Depression and anxiety are often first experienced during childhood and adolescence, and interest in the prevention of these disorders is growing. The focus of this review was to assess the effectiveness of psychological prevention programs delivered in schools, and to provide an update to our previous review from five years ago (Werner-Seidler, Perry, Calear, Newby, & Christensen, 2017). Three electronic databases were systematically searched for published articles of randomised controlled trials (RCTs) evaluating the efficacy of school-based prevention programs until October 2020. There were 130 articles that met inclusion criteria, representing 118 unique trials and 45,924 participants. Small between-group effect sizes for depression (g = 0.21) and anxiety (g = 0.18) were detected immediately post-intervention. Subgroup analyses suggested that targeted prevention programs (for young people with risk factors or symptoms) were associated with significantly greater effect sizes relative to universal programs for depression, which was confirmed by meta-regression. There was also some evidence that external providers conferred some benefit over school-staff delivered programs. Overall, study quality was moderate and no association between risk of bias and effect size was detected. School-delivered psychological prevention programs have small effects in reducing symptoms of depression and anxiety. Refinement of these programs, and knowledge about how they can be sustainably delivered in schools beyond the trial period is now needed for population-level preventive effects.

Systematic Review Registration Number: PROPSERO - CRD42020188323

抑郁和焦虑通常在童年和青春期首次出现，人们对预防这些疾病的兴趣正在增长。本次审查的重点是评估学校提供的心理预防计划的有效性，并对我们五年前的先前审查进行更新（Werner-Seidler、Perry、Calear、Newby 和 Christensen，2017 年）。系统搜索了三个电子数据库，以查找到 2020 年 10 月评估校本预防计划有效性的随机对照试验 (RCT) 已发表文章。共有 130 篇文章符合纳入标准，代表 118 项独特试验和 45,924 名参与者。抑郁 ( g  = 0.21) 和焦虑 ( g = 0.18) 在干预后立即检测到。亚组分析表明，相对于抑郁症的普遍计划，有针对性的预防计划（针对具有危险因素或症状的年轻人）与显着更大的效果相关，这通过元回归得到证实。还有一些证据表明，外部提供者比学校教职员工提供的项目带来了一些好处。总体而言，研究质量中等，未检测到偏倚风险与效应大小之间存在关联。学校提供的心理预防计划对减轻抑郁和焦虑症状的影响很小。现在需要改进这些计划，并了解如何在试验期过后在学校可持续地提供这些计划，以实现人口水平的预防效果。

系统审查注册号： PROPSERO - CRD42020188323