Psychological Interventions in Primary Care for Depressed and Anxious Youth: A Systematic Review and Meta-Analysis

AI Summary

Primary care psychological interventions showed large pre to post improvements (d = 0.77) and larger maintenance at follow up (d = 1.14) across trials.
Randomised controlled trials found small, nonsignificant between group effects versus controls, indicating interventions did not outperform control conditions.
Moderator analyses were nonsignificant; effects smaller for predominantly racially or ethnically minoritised youth and for depression outcomes, underscoring need for improvement.

TL;DR (AI Generated)

Moderator analyses were nonsignificant, but pre-post effects appeared smaller for studies with mostly racially/ethnically minoritized youth and for depression outcomes.

Primary care-based psychological interventions showed meaningful benefits for depressed and anxious youth but did not outperform controls, highlighting the need to improve their effects for maximum public health impact.

Basic summary

J Adolesc Health. 2026 Oct 27:S1054-139X(26)00371-X. doi: 10.1016/j.jadohealth.2026.08.030. Online ahead of print.

ABSTRACT

To characterize psychological interventions for depressed or anxious youth in primary care (PC), assess intervention effects and maintenance of treatment gains, and examine moderator and subgroup effects, we searched for randomized controlled trials (RCTs), quasi-experimental, and single-group design (SGD) studies evaluating psychological interventions delivered in PC to youth aged 2-21 years, published through October 2024. We extracted study, intervention, measure characteristics, and outcome data for measures of depression, anxiety, internalizing problems, suicidality, and functioning. We conducted meta-analyses using robust variance estimation to account for multiple outcomes per study and examined moderators including demographics, intervention characteristics, integration model, and target problem. Thirteen RCTs and 10 SGDs were included. Interventions had large pre-post effects (d = .77, 95% confidence interval [CI] [.52-1.03], k = 20), which strengthened at follow-up (d = 1.14, 95% CI [.65-1.63], k = 10) across RCTs and SGDs. However, intervention-control comparisons in RCTs revealed small, nonsignificant between-group effects. Moderator analyses were nonsignificant, but pre-post effects appeared smaller for studies with mostly racially/ethnically minoritized youth and for depression outcomes. Primary care-based psychological interventions showed meaningful benefits for depressed and anxious youth but did not outperform controls, highlighting the need to improve their effects for maximum public health impact.

PMID:42949699 | DOI:10.1016/j.jadohealth.2026.08.030

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