Systematic review and meta-analysis of interventions to improve outcomes for parents or carers of children with anxiety and/or depression

Tsang, Anthony; Dahmash, Dania; Bjornstad, Gretchen; Rutter, Nikki; Nisar, Aleem; Horne, Francesca; Martin, Faith

Abstract

Question: Depression and anxiety are common among children and young people and can impact on the well-being of their parents/carers. Dominant intervention approaches include parent training; however, this approach does not directly address parents’ well-being. Our objective was to examine the effect of interventions, with at least a component to directly address the parents’ own well-being, on parents’ well-being outcomes, including stress, depression and anxiety.

Study selection and analysis: A systematic search was performed in the following: MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, Scopus, CENTRAL, Web of Science Core Collection (six citation indexes) and WHO ICTRP from inception to 30 December 2023. Interventions that aimed to support parents/carers managing the impact of their child’s/young person’s mental health were eligible. EPHPP (Effective Public Health Practice Project) was used to quality appraise the included studies. A meta-analysis of relevant outcomes was conducted.

Findings: Fifteen studies were eligible comprising 812 parents/carers. Global methodological quality varied. Seven outcomes (anxiety, depression, stress, burden, self-efficacy, quality of life and knowledge of mood disorders) were synthesised at post-intervention. A small reduction in parental/carer anxiety favouring intervention was indicated in one of the analyses (g=−0.26, 95% CI −0.44 to –0.09, p=0.02), when excluding an influential case. Three outcomes were synthesised at follow-up, none of which were statistically significant.

Conclusions: Interventions directly addressing the well-being for parents of children with anxiety and/or depression appear not to be effective overall. Clearer conceptualisation of factors linked to parental distress is required to create more targeted interventions. PROSPERO registration number: CRD42022344453.

Citation

Tsang, A., Dahmash, D., Bjornstad, G., Rutter, N., Nisar, A., Horne, F., & Martin, F. (2024). Systematic review and meta-analysis of interventions to improve outcomes for parents or carers of children with anxiety and/or depression. BMJ Open, 27(1), Article e301218. https://doi.org/10.1136/bmjment-2024-301218

• Journal Article Type: Article
• Acceptance Date: Aug 21, 2024
• Online Publication Date: Sep 25, 2024
• Publication Date: Sep 25, 2024
• Deposit Date: Oct 1, 2024
• Publicly Available Date: Oct 3, 2024
• Journal: BMJ Mental Health
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 1
• Article Number: e301218
• DOI: https://doi.org/10.1136/bmjment-2024-301218
• Keywords: Adult psychiatry, Depression, Anxiety disorders, Child & adolescent psychiatry
• Public URL: https://durham-repository.worktribe.com/output/2893082