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Cited by 528Child and Adolescent Psychosocial and Emotional DevelopmentDigital Mental Health InterventionsMental Health Treatment and Access

Interventions for Adolescent Mental Health: An Overview of Systematic Reviews

Open access
Das, Jai K., Salam, Rehana A., Lassi, Zohra S., Khan, Marium Naveed, Mahmood, Wajeeha, Patel, Vikram, Bhutta, Zulfiqar A.·2016·Journal of Adolescent Health
DOI 10.1016/j.jadohealth.2016.06.020PMC PMC5026677
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Abstract

Many mental health disorders emerge in late childhood and early adolescence and contribute to the burden of these disorders among young people and later in life. We systematically reviewed literature published up to December 2015 to identify systematic reviews on mental health interventions in adolescent population. A total of 38 systematic reviews were included. We classified the included reviews into the following categories for reporting the findings: school-based interventions (n = 12); community-based interventions (n = 6); digital platforms (n = 8); and individual-/family-based interventions (n = 12). Evidence from school-based interventions suggests that targeted group-based interventions and cognitive behavioral therapy are effective in reducing depressive symptoms (standard mean difference [SMD]: -.16; 95% confidence interval [CI]: -.26 to -.05) and anxiety (SMD: -.33; 95% CI: -.59 to -.06). School-based suicide prevention programs suggest that classroom-based didactic and experiential programs increase short-term knowledge of suicide (SMD: 1.51; 95% CI: .57-2.45) and knowledge of suicide prevention (SMD: .72; 95% CI: .36-1.07) with no evidence of an effect on suicide-related attitudes or behaviors. Community-based creative activities have some positive effect on behavioral changes, self-confidence, self-esteem, levels of knowledge, and physical activity. Evidence from digital platforms supports Internet-based prevention and treatment programs for anxiety and depression; however, more extensive and rigorous research is warranted to further establish the conditions. Among individual- and family-based interventions, interventions focusing on eating attitudes and behaviors show no impact on body mass index (SMD: -.10; 95% CI: -.45 to .25); Eating Attitude Test (SMD: .01; 95% CI: -.13 to .15); and bulimia (SMD: -.03; 95% CI: -.16 to .10). Exercise is found to be effective in improving self-esteem (SMD: .49; 95% CI: .16-.81) and reducing depression score (SMD: -.66; 95% CI: -1.25 to -.08) with no impact on anxiety scores. Cognitive behavioral therapy compared to waitlist is effective in reducing remission (odds ratio: 7.85; 95% CI: 5.31-11.6). Psychological therapy when compared to antidepressants have comparable effect on remission, dropouts, and depression symptoms. The studies evaluating mental health interventions among adolescents were reported to be very heterogeneous, statistically, in their populations, interventions, and outcomes; hence, meta-analysis could not be conducted in most of the included reviews. Future trials should also focus on standardized interventions and outcomes for synthesizing the exiting body of knowledge. There is a need to report differential effects for gender, age groups, socioeconomic status, and geographic settings since the impact of mental health interventions might vary according to various contextual factors.

AI snapshot

Written from the paper’s full text.

TL;DR

This overview of 38 systematic reviews found that school-based CBT and targeted group interventions reduce depressive and anxiety symptoms, while school-based suicide prevention mainly improves short-term knowledge without changing suicide-related attitudes or behaviors. Digital, community, and individual-/family-based interventions show some promise, but heterogeneity and limited long-term data prevent firm conclusions.

Key findings

  • School-based CBT reduced depressive symptoms (SMD: −.16; 95% CI: −.26 to −.05) and anxiety (SMD: −.33; 95% CI: −.59 to −.06); school-based suicide prevention increased short-term knowledge of suicide (SMD: 1.51; 95% CI: .57–2.45) and knowledge of suicide prevention (SMD: .72; 95% CI: .36–1.07), with no evidence of effect on suicide-related attitudes or behaviors.
  • Community-based person-plus-environment interventions (SMD: .27; 95% CI: .16–.37) and environment-only interventions (SMD: .38; 95% CI: .15–.60) had significant positive mental health impacts, whereas person-only interventions did not (SMD: .03; 95% CI: −.19 to .25).
  • Digital platforms supported Internet-based prevention and treatment programs for anxiety and depression, but the review states more extensive and rigorous research is warranted.
  • Among individual-/family-based interventions, eating-attitude/behavior programs showed no impact on BMI (SMD: −.10; 95% CI: −.45 to .25), Eating Attitude Test (SMD: .01; 95% CI: −.13 to .15), or bulimia (SMD: −.03; 95% CI: −.16 to .10); exercise improved self-esteem (SMD: .49; 95% CI: .16–.81) and reduced depression score (SMD: −.66; 95% CI: −1.25 to −.08) with no impact on anxiety; CBT versus waitlist reduced remission (OR: 7.85; 95% CI: 5.31–11.6).

Methods

  • Systematic review of literature published up to December 2015, searching Cochrane Library and PubMed for systematic reviews on interventions to prevent and manage mental health disorders in adolescents, defined as ages 11–19 years, with exceptions for reviews also targeting youth aged 15–24 years.
  • Included 38 systematic reviews, categorized as school-based (n = 12), community-based (n = 6), digital platforms (n = 8), and individual-/family-based (n = 12); data were extracted independently, pooled effect sizes with 95% CIs were recorded, and review quality was assessed using AMSTAR.
  • Meta-analysis could not be conducted in most included reviews because of heterogeneity in populations, interventions, and outcomes.

Limitations

  • The paper states its scope was limited to interventions targeting adolescents and youth only, although mental health interventions take a life-course perspective; most evidence came from high-income countries, limiting generalizability to low- and middle-income countries.
  • The paper states there was a lack of standardized interventions and outcomes, meta-analysis could not be conducted in most included reviews, and long-term follow-up data were generally unavailable because most studies reported short-term outcomes.
  • The paper calls for reporting differential effects by gender, age group, socioeconomic status, and geographic setting; evident from the text, this overview synthesizes other systematic reviews rather than primary trials, and included review quality varied.

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

Integrity signals

Registry

Crossref · 10.1016/j.jadohealth.2016.06.020

Cites

72 of 72 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 107 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    AMSTAR ratings for school-based reviews ranged between 5 and 11 with a median score of 7.5.

    “AMSTAR rating ranged between 5 and 11 with a median score of 7.5.”
    Quote in the paperNot a substantial claim
  • Findingcitation

    Classroom-based didactic and experiential suicide prevention programs increased short-term knowledge of suicide (SMD 1.51; 95% CI .57-2.45).

    “School-based suicide prevention programs suggest that classroom-based didactic and experiential programs increase short-term knowledge of suicide (SMD: 1.51; 95% CI: .57–2.45)”
    • Also stated in: § School-based interventions · hedged
      “Interventions for primary prevention of suicide in university and other postsecondary educational settings suggest that classroom-based didactic and experiential programs increased short-term knowledge of suicide (SMD: 1.51; 95% CI: .57–2.45)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [28] Harrod, 2014, Interventions for primary prevention of suicide in university and other post-secondary educational settings. status and date, Cochrane Database Syst Rev

      Not checked in the free run.

  • Findingcitation

    Person-only community-based mental health and behavioral interventions for low-income urban youth had a nonsignificant impact on improving mental health (SMD .03; 95% CI −.19 to .25).

    “Another review evaluating community-based mental health and behavioral programs for low-income urban youth suggested that person-only interventions had a nonsignificant impact on improving mental health (measured by an aggregate outcome measure; SMD: .03; 95% CI: −.19 to .25)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Farahmand, 2012, Community-based mental health and behavioral programs for low-income urban youth: A meta-analytic review, Clin Psychol Sci Pract source

      Not checked in the free run.

  • Findingcitation

    Classroom-based didactic and experiential suicide prevention programs had no evidence of an effect on participant's suicide-related attitudes or behaviors.

    “with no evidence of an effect on suicide-related attitudes or behaviors.”
    • Also stated in: § School-based interventions · hedged
      “with no evidence of an effect on participant's suicide-related attitudes or behaviors; however, these findings are limited by the overall low quality [28].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [28] Harrod, 2014, Interventions for primary prevention of suicide in university and other post-secondary educational settings. status and date, Cochrane Database Syst Rev

      Not checked in the free run.

  • Findingcitation

    A systematic review on school nurse implemented mental health screening for adolescents in schools did not find any evidence of existing screening tools to detect mental ill health among adolescents in schools.

    “A systematic review on the effectiveness of school nurse implemented mental health screening for adolescents in schools did not find any evidence of existing screening tools to detect mental ill health among adolescents in schools [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Fothergill, 2003, A systematic review on the effectiveness of school nurse implemented mental health screening available for adolescents in schools, J Psychiatr Ment Health Nurs source

      Not checked in the free run.

  • May combine two claims. 29
  • Classified as probably not a substantial claim. 14
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingown data

    Twelve reviews reported school-based interventions for adolescent mental health, of which one performed meta-analysis.

    “We found a total of 12 reviews reporting school-based interventions for adolescent mental health, of which one review performed meta-analysis.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    The included reviews were classified into school-based (n = 12), community-based (n = 6), digital platforms (n = 8), and individual-/family-based (n = 12) categories.

    “We classified the included reviews into the following categories for reporting the findings:•School-based interventions (n = 12)•Community-based interventions (n = 6)•Digital platforms (n = 8)•Individual-/family-based interventions (n = 12)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Six systematic reviews evaluated community-based interventions targeting adolescents and youth, and meta-analysis was conducted in two reviews.

    “We report findings from six systematic reviews evaluating various community-based interventions targeting adolescents and youth; meta-analysis was conducted in two reviews.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Findingcitation

    A school mental health promotion approach focusing on mental health promotion rather than mental illness prevention is effective in promoting adolescent and youth mental health.

    “A review on school mental health promotion programs based on the findings from 15 studies suggests that an approach focusing on mental health promotion rather than on mental illness prevention is effective in promoting adolescent and youth mental health [18].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [18] O'Mara, 2013, What do we know about school mental health promotion programmes for children and youth?, Adv Sch Ment Health Promot source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Due to heterogeneity of design, meta-analysis of nurture groups was not possible and studies were examined for effectiveness qualitatively.

    “Due to heterogeneity of design, it was not possible to conduct a meta-analysis, and the studies were examined for effectiveness qualitatively.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Cheney, 2014, Targeted group-based interventions in schools to promote emotional well-being: A systematic review, Clin child Psychol Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Solution-focused brief therapy in schools has mixed results with some promise for reducing the intensity of students' negative feelings, managing conduct problems, and externalizing behavioral problems.

    “A review evaluating solution-focused brief therapy in schools has suggested mixed results with some promise in working with students in school settings, specifically for reducing the intensity of students' negative feelings, managing conduct problems, and externalizing behavioral problems [21].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Kim, 2009, Solution-focused brief therapy in schools: A review of the outcome literature, Child Youth Serv Rev source

      Not checked in the free run.

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    Findingcitation

    Indicated programs targeting students exhibiting elevated levels of depression were the most effective in reducing depressive symptoms, with effect sizes ranging from .21 to 1.40.

    “Indicated programs, which targeted students exhibiting elevated levels of depression, were found to be the most effective in reducing depressive symptoms with effect sizes ranging from .21 to 1.40.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23] Calear, 2010, Systematic review of school-based prevention and early intervention programs for depression, J Adolesc

      Not checked in the free run.

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

    Findingcitation

    Meta-analysis was not conducted in the review of school-based depression prevention and early intervention programs.

    “Meta-analysis was not conducted.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Calear, 2010, Systematic review of school-based prevention and early intervention programs for depression, J Adolesc

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The solution-focused brief therapy findings are based on seven studies and meta-analysis could not be conducted.

    “These findings are based on seven studies while meta-analysis could not be conducted.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Kim, 2009, Solution-focused brief therapy in schools: A review of the outcome literature, Child Youth Serv Rev source

      Not checked in the free run.

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

    Findingown data

    The search identified 107 potentially relevant review titles.

    “Our search identified 107 potentially relevant review titles.”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    Meta-analysis was not conducted in the community-based parent training and social skills training review.

    “However, meta-analysis was not conducted.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] Waddell, 2007, Preventing mental disorders in children: A systematic review to inform policy-making, Can J Public Health source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    In the community-based creative activities review, interventions were diverse and research was heterogeneous, so overall synthesis of results was not attempted.

    “The interventions used in the studies were diverse, and the research was heterogeneous, and hence overall synthesis of the results was not attempted.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] Bungay, 2013, The effects of participating in creative activities on the health and well-being of children and young people: A rapid review of the literature, Perspect Public Health source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Community-based mental health delivery programs specifically targeting mental health promotion of young people in LMICs have positive impacts on mental health outcomes, but pooled analysis could not be conducted.

    “Evidence from community-based mental health delivery programs specifically targeting mental health promotion of young people in LMICs suggests positive impacts on mental health outcomes; however, pooled analysis could not be conducted [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Mason-Jones, 2012, A systematic review of the role of school-based healthcare in adolescent sexual, reproductive, and mental health, Syst Rev source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    School-based life skills and resilience programs in LMICs had mixed results, including differential effects for gender and age groups, and effect estimates could not be pooled.

    “However, there were mixed results, including differential effects for gender and age groups [19], and effect estimates could not be pooled.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Mason-Jones, 2012, A systematic review of the role of school-based healthcare in adolescent sexual, reproductive, and mental health, Syst Rev source

      Not checked in the free run.

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

    Findingcitation

    School-based preventive health care is popular with young people and provides important mental health services.

    “Another review reported from 27 studies that school-based preventive health care is popular with young people and provides important mental health services [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Mason-Jones, 2012, A systematic review of the role of school-based healthcare in adolescent sexual, reproductive, and mental health, Syst Rev source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In the review of school mental health promotion programs, study populations were limited and studies lacked clarity regarding who implemented interventions or lacked theoretical foundations, process evaluations, or youth viewpoints.

    “However, study populations were limited, and studies either lack clarity regarding who implemented interventions or lack theoretical foundations, process evaluations, or youth viewpoints [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] O'Mara, 2013, What do we know about school mental health promotion programmes for children and youth?, Adv Sch Ment Health Promot source

      Not checked in the free run.

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    Findingcitation

    Some educational interventions showed potential for increasing skills and confidence of primary care staff, but controlled evaluations were rare, and few studies reported actual change in professional behavior or patient health outcomes.

    “Some educational interventions showed potential for increasing skills and confidence of primary care staff, but controlled evaluations were rare, and few studies reported the actual change in professional behavior or patient health outcomes [34].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] Bower, 2001, The treatment of child and adolescent mental health problems in primary care: A systematic review, Fam Pract source

      Not checked in the free run.

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

    Findingown data

    AMSTAR ratings for digital platform reviews ranged between 4 and 11 with a median score of 9.

    “AMSTAR rating ranged between 4 and 11 with a median score of 9.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Treatments by specialist staff working in primary care for adolescent mental health disorders were effective, although quality of included studies was variable.

    “One review reporting the impact of treatment of adolescent mental health disorders in primary care settings suggests some preliminary evidence that treatments by specialist staff working in primary care were effective, although quality of included studies was variable.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] Bower, 2001, The treatment of child and adolescent mental health problems in primary care: A systematic review, Fam Pract source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Computerized CBT for mental health is cost-effective and often cheaper than usual care.

    “while computerized CBT for mental health suggests that such interventions are cost-effective and often cheaper than usual care [36], [37].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [36] Musiat, 2014, Collateral outcomes in e-mental health: A systematic review of the evidence for added benefits of computerized cognitive behavior therapy interventions for mental health, Psychol Med source

      Not checked in the free run.

    • cites [37] Montgomery, 2006, Media-based behavioural treatments for behavioural problems in children, Cochrane Database Syst Rev

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). The quote only partly states this claim.

    Findingreasoning

    Meta-analysis could not be conducted in the primary care treatment review.

    “Meta-analysis could not be conducted.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] Bower, 2001, The treatment of child and adolescent mental health problems in primary care: A systematic review, Fam Pract source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Twelve systematic reviews focused on individual- or family-based interventions, of which 10 performed meta-analysis.

    “We included 12 systematic reviews focusing on individual- or family-based interventions, of which 10 reviews performed meta-analysis.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In the mass media review, studies were very heterogeneous statistically in populations, interventions, and outcomes, so meta-analysis could not be conducted.

    “The studies were very heterogeneous, statistically, in their populations, interventions, and outcomes, and hence meta-analysis could not be conducted [35].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Clement, 2013, Mass media interventions for reducing mental health-related stigma, Cochrane Database Syst Rev

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    AMSTAR ratings for individual-/family-based reviews ranged between 6 and 11 with a median score of 11.

    “AMSTAR rating ranged between 6 and 11 with a median score of 11.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The online intervention findings are based on 20 studies, but meta-analysis could not be conducted due to heterogeneity.

    “These findings are based on 20 studies; however, meta-analysis could not be conducted in this review due to heterogeneity in studies.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Clarke, 2015, A systematic review of online youth mental health promotion and prevention interventions, J Youth Adolesc source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Young people regularly use and are generally satisfied with online mental health resources.

    “Three reviews evaluating the acceptability and feasibility of mental health resources among youth suggested that young people regularly use and are generally satisfied with online mental health resources [40], [41], [42].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [40] Kauer, 2014, Do online mental health services improve help-seeking for young people? A systematic review, J Med Internet Res source

      Not checked in the free run.

    • cites [41] Martin, 2011, Effectiveness and impact of networked communication interventions in young people with mental health conditions: A systematic review, Patient Educ Couns source

      Not checked in the free run.

    • cites [42] Farrer, 2013, Technology-based interventions for mental health in tertiary students: Systematic review, J Med Internet Res source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Eight systematic reviews evaluated digital platforms for mental health disorders, and none conducted meta-analysis.

    “We report findings from eight systematic reviews evaluating impact of digital platforms for mental health disorders. None of the included reviews conducted meta-analysis.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    The studies evaluating mental health interventions among adolescents were reported to be very heterogeneous, statistically, in their populations, interventions, and outcomes; hence, meta-analysis could not be conducted in most of the included reviews.

    “The studies evaluating mental health interventions among adolescents were reported to be very heterogeneous, statistically, in their populations, interventions, and outcomes; hence, meta-analysis could not be conducted in most of the included reviews.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The overview included 38 systematic reviews with an AMSTAR rating ranging between 7 and 11 and a median score of 8.

    “We report findings from a total of 38 systematic reviews with an AMSTAR rating ranging between 7 and 11 and a median score of 8.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    School-based targeted group-based interventions and CBT were effective in reducing depressive symptoms and anxiety.

    “Evidence from school-based interventions suggests that targeted group-based interventions and CBT were found to be effective in reducing depressive symptoms and anxiety.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Community-based creative activities had some positive effect on behavioral changes, self-confidence, self-esteem, levels of knowledge, and physical activity.

    “Community-based creative activities had some positive effect on behavioral changes, self-confidence, self-esteem, levels of knowledge, and physical activity.”
    Quote in the paperSubstantial claim

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

    Study design and conductnone given

    Data from each included review were extracted independently into a standardized form.

    “After retrieval of the full texts of all the reviews that met the inclusion/exclusion criteria, data from each review were extracted independently into a standardized form.”
    Quote in the paperNot a substantial claim

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

    Interpretationcitation

    Distinctive characteristics of low-income, urban schools, and nonschool environments were emphasized as potential explanations for the negative effects of selective externalizing programs in LMICs.

    “Distinctive characteristics of low-income, urban schools, and nonschool environments were emphasized as potential explanations for the findings [25].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25] Farahmand, 2011, School-based mental health and behavioral programs for low-income, urban youth: A systematic and meta-analytic review, Clin Psychol Sci Pract source

      Not checked in the free run.

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

    Study design and conductcitation

    The quality of included reviews was assessed and reported using the 11-point AMSTAR criteria.

    “We assessed and reported the quality of included reviews using the 11-point assessment of the methodological quality of systematic reviews criteria (AMSTAR) [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Shea, 2007, Development of AMSTAR: A measurement tool to assess the methodological quality of systematic reviews, BMC Med Res Methodol 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

    The abstracts (and full sources where abstracts were not available) were screened by two abstractors to identify systematic reviews adhering to the objectives, with disagreements resolved by a third reviewer.

    “The abstracts (and the full sources where abstracts are not available) were screened by two abstractors to identify systematic reviews adhering to our objectives. Any disagreements on selection of reviews between these two primary abstractors were resolved by the third reviewer.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The conclusions on exercise and self-esteem are based on a small number of trials reporting poolable data and lack long-term follow-up data.

    “However, these conclusions are based on several small number of trials reporting poolable data with lack of long-term follow-up data [44].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [44] Ekeland, 2004, Exercise to improve self-esteem in children and young people, Cochrane Database Syst Rev

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    There is considerable diversity in the design of trials, making it difficult to compare outcomes across studies.

    “However, there is considerable diversity in the design of trials, making it difficult to compare outcomes across studies [50].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50] Cox, 2012, Interventions for preventing relapse and recurrence of a depressive disorder in children and adolescents, Cochrane Database Syst Rev

      Not checked in the free run.

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

    Premisecitation

    Mental health disorders are linked in different ways and levels, exerting a dimensional effect between environmental, genetic factors and other biological mechanisms.

    “Mental health disorders are linked in different ways and levels, exerting a dimensional effect between environmental, genetic factors and other biological mechanisms [55], [56], [57].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [55] Polanczyk, 2009, Searching for the developmental origins of mental disorders, Revista de Psiquiatria do Rio Grande do Sul source

      Not checked in the free run.

    • cites [56] Lester, 2012, Behavioral epigenetics and the developmental origins of child mental health disorders, J Dev Orig Health Dis source

      Not checked in the free run.

    • cites [57] Swanson, 2008, Developmental origins of child mental health disorders, J Child Psychol Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Early childhood development interventions are low-cost interventions delivered in home and at school.

    “Evidence suggests that early childhood development (ECD) interventions including stimulation in early childhood, preschool level interventions, and ECD consultations have shown to be effective in improving health behaviors, conduct problems, and social skills and are also low-cost interventions delivered in home and at school [63], [64], [65], [66], [67].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [63] Baker-Henningham, 2014, The role of early childhood education programmes in the promotion of child and adolescent mental health in low-and middle-income countries, Int J Epidemiol source

      Not checked in the free run.

    • cites [64] Walker, 2006, Effects of psychosocial stimulation and dietary supplementation in early childhood on psychosocial functioning in late adolescence: Follow-up of randomised controlled trial, BMJ source

      Not checked in the free run.

    • cites [65] D'Onise, 2010, Does attendance at preschool affect adult health? A systematic review, Public Health source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The scope of the review was limited to interventions targeting adolescents and youth only.

    “One of the limitations of our review was that the scope of our review was limited to interventions targeting adolescents and youth only; however, mental health interventions take a life course perspective.”
    Quote in the paperSubstantial claim
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Each contradiction between two passages listed here was confirmed by an independent check.

  • Overall AMSTAR range excludes reported subgroup scores

    Minor

    The discussion gives an overall minimum AMSTAR score of 7, but the community-based subgroup reports scores as low as 4. An overall range covering all included reviews must include that score.

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Authors
Das, J. K., Salam, R. A., Lassi, Z. S., Khan, M. N., Mahmood, W., Patel, V., & Bhutta, Z. A.
Affiliations
  • Aga Khan University (PK)
  • The University of Adelaide (AU)
  • Ziauddin University (PK)
  • London School of Hygiene & Tropical Medicine (GB)
Corresponding author
Bhutta, Zulfiqar A.
ORCID
Venue
Journal of Adolescent Health
Publisher
Elsevier BV
Published
2016-10
Volume
59
Issue
4
Pages
S49-S60
ISSN
1054-139X (ISSN-L)
DOI
10.1016/j.jadohealth.2016.06.020
PMC
PMC5026677
OpenAlex
W2522424413
Semantic Scholar
cfd46f441f93ececdf6663ee72956fdac5b39632
Cited by
528
References
74
Citations by year
2026: 33 · 2025: 57 · 2024: 66 · 2023: 69 · 2022: 81 · 2021: 75 · 2020: 57 · 2019: 42 · 2018: 28 · 2017: 12 · 2016: 8
FWCI
4.37
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Adolescent Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • eCommons - AKU (Aga Khan University) (submittedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
  • Greater South Information System
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
adolescent mental health, mental health interventions, school-based intervention, community-based intervention, digital mental health platforms, family intervention, cognitive behavioral therapy, depression, anxiety, suicide prevention, eating disorders, bulimia nervosa, physical activity, self-esteem, body mass index, eating attitudes, creative activity, psychotherapy, remission, publication bias

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 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

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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