School-based cognitive-behavioural interventions: A systematic review of effects and inequalities

摘要

Little is known about the impact of preventive interventions on inequalities in young people's mental health. We conducted a systematic review of mental health promotion interventions based on cognitive behavioural therapy (CBT) delivered in schools to young people aged 11-19. Meta-analysis of 17 high quality randomised controlled trials (RCTs) showed a reduction in symptoms of depression, which was generally short term. Interventions for people with clinical risk factors or existing symptoms were more effective, with benefits lasting up to six months. We also found that CBT may be more effective for young people from families with middle to high socioeconomic status (SES) than for those from low SES backgrounds. However, this finding was based on a meta-regression with only six studies. A lack of long-term follow-up data and a failure to report subgroup analyses prevented further conclusions being drawn about the effect of these types of interventions on mental health inequalities.