PREVENTING CHILD AND ADOLESCENT ANXIETY DISORDERS: OVERVIEW OF SYSTEMATIC REVIEWS
Corresponding Author
Kathryn Bennett Ph.D.
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Correspondence to: Kathryn Bennett, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main St. W., HSC 3V43D, Hamilton, Ontario, Canada L8S 4K1. E-mail: [email protected]Search for more papers by this authorKatharina Manassis M.D.
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorStephanie Duda M.Sc.
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Search for more papers by this authorAlexa Bagnell M.D.
Department of Psychiatry, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
Search for more papers by this authorGail A. Bernstein M.D.
Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
Search for more papers by this authorE. Jane Garland M.D.
Department of Psychiatry, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
Search for more papers by this authorLynn D. Miller Ph.D.
Department of Educational and Counselling Psychology and Special Education, University of British Columbia, Vancouver, British Columbia, Canada
Search for more papers by this authorAmanda Newton Ph.D.
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
Search for more papers by this authorLehana Thabane Ph.D.
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Search for more papers by this authorPamela Wilansky Ph.D.
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorCorresponding Author
Kathryn Bennett Ph.D.
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Correspondence to: Kathryn Bennett, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main St. W., HSC 3V43D, Hamilton, Ontario, Canada L8S 4K1. E-mail: [email protected]Search for more papers by this authorKatharina Manassis M.D.
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorStephanie Duda M.Sc.
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Search for more papers by this authorAlexa Bagnell M.D.
Department of Psychiatry, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
Search for more papers by this authorGail A. Bernstein M.D.
Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
Search for more papers by this authorE. Jane Garland M.D.
Department of Psychiatry, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
Search for more papers by this authorLynn D. Miller Ph.D.
Department of Educational and Counselling Psychology and Special Education, University of British Columbia, Vancouver, British Columbia, Canada
Search for more papers by this authorAmanda Newton Ph.D.
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
Search for more papers by this authorLehana Thabane Ph.D.
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Search for more papers by this authorPamela Wilansky Ph.D.
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorContract grant sponsor: Canadian Institutes of Health Research; Contract grant number: KA1-119793.
Abstract
Overviews of systematic reviews (OSRs) provide rapid access to high quality, consolidated research evidence about prevention intervention options, supporting evidence-informed decision-making, and the identification of fruitful areas of new research. This OSR addressed three questions about prevention strategies for child and adolescent anxiety: (1) Does the intervention prevent anxiety diagnosis and/or reduce anxiety symptoms compared to passive controls? (2) Is the intervention equal to or more effective than active controls? (3) What is the evidence quality (EQ) for the intervention? Prespecified inclusion criteria identified systematic reviews and meta-analyses (2000–2014) with an AMSTAR quality score ≥ 3/5. EQ was rated using Oxford evidence levels EQ1 (highest) to EQ5 (lowest). Three reviews met inclusion criteria. One narrative systematic review concluded school-based interventions reduce anxiety symptoms. One meta-analysis pooled 65 randomized controlled trials (RCTs; any intervention) and reported a small, statistically significant reduction in anxiety symptoms and diagnosis incidence. Neither review provided pooled effect size estimates for specific intervention options defined by type (i.e., universal/selective/indicated), intervention content, or comparison group (i.e., passive/active control), thus precluding EQ ratings. One meta-analysis pooled trials of vigorous exercise and reported small, nonstatistically significant reductions in anxiety symptoms for comparisons against passive and active controls (EQ1). Better use of primary studies in meta-analyses, including program-specific pooled effect size estimates and network meta-analysis is needed to guide evidence-informed anxiety prevention program choices. RCTs of innovative community/primary care based interventions and web-based strategies can fill knowledge gaps.
Supporting Information
Disclaimer: Supplementary materials have been peer-reviewed but not copyedited.
| Filename | Description |
|---|---|
| da22400-sup-0001-SuppMat.zip11.1 MB | Supporting Information 1. Medline—OVID Search Strategy Supporting Information 2. List of Excluded Reviews |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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