Effectiveness of interventions for anxiety and depression in children and young people: an umbrella review of meta-analyses

Abstract

Anxiety and depression are the most common mental health conditions for children and young people (CYP), yet treatment recommendations vary. Through this umbrella review (meta-analysis of meta-analyses), we aimed to identify the most effective interventions for CYP with anxiety and depression. We searched five electronic databases (PubMed, Medline, PsycINFO, Web of Science, ASSIA) from 1 October 2017 to 1 October 2022, with an updated search in PubMed from October 2022 to February 2026. Eligible meta-analyses reported on interventions for CYP (≤ 18 years) with anxiety or depression and/or associated symptoms. We identified 57 meta-analyses (569 effect sizes); of these, 43 (391 effects) were included in statistical analyses. For anxiety, psychosocial (d = -0.51, 95% CI [-0.56, -0.46], p < 0.001) and pharmacological (d = -0.67, 95% CI [-0.87, -0.46], p < 0.001) interventions appeared equally effective (t(5.50) = 0.64, p = 0.546). For depression, physical (d = -0.49, CI [-0.57, -0.40], p < 0.001) interventions appeared most effective, followed by psychosocial (d = -0.35, CI [-0.39, -0.32], p < 0.001), then pharmacological (d = -0.17, CI [-0.20, -0.15], p < 0.001), (F(2,151) = 11.44, p < 0.001). Psychosocial interventions were also associated with better outcomes for anxiety than for depression (MD = -0.14, CI [-0.21, -0.06], t(314.30) = -3.45, p < 0.001). As physical interventions and interpersonal therapy were the specific therapies associated with the greatest improvements in CYP’s depression, policymakers and practitioners should monitor emerging evidence in these areas when shaping treatment recommendations, and researchers should consider exploring their effectiveness for the treatment of anxiety. In general, future research should focus on understanding the effectiveness of the studied interventions in real clinical practice settings.