Universal and selective interventions to promote good mental health in young people: Systematic review and meta-analysis

Gonzalo Salazar de Pablo, Andrea De Micheli, Dorien H Nieman, Christoph U Correll, Lars Vedel Kessing, Andrea Pfennig, Andreas Bechdolf, Stefan Borgwardt, Celso Arango, Therese van Amelsvoort, Eduard Vieta, Marco Solmi, Dominic Oliver, Ana Catalan, Valeria Verdino, Lucia Di Maggio, Ilaria Bonoldi, Julio Vaquerizo-Serrano, Ottone Baccaredda Boy, Umberto ProvenzaniFrancesca Ruzzi, Federica Calorio, Guido Nosari, Benedetto Di Marco, Irene Famularo, Silvia Molteni, Eleonora Filosi, Martina Mensi, Umberto Balottin, Pierluigi Politi, Jae Il Shin, Paolo Fusar-Poli


Promotion of good mental health in young people is important. Our aim was to evaluate the consistency and magnitude of the efficacy of universal/selective interventions to promote good mental health. A systematic PRISMA/RIGHT-compliant meta-analysis (PROSPERO: CRD42018088708) search of Web of Science until 04/31/2019 identified original studies comparing the efficacy of universal/selective interventions for good mental health vs a control group, in samples with a mean age <35 years. Meta-analytical random-effects model, heterogeneity statistics, assessment of publication bias, study quality and sensitivity analyses investigated the efficacy (Hedges' g=effect size, ES) of universal/selective interventions to promote 14 good mental health outcomes defined a-priori. 276 studies were included (total participants: 159,508, 79,142 interventions and 80,366 controls), mean age=15.0 (SD=7.4); female=56.0%. There was a significant overall improvement in 10/13 good mental health outcome categories that could be meta-analysed: compared to controls, interventions significantly improved (in descending order of magnitude) mental health literacy (ES=0.685, p<0.001), emotions (ES=0.541, p<0.001), self-perceptions and values (ES=0.49, p<0.001), quality of life (ES=0.457, p=0.001), cognitive skills (ES=0.428, p<0.001), social skills (ES=0.371, p<0.001), physical health (ES=0.285, p<0.001), sexual health (ES=0.257, p=0.017), academic/occupational performance (ES=0.211, p<0.001) and attitude towards mental disorders (ES=0.177, p=0.006). Psychoeducation was the most effective intervention for promoting mental health literacy (ES=0.774, p<0.001) and cognitive skills (ES=1.153, p=0.03). Physical therapy, exercise and relaxation were more effective than psychoeducation and psychotherapy for promoting physical health (ES=0.498, p<0.001). In conclusion, several universal/selective interventions can be effective to promote good mental health in young people. Future research should consolidate and extend these findings.

Original languageEnglish
JournalEuropean Neuropsychopharmacology
Pages (from-to)28-39
Number of pages12
Publication statusPublished - 12.2020


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