSION

    Universal and selective interventions are equally effective for the prevention of emotional and behavioural problems.

    “Our meta-analysis also found that universal and selective interventions are equally effective for the prevention of emotional and behavioural problems”
    Quote in the paperSubstantial claim
  • May combine two claims. 23
  • The quote only partly states this claim. 1
  • Classified as probably not a substantial claim. 20

  • May combine two claims.

    Findingown data
    § Heterogeneity, publication bias and meta-regressions

    Heterogeneity across the included studies was statistically significant (p<0.001) and ranged from 57.4% (internalising behaviours) to 98.7% (alcohol use).

    “Heterogeneity (I 2 ) across the included studies was statistically significant (p<0.001) and ranged from 57.4% (internalising behaviours) to 98.7% (alcohol use).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Heterogeneity, publication bias and meta-regressions

    Publication bias was detected in two outcome categories with Egger's test and corrected with the trim and fill method.

    “Publication bias was detected in two of the outcome categories with Egger's test (eTable VIII) and corrected with the trim and fill method.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § DISCUSSION

    Preventive interventions for PTSD features are effective, with small effect sizes, in both the general population and individuals with risk factors.

    “According to our results, preventive interventions for PTSD features are effective, although effect sizes are small , both in the general population and in individuals with risk factors.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data
    § CONCLUSIONS

    Overall interventions were not statistically significant for externalising behaviours.

    “but overall interventions were not statistically significant.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data
    § DISCUSSION

    Overall, primary universal and selective preventive interventions for poor mental health outcomes in young people are feasible and appear to be effective.

    “Overall, the study demonstrated that primary universal and selective preventive interventions for poor mental health outcomes in young people are feasible and appear to be effective”
    Quote in the paperSubstantial claim
    • Rests on an assumption: No prior systematic review and meta-analysis has comprehensively appraised the efficacy of primary universal and selective preventive interventions for poor mental health outcomes in young people.
    • Rests on an assumption: It is not clear for which outcomes universal or selective approaches may be more effective.

  • May combine two claims.

    Interpretationown data
    § DISCUSSION

    Universal and selective interventions in young people can also improve externalising behaviours, ADHD features and cannabis use, but only with a marginal effect.

    “Compared to control conditions, universal and selective interventions in young people can also improve externalising behaviours, ADHD features and cannabis use, but only with a marginal effect.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data
    § DISCUSSION

    Selective and universal interventions for young people are feasible and generally consistent in their efficacy, being unaffected by publication bias (except for internalising behaviours) or study quality (except for impaired functioning).

    “Overall, these findings indicate that selective and universal interventions for young people are feasible and generally consistent in their efficacy, being unaffected by publication bias (except for internalising behaviours) or study quality (except for impaired functioning).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given
    § DISCUSSION

    Quality for most of the studies was low, with no blinding and/or randomisation.

    “Third, quality for most of the studies was low, with no blinding and/or randomisation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given
    § DISCUSSION

    The database was large and sufficiently powered to test the preventive efficacy for most outcomes.

    “However, the database was large and sufficiently powered to test the preventive efficacy for most outcomes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data
    § DISCUSSION

    Universal and selective interventions are equally effective for the prevention of emotional and behavioural problems, with a smaller effect size compared to a previous meta-analysis of preventive parenting programmes for emotional and behavioural problems in children, in which the effect was medium.

    “Our meta-analysis also found that universal and selective interventions are equally effective for the prevention of emotional and behavioural problems, with a smaller ES compared to a previous meta-analysis focusing on preventive parenting programmes for emotional and behavioural problems on children in which this was medium 61 .”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [61]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION

    A previous meta-analysis found that psychosocial interventions for disruptive behaviour problems had small effect sizes.

    “a previous meta-analysis investigating the effect of psychosocial interventions on the prevention of disruptive behaviour problems that also had small effect sizes 63”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data
    § Strategy for data synthesis

    Sensitivity analyses were stratified for type of intervention, universal versus selective intervention, and age group.

    “Sensitivity analyses stratified for (i) the type of intervention provided (psychoeducation vs psychotherapy vs combined vs others), (ii) the type of intervention (universal vs selective) and (iii) the age group of the population (children and adolescents -including studies in which all individuals are ≤18 years old, vs adults -including studies in which all individuals are ≥18 years old).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Study design and conductnone given
    § DISCUSSION

    The quality assessment procedure employed in the current protocol may have been suboptimal compared to currently recommended methods.

    “Also, the quality assessment procedure employed in the current protocol may have been suboptimal compared to currently recommended methods.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § UNIVERSAL AND SELECTIVE INTERVENTIONS TO PREVENT POOR MENTAL HEALTH OUTCOMES IN YOUNG PEOPLE: SYSTEMATIC REVIEW AND META-ANALYSIS INTRODUCTION

    Most available studies on selective or universal prevention have focused on the prevention of depression and related affective symptoms, but the findings are conflicting.

    “Most of the available studies on selective or universal prevention have focused on the prevention of depression and related affective symptoms, but the findings are conflicting [15][16][17][18] .”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [15] Fatori, 2018, The economic impact of subthreshold and clinical childhood mental disorders, J. Ment. Health source

      Not checked in the free run.

    • cites [16] Firth, 2019, The Lancet psychiatry commission: a blueprint for protecting physical health in people with mental illness, Lancet Psychiatry source

      Not checked in the free run.

    • cites [17] Fusar-Poli, 2019, Integrated mental health services for the developmental period (0 to 25 Years): a critical review of the evidence, Front. Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning
    § DISCUSSION

    The accuracy of the categorical outcomes relied on their definition provided by each individual study.

    “Consequently, the accuracy of these categorical outcomes relied on their definition provided by each individual study.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given
    § DISCUSSION

    The study did not address systematically the financial and social benefits of preventive interventions.

    “We also did not address systematically the financial and social benefits of preventive interventions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data
    § METHODS

    The systematic review was PRISMA/MOOSE-compliant and registered on PROSPERO (CRD42018102143).

    “This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 28 (eTable I) and Meta-analyses Of Observational Studies in Epidemiology (MOOSE) checklist 29 (eTable II)-compliant systematic review was registered on PROSPERO (CRD42018102143).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [28] Kolubinski, 2018, A systematic review and meta-analysis of CBT interventions based on the Fennell model of low self-esteem, Psychiatry Res. source

      Not checked in the free run.

    • cites [29] Kumar, 2017, Cognitive rehabilitation for adults with traumatic brain injury to improve occupational outcomes, Cochrane Database Syst. Rev.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § DISCUSSION

    A previous meta-analysis found significant reductions in anxiety symptoms after cognitive behavioural interventions, but effect sizes were small.

    “A previous meta-analysis found significant reductions in anxiety symptoms after cognitive behavioural interventions, but effect sizes were small 59 .”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data
    § Risk of bias (quality) assessment

    Blinding was rated according to a pre-specified scoring system.

    “We also rated blinding using the following scoring system: 0 for studies without a proper blinding or studies that did not clarify if blinding was carried out or not; 1 for studies with single blinding; 2 for studies with double or triple blinding.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § DISCUSSION

    NICE guidelines highlight the need for psychoeducation for individuals with ADHD, while they limit the indications of psychotherapy to particular ADHD cases.

    “Interestingly, NICE guidelines highlight the need for psychoeducation for individuals with ADHD, while they limit the indications of psychotherapy to particular ADHD cases 66 .”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [66]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given
    § DISCUSSION

    The outcomes analysed by the current review were pragmatically aligned with the operationalisation provided by each individual study.

    “Finally, the outcomes analysed by the current review were pragmatically aligned with the operationalisation provided by each individual study.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § DISCUSSION

    Psychoeducation interventions have been able to increase self-esteem and decrease stigma-related behaviours.

    “These interventions have been able to increase self-esteem and decrease stigma related behaviours 69 ,”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [69]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given
    § Strategy for data synthesis

    Meta-regressions were conducted to estimate the association between efficacy of the interventions and study quality.

    “We conducted meta-regressions to estimate the association between the efficacy of the interventions and study quality.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning
    § DISCUSSION

    The quality assessment approach was decided a priori in the study protocol to fully meet the characteristics of the evidence reviewed and the expected large number of studies to be extracted and screened.

    “However, this approach was decided a priori in the study protocol to fully meet the characteristics of the evidence reviewed and the expected large number of studies to be extracted and screened.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning
    § DISCUSSION

    Prevention of mental disorders is more established through indicated as opposed to universal or selective approaches.

    “This was likely due to the fact that prevention of mental disorders is more established through indicated as opposed to universal or selective approaches.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation
    § DISCUSSION

    Young people in the general population could benefit from preventive interventions for interpersonal violence regardless of their exposure to risk factors, potentially by improving social competence and reducing antisocial behaviours.

    “our results suggest that young people in the general population could benefit from preventive interventions regardless of their exposure to these risk factors, potentially by improving social competence and reducing antisocial behaviours 54”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [54] Tay, 2018, Effectiveness of information and communication technologies interventions to increase mental health literacy: a systematic review, Early Interv. Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § UNIVERSAL AND SELECTIVE INTERVENTIONS TO PREVENT POOR MENTAL HEALTH OUTCOMES IN YOUNG PEOPLE: SYSTEMATIC REVIEW AND META-ANALYSIS INTRODUCTION

    Other interventions may include parent training, physical activity or mindfulness-based interventions, but their efficacy is not fully consolidated.

    “Other interventions may include parent training 22 , physical activity 23 or mindfulness-based interventions 24 , but their efficacy is again not fully consolidated.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [22] Fusar-Poli, 2020, What is good mental health? A scoping review, Eur. Neuropsychopharmacol. source

      Not checked in the free run.

    • cites [23] Gates, 2017, Efficacy of group social skills interventions for youth with autism spectrum disorder: a systematic review and meta-analysis, Clin. Psychol. Rev. source

      Not checked in the free run.

    • cites [24] Gore, 2011, Global burden of disease in young people aged 10–24 years: a systematic analysis, Lancet source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § UNIVERSAL AND SELECTIVE INTERVENTIONS TO PREVENT POOR MENTAL HEALTH OUTCOMES IN YOUNG PEOPLE: SYSTEMATIC REVIEW AND META-ANALYSIS INTRODUCTION

    Among specific types of selective or universal interventions, psychopharmacological treatments are rarely used, whereas psychotherapy or psychoeducation are more frequent.

    “Among the specific types of selective or universal interventions, psychopharmacological treatments are rarely used 19 , whereas psychotherapy 20 or psychoeducation 21 are more frequent.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [19] Fusar-Poli, 2013, The psychosis high-risk state a comprehensive state-of-the-art review, JAMA Psychiatry source

      Not checked in the free run.

    • cites [20] Fusar-Poli, 2016, Towards a standard psychometric diagnostic interview for subjects at ultra high risk of psychosis: CAARMS versus SIPS, Psychiatry J. source

      Not checked in the free run.

    • cites [21] Fusar-Poli, 2018, The science of prognosis in psychiatry: a review, JAMA Psychiatry source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation
    § Strategy for data synthesis

    Random-effects models were employed due to high heterogeneity in the included studies.

    “Random-effects models were employed due to high heterogeneity in the included stdies 36 .”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [36] Medalia, 2017, Cognitive skills training for homeless transition-age youth: feasibility and pilot efficacy of a community based randomized controlled trial, J. Nerv. Ment. Dis. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data
    § Data extraction

    Data was extracted independently by independent researchers, crosschecked by experienced clinical researchers, and discrepancies were resolved through consensus.

    “Data was extracted independently from all the studies included by independent researchers.Both databases were then crosschecked by experienced clinical researchers, and discrepancies were resolved through consensus.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data
    § CONCLUSIONS

    Psychoeducation for ADHD features, affective symptoms and interpersonal violence, and psychotherapy for anxiety features are particularly promising.

    “Psychoeducation for ADHD features, affective symptoms and interpersonal violence, and psychotherapy for anxiety features are particularly promising.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The definitions of categorical outcomes provided by each individual study are accurate.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data
    § Risk of bias (quality) assessment

    Randomisation was rated according to a pre-specified scoring system.

    “We rated randomisation, as we had planned and detailed in our protocol, according to the following scoring system: 0 for studies without a proper randomisation or studies that did not clarify if randomisation was carried out or not; 1 for studies that mentioned they carried out some randomisation but did not clearly specify the type; 2 for studies that detailed clearly their method of randomis”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § DISCUSSION

    Trauma-focused psychotherapy is effective to prevent PTSD in patients with acute stress symptoms.

    “A previous meta-analysis found that trauma-focused psychotherapy is effective to prevent PTSD in patients with acute stress symptoms 62 .”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § DISCUSSION

    Psychotherapy and particularly CBT-based interventions prevent mental conditions by mechanisms including reduction of avoidance coping skills and increase in problem-solving coping skills.

    “by different mechanisms including the reduction of the use of avoidance coping skills and an increase in the levels of problem-solving coping skills 73 .”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [73]

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given
    § DISCUSSION

    It was not possible to ascertain the long-term efficacy of the interventions, only the post-test efficacy and other implementation factors related to this.

    “Sixthly, it was not possible to ascertain the long-term efficacy of the interventions, only the post-test efficacy and other implementation factors related to this.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data
    § CONCLUSIONS

    Screening was performed by the same researchers who carried out the literature search, and discrepancies were resolved through consensus.

    “The same researchers who carried out the literature search screened, first looking at the title and abstract, and then to the full text all the articles.Discrepancies were resolved through consensus”
    Quote in the paperNot a substantial claim
36 of 36

  • The paper relies on this without support.

    No prior systematic review and meta-analysis has comprehensively appraised the efficacy of primary universal and selective preventive interventions for poor mental health outcomes in young people.

    “However, to our knowledge, no systematic review and metaanalysis has comprehensively appraised the efficacy of primary universal and selective preventive interventions for poor mental health outcomes in young people.”

  • The paper relies on this without support.

    It is not clear for which outcomes universal or selective approaches may be more effective.

    “It is also not clear for which outcomes universal or selective approaches may be more effective.”

  • The paper relies on this without support.

    The 17 outcome categories represent the outcomes of universal and selective preventative approaches in young people that have been most widely and pragmatically investigated.

    “Therefore, these categories represent the outcomes of universal and selective preventative approaches in young people that have been most widely and pragmatically investigated.”

  • The paper relies on this without support.

    The definitions of categorical outcomes provided by each individual study are accurate.

    “the accuracy of these categorical outcomes relied on their definition provided by each individual study.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A meta-analysis found that interventions to promote good mental health in asymptomatic young people significantly improved mental health literacy (Hedges' g=0.685), emotions (g=0.541), self-perceptions and values (g=0.49), quality of life (g=0.457), cognitive skills (g=0.428), social skills (g=0.371), physical health (g=0.285), sexual health (g=0.257), academic/occupational performance (g=0.211) и

    “Compared to controls, available interventions significantly improved mental health literacy (Hedges' g=0.685), emotions (g=0.541), selfperceptions and values (g=0.49), quality of life (g=0.457), cognitive skills (g=0.428), social skills (g=0.371), physical health (g=0.285), sexual health (g=0.257), academic/occupational performance (g=0.211) and attitude towards mental disorders (g=0.177)”

    From Preventive psychiatry: a blueprint for improving the mental health of young people (2021) · cites this paper as [185]

  • One in every seven adolescents aged 10-19 years experiences a mental health condition.

    “This is especially important given that one in every seven adolescents aged 10-19 years experiences a mental health condition, 85”

    From The Lancet Commission on ending stigma and discrimination in mental health (2022) · cites this paper as [85]

  • Salazar de Pablo and colleagues found a small effect for changes in attitudes towards people with mental health conditions across 16 studies involving youth of various ages (Hedges g=0.18).

    “In a meta-analysis, Salazar de Pablo and colleagues 85 found a small effect for changes in attitudes towards people with mental health conditions across 16 studies involving youth of various ages (effect size Hedges g=0•18).”

    From The Lancet Commission on ending stigma and discrimination in mental health (2022) · cites this paper as [85]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting p-values for emotional and behavioural problems

    Major

    The abstract reports p<0.001, but the detailed results report p=0.004 for the same effect size and outcome.

  • Conflicting p-values for conduct problems

    Minor

    The abstract reports p<0.001, whereas the detailed results report p=0.021 for the same effect size and outcome.

  • Overall externalising-behaviour result called nonsignificant despite p=0.001

    Minor

    The comparison of selective and universal interventions says the overall interventions were not statistically significant. The reported overall result for externalising behaviours is p=0.001, which is significant under the paper's stated alpha of 0.05.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Sharp, 2016, The effects of a pedometer-based intervention on first-year university students: a randomized control trial, J. Am. Coll. Health, 64, 630, 10.1080/07448481.2016.1217538 · DOI

Cited by

Sorted by citations

Related

Authors
Salazar de Pablo, G., De Micheli, A., Nieman, D. H., Correll, C. U., Kessing, L. V., Pfennig, A., Bechdolf, A., Borgwardt, S., Arango, C., van Amelsvoort, T., Vieta, E., Solmi, M., Oliver, D., Catalan, A., Verdino, V., Di Maggio, L., Bonoldi, I., Vaquerizo-Serrano, J., Baccaredda Boy, O., Provenzani, U., Ruzzi, F., Calorio, F., Nosari, G., Di Marco, B., Famularo, I., Molteni, S., Filosi, E., Mensi, M., Balottin, U., Politi, P., Shin, J. I., & Fusar-Poli, P.
Affiliations
  • Amsterdam UMC Location University of Amsterdam (NL)
  • Northwell Health (US)
  • Rigshospitalet (DK)
  • University Hospital Carl Gustav Carus (DE)
  • University of Cologne (DE)
  • University of Basel (CH)
  • Hospital General Universitario Gregorio Marañón (ES)
  • Centro de Investigación Biomédica en Red de Salud Mental (ES)
  • University of Padua (IT)
  • King's College London (GB)
  • University of Siena (IT)
  • University of Pavia (IT)
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
  • Yonsei University (KR)
ORCID
Venue
European Neuropsychopharmacology
Publisher
Elsevier BV
Published
2020-12
Volume
41
Pages
28-39
ISSN
0924-977X (ISSN-L)
DOI
10.1016/j.euroneuro.2020.10.007
OpenAlex
W3095238552
Cited by
104
References
58
Citations by year
2026: 5 · 2025: 17 · 2024: 20 · 2023: 15 · 2022: 28 · 2021: 19
FWCI
3.73
Type
journal article
Language
en
Open access
Licence
Locations
  • European Neuropsychopharmacology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc-nd)
  • Research Portal (King's College London) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Communities in ADDI (University of the Basque Country) (submittedVersion, other-oa)
  • Communities in ADDI (Universidad del Pais Vasco) (submittedVersion, cc-by-nc-nd)
  • Research Publications (Maastricht University) (submittedVersion, cc-by-nc-nd)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-nd)
  • Hispana (submittedVersion, cc-by-nc-nd)
  • YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
  • Pure Amsterdam UMC (submittedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion, cc-by-nc-nd)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Funders
Wellcome Trust
Topics
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
universal interventions, selective intervention, youth, mental health literacy, psychoeducation, social skills, quality of life, physical health, sexual health, academic performance, intervention efficacy, school-based intervention, physiotherapy, psychotherapy, cognitive skills, emotions
MeSH terms
Adolescent, Adult, Age Factors, Mental Disorders, Clinical Trials as Topic, Female, Humans, Male, Mental Health, Psychotherapy, Cognitive Behavioral Therapy, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review