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Universal and selective interventions to promote good mental health in young people: Systematic review and meta-analysis
Open accessAbstract
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.
Overview
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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.
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69 Own result · 26 Not checked yet · 20 Own method · 10 Own interpretation · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“externalising behaviours (ES=0.137,p=0.001)”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“improved (in descending magnitude order) interpersonal violence (ES=0.431,p=0.021)”
plaindirectn = 447,206 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“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%”
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Psychoeducation had the highest effect size for ADHD features (ES=0.202,p=0.004)”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our meta-analysis also found that universal and selective interventions are equally effective for the prevention of emotional and behavioural problems”
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We showed that preventive universal and selective interventions for anxiety features were equally effective, with a particular high efficacy for psychotherapy, although effect sizes were small.”
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no differences between preventive interventions conducted in children and adolescents and in adults for any of the outcomes evaluated (all p>0.05)”
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“there were no statistically significant differences between the intervention and the control condition for all the interventions (all p>0.05)”
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We also found that selective preventive interventions were more effective than universal interventions for general psychological distress.”
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“internalising behaviours (ES=0.084;p=0.018 corrected with the trim and fill method to ES=0.001, p=0.32)”
plain- Asserted: passes — The authors put it forward as true.
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- It may state two separate claims as one. 23
- The quote only partly states this claim. 1
- Probably not a substantial claim. 20
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Publication bias was detected in two of the outcome categories with Egger's test (eTable VIII) and corrected with the trim and fill method.”
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“but overall interventions were not statistically significant.”
plain- Asserted: passes — The authors put it forward as true.
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The quote only partly states this claim.
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In the paper
“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”
hedgedconditionaln = 447,206 ·- Asserted: passes — The authors put it forward as true.
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- 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.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
hedged- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Third, quality for most of the studies was low, with no blinding and/or randomisation.”
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the database was large and sufficiently powered to test the preventive efficacy for most outcomes.”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“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 .”
What the sources say
- Not checked yetcites [61]
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“a previous meta-analysis investigating the effect of psychosocial interventions on the prevention of disruptive behaviour problems that also had small effect sizes 63”
What the sources say
- Not checked yetcites [63]
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Also, the quality assessment procedure employed in the current protocol may have been suboptimal compared to currently recommended methods.”
hedged- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“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] .”
What the sources say
- Not checked yetcites [15] Fatori, 2018, The economic impact of subthreshold and clinical childhood mental disorders, J. Ment. Health source
- Not checked yetcites [16] Firth, 2019, The Lancet psychiatry commission: a blueprint for protecting physical health in people with mental illness, Lancet Psychiatry source
- Not checked yetcites [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
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Consequently, the accuracy of these categorical outcomes relied on their definition provided by each individual study.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We also did not address systematically the financial and social benefits of preventive interventions.”
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“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).”
What the sources say
- Not checked yetcites [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 yetcites [29] Kumar, 2017, Cognitive rehabilitation for adults with traumatic brain injury to improve occupational outcomes, Cochrane Database Syst. Rev.
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A previous meta-analysis found significant reductions in anxiety symptoms after cognitive behavioural interventions, but effect sizes were small 59 .”
What the sources say
- Not checked yetcites [59]
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“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.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Interestingly, NICE guidelines highlight the need for psychoeducation for individuals with ADHD, while they limit the indications of psychotherapy to particular ADHD cases 66 .”
What the sources say
- Not checked yetcites [66]
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Finally, the outcomes analysed by the current review were pragmatically aligned with the operationalisation provided by each individual study.”
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“These interventions have been able to increase self-esteem and decrease stigma related behaviours 69 ,”
What the sources say
- Not checked yetcites [69]
plaindirect- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We conducted meta-regressions to estimate the association between the efficacy of the interventions and study quality.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“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.”
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This was likely due to the fact that prevention of mental disorders is more established through indicated as opposed to universal or selective approaches.”
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“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”
What the sources say
- Not checked yetcites [54] Tay, 2018, Effectiveness of information and communication technologies interventions to increase mental health literacy: a systematic review, Early Interv. Psychiatry source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Other interventions may include parent training 22 , physical activity 23 or mindfulness-based interventions 24 , but their efficacy is again not fully consolidated.”
What the sources say
- Not checked yetcites [22] Fusar-Poli, 2020, What is good mental health? A scoping review, Eur. Neuropsychopharmacol. source
- Not checked yetcites [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 yetcites [24] Gore, 2011, Global burden of disease in young people aged 10–24 years: a systematic analysis, Lancet source
hedged- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Among the specific types of selective or universal interventions, psychopharmacological treatments are rarely used 19 , whereas psychotherapy 20 or psychoeducation 21 are more frequent.”
What the sources say
- Not checked yetcites [19] Fusar-Poli, 2013, The psychosis high-risk state a comprehensive state-of-the-art review, JAMA Psychiatry source
- Not checked yetcites [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 yetcites [21] Fusar-Poli, 2018, The science of prognosis in psychiatry: a review, JAMA Psychiatry source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Random-effects models were employed due to high heterogeneity in the included stdies 36 .”
What the sources say
- Not checked yetcites [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
plaindirect- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Psychoeducation for ADHD features, affective symptoms and interpersonal violence, and psychotherapy for anxiety features are particularly promising.”
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The definitions of categorical outcomes provided by each individual study are accurate.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A previous meta-analysis found that trauma-focused psychotherapy is effective to prevent PTSD in patients with acute stress symptoms 62 .”
What the sources say
- Not checked yetcites [62]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“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 .”
What the sources say
- Not checked yetcites [73]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
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.”
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?
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“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]
Experimental — accuracy not yet measuredIn the citing paper
“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]
In the citing paper
“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.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Abstract
“other emotional and behavioural problems (ES=0.304,p<0.001)”
§ CONCLUSIONS
“other emotional and behavioural problems (ES=0.304;p=0.004)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Abstract
“conduct problems (ES=0.21,p<0.001)”
§ CONCLUSIONS
“conduct problems (ES=0.210;p=0.021)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ CONCLUSIONS
“Selective interventions outperformed universal interventions for externalising behaviours as well (ES=0.217p=0.040), but overall interventions were not statistically significant.”
§ CONCLUSIONS
“externalising behaviours (ES=0.137;p=0.001)”
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Metadata
- 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)
- 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
- hybrid
- doi.org
- 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 › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › 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.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
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 ›
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