Background: An estimated 1 in 5 adolescents experience a mental health disorder each year; yet because of barriers to accessing and seeking care, most remain undiagnosed and untreated. Furthermore, the early emergence of psychopathology contributes to a lifelong course of challenges across a broad set of functional domains, so addressing this early in the life course is essential. With increasing digital connectivity, including in low- and middle-income countries, digital health technologies are considered promising for addressing mental health among adolescents and young people. In recent years, a growing number of digital health interventions, including more than 2 million web-based mental health apps, have been developed to address a range of mental health issues. Objective: This review aims to synthesize the current evidence on digital health interventions targeting adolescents and young people with mental health conditions, aged between 10-24 years, with a focus on effectiveness, cost-effectiveness, and generalizability to low-resource settings (eg, low- and middle-income countries). Methods: We searched MEDLINE, PubMed, PsycINFO, and Cochrane databases between January 2010 and June 2020 for systematic reviews and meta-analyses on digital mental health interventions targeting adolescents and young people aged between 10-24 years. Two authors independently screened the studies, extracted data, and assessed the quality of the reviews. Results: In this systematic overview, we included 18 systematic reviews and meta-analyses. We found evidence on the effectiveness of computerized cognitive behavioral therapy on anxiety and depression, whereas the effectiveness of other digital mental health interventions remains inconclusive. Interventions with an in-person element with a professional, peer, or parent were associated with greater effectiveness, adherence, and lower dropout than fully automatized or self-administered interventions. Despite the proposed utility of digital interventions for increasing accessibility of treatment across settings, no study has reported sample-specific metrics of social context (eg, socioeconomic background) or focused on low-resource settings. Conclusions: Although digital interventions for mental health can be effective for both supplementing and supplanting traditional mental health treatment, only a small proportion of existing digital platforms are evidence based. Furthermore, their cost-effectiveness and effectiveness, including in low- and middle-income countries, have been understudied. Widespread adoption and scale-up of digital mental health interventions, especially in settings with limited resources for health, will require more rigorous and consistent demonstrations of effectiveness and cost-effectiveness vis-à-vis the type of service provided, target population, and the current standard of care.

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关于青少年数字心理健康干预的证据：系统概述

背景：每年估计有五分之一的青少年患有精神疾病。然而，由于获得和寻求护理的障碍，大多数人仍未得到诊断和治疗。此外，心理病理学的较早出现在整个功能域中造成了一生的挑战，因此在生命历程中尽早解决这一问题至关重要。随着数字连接的不断增加，包括在低收入和中等收入国家，数字健康技术被认为有希望解决青少年和年轻人的心理健康问题。近年来，已经开发了越来越多的数字健康干预措施，包括超过200万个基于Web的心理健康应用程序，以解决一系列心理健康问题。客观的：这篇综述旨在综合针对年龄在10-24岁之间的青少年和患有精神疾病的年轻人的数字健康干预措施的现有证据，重点是有效性，成本效益和对低资源环境（例如低-和中等收入国家）。方法：我们在2010年1月至2020年6月之间搜索MEDLINE，PubMed，PsycINFO和Cochrane数据库，以系统评价和荟萃分析针对针对10-24岁青少年的数字心理健康干预措施。两位作者独立筛选研究，提取数据并评估评论的质量。结果：在此系统概述中，我们包括18个系统评价和荟萃分析。我们发现有关计算机认知行为疗法对焦虑和抑郁的有效性的证据，而其他数字心理健康干预措施的有效性尚无定论。与完全自动化或自行管理的干预措施相比，对具有专业人士，同伴或父母的亲临元素的干预措施具有更高的效力，依从性和更低的辍学率。尽管提出了数字干预措施来提高跨场所治疗可及性的建议效用，但尚无研究报告针对社会背景（例如，社会经济背景）的样本特定指标或针对资源匮乏的场所进行研究。结论：尽管数字心理健康干预可以有效地补充和取代传统的心理健康治疗，但现有数字平台中只有一小部分基于证据。此外，对它们的成本效益和有效性，包括在低收入和中等收入国家中，都没有得到充分研究。数字心理健康干预措施的广泛采用和扩大规模，尤其是在卫生资源有限的环境中，将需要针对所提供的服务类型，目标人群和服务对象，更严格，更一致地证明其有效性和成本效益。当前的护理标准。