Purpose

This meta-analysis aimed to determine the effect of interventions targeting multiple modifiable health behaviors (i.e., physical activity/sedentary behaviors, nutrition/diet, sleep, substance use) on depression and anxiety in young people.

Methods

A search of electronic databases from inception until May 2020 was conducted. Randomized controlled trials (RCTs) that explicitly targeted at least two modifiable health behaviors, measured anxiety or depression at baseline and after intervention using a validated instrument, and included participants with an average age between 12 and 25 years were included. The effect of interventions was synthesized using random effects meta-analysis.

Results

A total of 14 RCTs reporting on depression and six RCTs reporting on anxiety were included in the quantitative synthesis. Results showed that although interventions targeting multiple modifiable health behaviors did not produce significant reductions in symptoms of depression ($\overline{g}$ = -.16, 95% confidence interval [CI] = [-.34, .02], 95% prediction interval [PI] = [-.80, .48], very low certainty evidence) or anxiety ($\overline{g}$ = -.55, 95% CI = [-1.36, .26], 95% PI = [-3.48, 2.83], very low certainty evidence) across all young people, there was a significant difference in the effect of interventions on depression based on intervention type (Q = 8.37, df = 2, p = .012). Specifically, interventions targeting multiple modifiable health behaviors delivered to groups of young people with an elevated risk of depression had a favorable effect ($\overline{g}$ = -.28, 95% CI = [-.52, -.05], 95% PI = [-1.04, .47]) on symptoms of depression compared with controls.

Conclusions

Although not universally effective, this meta-analysis establishes the potential efficacy of targeted interventions aiming to improve multiple modifiable health behaviors to address depression in young people at elevated risk of depression. More research is needed to understand the effect of such interventions on symptoms of anxiety in young people.

中文翻译：

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针对多种可改变健康行为的干预措施对年轻人焦虑和抑郁症状的影响：随机对照试验的荟萃分析

目的

这项荟萃分析旨在确定针对多种可改变的健康行为（即身体活动/久坐行为、营养/饮食、睡眠、物质使用）的干预措施对年轻人抑郁和焦虑的影响。

方法

对从开始到 2020 年 5 月的电子数据库进行了搜索。随机对照试验 (RCT) 明确针对至少两种可改变的健康行为，在基线和使用经过验证的仪器进行干预后测量焦虑或抑郁，并纳入平均年龄在 12 至 25 岁之间的参与者。使用随机效应荟萃分析综合了干预措施的效果。

结果

共有 14 项关于抑郁症的 RCT 和 6 项关于焦虑的 RCT 被纳入定量综合。结果表明，尽管针对多种可改变的健康行为的干预措施并没有显着减轻抑郁症状（$\overline{G}$ = -.16, 95% 置信区间 [CI] = [-.34, .02], 95% 预测区间 [PI] = [-.80, .48]，非常低确定性证据）或焦虑（$\overline{G}$ = -.55, 95% CI = [-1.36, .26], 95% PI = [-3.48, 2.83]，非常低确定性证据）在所有年轻人中，干预措施对抑郁症的影响存在显着差异基于干预类型（Q = 8.37，df = 2，p  = .012）。具体来说，针对抑郁症风险较高的年轻人群体提供的针对多种可改变健康行为的干预措施具有良好的效果。$\overline{G}$ = -.28, 95% CI = [-.52, -.05], 95% PI = [-1.04, .47]) 与对照组相比抑郁症状。

结论

尽管并非普遍有效，但这项荟萃分析确定了旨在改善多种可改变的健康行为以解决抑郁症风险较高的年轻人的抑郁症的针对性干预措施的潜在功效。需要更多的研究来了解此类干预措施对年轻人焦虑症状的影响。