Systematic review and meta-analysis of psychological interventions for depression symptoms in young people with long-term physical health conditions.

OBJECTIVES

Depression is prevalent, impairing, and detrimental to health. The objective of this systematic review and meta-analysis was to assess the efficacy of psychological interventions for decreasing symptoms of depression among young people with long-term physical health conditions.

METHODS

CENTRAL, MEDLINE, PsycINFO, PubMed, clinicaltrials.gov, and WHO ICTRIP were searched through July 1, 2023. Selection criteria were randomized controlled trials of psychological interventions targeting depression symptoms among people ≤29 years diagnosed with long-term physical health conditions. Risk of bias was assessed using the Cochrane RoB version 2 tool. Outcome data were analyzed using fixed-effects models. Pooled standardized mean difference (SMD) between experimental and control was calculated using an inverse variance approach with a linear model. Heterogeneity was assessed by χ2 test on Cochran's Q statistic and quantified with I2 statistic.

RESULTS

Results included six trials (N = 376) of 11- to 18-year-olds (Mfemale=80%), recruited from pediatric clinics in the United States. Two of six eligible studies had an inclusion criterion related to elevated depression symptoms; the remainder included youth with heterogeneous depression levels. Psychological interventions were more efficacious than controls for reducing depression symptoms and functional disability. Pooled SMD for depression symptoms was -.30 (-.51, -.10), with a significant overall effect (Z = 2.92, p = .004). Pooled SMD for functional disability was -.35 (-.66, -.05), with a significant overall effect (Z = 2.28, p = .02). Moderate study heterogeneity was noted in two study outcomes.

CONCLUSIONS

Psychological interventions reduce depression symptoms and functional disability among youth with long-term physical health conditions. Research is needed to elucidate participant/trial characteristics contributing to outcomes.