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. 2022 May;67(5):336-350.
doi: 10.1177/07067437211070648. Epub 2022 Mar 11.

Effects of COVID-19 Mental Health Interventions Among Children, Adolescents, and Adults Not Quarantined or Undergoing Treatment Due to COVID-19 Infection: A Systematic Review of Randomised Controlled Trials

Olivia Bonardi  1 , Yutong Wang  1 , Kexin Li  1 , Xiaowen Jiang  1 , Ankur Krishnan  1 , Chen He  1 , Ying Sun  1 , Yin Wu  1   2 , Jill T Boruff  3 , Sarah Markham  4 , Danielle B Rice  1   5 , Ian Thombs-Vite  1 , Amina Tasleem  1   5 , Tiffany Dal Santo  1   5 , Anneke Yao  1   5 , Marleine Azar  1 , Branka Agic  6   7 , Christine Fahim  8 , Michael S Martin  9   10 , Sanjeev Sockalingam  6   11 , Gustavo Turecki  2   12 , Andrea Benedetti  13   14   15 , Brett D Thombs  1   2   5   13   14   16   17
Affiliations

Effects of COVID-19 Mental Health Interventions Among Children, Adolescents, and Adults Not Quarantined or Undergoing Treatment Due to COVID-19 Infection: A Systematic Review of Randomised Controlled Trials

Olivia Bonardi et al. Can J Psychiatry. 2022 May.

Abstract
in English, French

Objectives: Our objective was to assess the effects of mental health interventions for children, adolescents, and adults not quarantined or undergoing treatment due to COVID-19 infection.

Methods: We searched 9 databases (2 Chinese-language) from December 31, 2019, to March 22, 2021. We included randomised controlled trials of interventions to address COVID-19 mental health challenges among people not hospitalised or quarantined due to COVID-19 infection. We synthesized results descriptively due to substantial heterogeneity of populations and interventions and risk of bias concerns.

Results: We identified 9 eligible trials, including 3 well-conducted, well-reported trials that tested interventions designed specifically for COVID-19 mental health challenges, plus 6 other trials with high risk of bias and reporting concerns, all of which tested standard interventions (e.g., individual or group therapy, expressive writing, mindfulness recordings) minimally adapted or not specifically adapted for COVID-19. Among the 3 well-conducted and reported trials, 1 (N = 670) found that a self-guided, internet-based cognitive-behavioural intervention targeting dysfunctional COVID-19 worry significantly reduced COVID-19 anxiety (standardized mean difference [SMD] 0.74, 95% confidence interval [CI], 0.58 to 0.90) and depression symptoms (SMD 0.38, 95% CI, 0.22 to 0.55) in Swedish general population participants. A lay-delivered telephone intervention for homebound older adults in the United States (N = 240) and a peer-moderated education and support intervention for people with a rare autoimmune condition from 12 countries (N = 172) significantly improved anxiety (SMD 0.35, 95% CI, 0.09 to 0.60; SMD 0.31, 95% CI, 0.03 to 0.58) and depressive symptoms (SMD 0.31, 95% CI, 0.05 to 0.56; SMD 0.31, 95% CI, 0.07 to 0.55) 6-week post-intervention, but these were not significant immediately post-intervention. No trials in children or adolescents were identified.

Conclusions: Interventions that adapt evidence-based strategies for feasible delivery may be effective to address mental health in COVID-19. More well-conducted trials, including for children and adolescents, are needed.

Objectifs: Notre objectif était d’évaluer les effets des interventions de santé mentale pour les enfants, les adolescents, et les adultes qui ne sont pas en quarantaine ni ne subissent un traitement en raison d’une infection de la COVID-19.

Méthodes: Nous avons cherché dans 9 bases de données (2 en chinois) du 31 décembre 2019 au 22 mars 2021. Nous avons inclus des essais randomisés contrôlés des interventions pour aborder les problèmes de santé mentale de la COVID-19 chez les personnes non hospitalisées ni en quarantaine en raison d’une infection de la COVID-19. Nous avons fait un résumé descriptif des résultats à cause de l’hétérogénéité substantielle des populations et des interventions, et des préoccupations quant au risque d’un biais.

Résultats: Nous avons identifié 9 essais admissibles, notamment 3 essais bien menés et bien rapportés qui vérifiaient les interventions conçues spécifiquement pour les problèmes de santé mentale de la COVID-19, plus 6 autres essais comportant un risque de biais élevé et des préoccupations de rapport, et tous vérifiaient les interventions normales (p. ex., la thérapie individuelle ou de groupe, l’écriture expressive, les enregistrements de pleine conscience) minimalement adaptées ou non spécifiquement adaptées à la COVID-19. Parmi les 3 essais bien menés et bien rapportés, l’un (N = 670) a constaté qu’une intervention autoguidée, sur Internet, cognitivo-comportementale qui ciblait une possibilité dysfonctionnelle de la COVID-19 réduisait significativement l’anxiété de la COVID-19 (différence moyenne normalisée [DMN] 0,74, IC à 95% 0,58 à 0,90) et les symptômes de dépression (DMN 0,38, IC à 95% 0,22 à 0,55) chez les participants de la population générale suédoise. Une intervention téléphonique par des non-professionnels à des adultes âgé à la maison aux États-Unis (N = 240) et une intervention éducative de soutien modérée par les pairs pour les personnes ayant une rare condition auto-immune de 12 pays (N = 172) ont significativement amélioré l’anxiété (DMN 0,35, IC à 95% 0,09 à 0,60; DMN 0,31, IC à 95% 0,03 à 0,58) et les symptômes dépressifs (DMN 0,31, IC à 95% 0,05 à 0,56; DMN 0,31, IC à 95% 0,07 à 0,55) 6 semaines après l’intervention, mais celles-ci n’étaient pas significatives immédiatement après l’intervention. Aucun essai sur les enfants ou les adolescents n’a été identifié.

Conclusions: Les interventions qui adaptent les stratégies fondées sur des données probantes pour une prestation faisable peuvent être efficaces pour aborder la santé mentale dans la COVID-19. Il faut plus d’essais bien menés, notamment pour les enfants et les adolescents.

Keywords: COVID-19; coronavirus; living systematic review; mental health interventions; psychological outcomes.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors have completed the ICJME uniform disclosure form. SM, DBR, MSM, AB, and BDT declared that they were authors of an included trial. All other authors declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years. All authors declare no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1.
Figure 1.
Forest plot of effects on symptoms of anxiety among well-conducted and reported interventions designed to address COVID-19 mental health challenges.
Figure 2.
Figure 2.
Forest plot of effects on symptoms of depression among well-conducted and reported interventions designed to address COVID-19 mental health challenges.
See this image and copyright information in PMC

References

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