Effectiveness of school-based depression prevention interventions: An overview of systematic reviews with meta-analyses on depression outcomes

J Consult Clin Psychol. 2025 Apr;93(4):194-212. doi: 10.1037/ccp0000930. Epub 2024 Dec 30.

ABSTRACT

OBJECTIVE: This overview aims to summarize systematic reviews with meta-analyses estimating the effects of school-based depression prevention interventions on depression outcomes.

METHOD: We conducted electronic searches (Australian Education Index, Google Scholar, ProQuest Dissertations and Theses A&I, Pubmed, Social Science Premium Collection), hand-searched key journals, and conducted backward and forward citation chasing to identify eligible reviews. Two reviewers independently screened records, assessed full texts for eligibility, and collected data. We narratively summarized review findings and quantified the overlap of primary studies across systematic reviews using Corrected Covered Area.

RESULTS: We identified 29 eligible systematic reviews with 472 included primary studies overall (Mdn = 35, range = 4-137). Only 177 primary studies (37%) were included in more than one review (Corrected Covered Area = 6%). We rated all reviews as low (10%) or critically low (90%) quality on A MeaSurement Tool to Assess systematic Reviews-2, and most reviews (86%) at high risk of bias on Risk Of Bias In Systematic reviews. Reviews mostly suggest school-based depression prevention interventions may have modest average positive impacts on depression-related outcomes-both overall and for specific stages of prevention, school levels and student ages, and specific program manuals and intervention types. However, some reviews did not detect effects, and most reviews noted concerns about primary study quality, heterogeneity, and publication bias in this body of evidence.

CONCLUSIONS: School-based depression prevention interventions may be beneficial on average, though existing reviews have important methodological limitations. A living systematic review conducted according to methodological best practice could provide timely, relevant, and rigorous evidence for educational decision making. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40126559 | DOI:10.1037/ccp0000930