The effectiveness of psychological interventions for loneliness: A systematic review and meta-analysis.

Chronic loneliness is associated with a range of mental health difficulties. Previous theory and research indicate that psychological interventions show promise for reducing loneliness, however, there have been no systematic reviews or meta-analyses to ascertain the efficacy of these interventions across the lifespan. The aim of this study was to synthesise, meta-analyse and explore the heterogeneity in RCTs of psychological interventions for loneliness in order to establish their efficacy. Five databases (Ovid Embase, Ovid Medline, PsycINFO, Web of Science and CINAHL) were systematically searched in order to identify relevant studies. Included studies were required to be peer-reviewed RCTs examining psychological interventions for loneliness. Two independent coders examined the abstracts of the 3973 studies and 103 full texts, finding 31 studies that met inclusion criteria, 28 of which contained sufficient statistical information to be included in the meta-analysis. The quality of included studies was assessed using the Cochrane Risk of Bias Tool. The 31 studies (N = 3959) that were included in the systematic review were conducted with participants from a diverse range of cultures, age groups and populations. The interventions were of mixed quality and were mostly face to face, group-based and delivered weekly. The most common type of intervention was Cognitive Behavioural Therapy (CBT). 28 studies (N = 3039) were included in a meta-analysis which found that psychological interventions significantly reduced loneliness compared to control groups, yielding a small to medium effect size (g = 0.43). Subgroup analysis and meta-regressions were conducted in order to explore heterogeneity and found that type of psychological intervention was approaching significance as a moderator of the effectiveness of psychological interventions for loneliness. In conclusion, psychological interventions for loneliness across the lifespan are effective. This finding should inform policy makers, researchers and clinicians going forward, especially in the context of increased loneliness due to the COVID-19 pandemic. There was considerable heterogeneity in the effectiveness of the interventions, suggesting that future research should also explore what works for whom and consider personalising psychological treatment.

Practitioner Review: Unguided and guided self-help interventions for common mental health disorders in children and adolescents: a systematic review and meta-analysis.

Mental health problems are common in children and adolescents, yet evidence-based treatments are hard to access. Self-help interventions can increase such access. The aim of this paper was to conduct a systematic review and meta-analysis of the use of guided and unguided self-help for children and young people with symptoms of common mental health disorders. In contrast to previous reviews of self-help in children, all types of self-help and multiple mental health disorders were investigated in order to increase power to investigate potential moderators of efficacy. Importantly, studies with control arms as well as those comparing against traditional face-to-face treatments were included. Fifty studies (n = 3396 participants in self-help/guided self-help conditions) met the inclusion criteria. Results demonstrated a moderate positive effect size for guided and unguided self-help interventions when compared against a control group (n = 44; g = 0.49; 95% CI: 0.37 to 0.61, p < .01) and a small but significant negative effect size when compared to other therapies (n = 15; g = -0.17; 95% CI: -0.27 to -0.07, p < .01). Few potential moderators had a significant effect on outcome. Most comparisons resulted in significant heterogeneity and therefore results are interpreted with caution.

Lack of uniformity in the clinical assessment of children with lipomyelomeningocele: a review of the literature and recommendations for the future.

OBJECTIVE: An objective clinical assessment tool whose accuracy and reproducibility can be validated is essential for the initial evaluation, selection for surgery and surveillance of children with lipomyelomeningocele (LMMC). The aim of this study was to analyse the large number of such tools presently in use and recommend an alternative that could lead to greater uniformity between different series and greater consistency in the assessment of individual patients. METHODS: A systematic review of the literature between January 1980 and December 2010 was undertaken and details of how the children in each series were assessed and the degree to which age was taken into account recorded. RESULTS: Thirty-six different assessment tools were used in 40 different publications. None was validated in all aspects. Objective measures were used most in urological assessments but rarely in other domains. Age-specific assessments were used in only 10 % of publications. CONCLUSION: This study confirmed that the assessment tools for evaluation of children with LMMC are inconsistent, often vague and poorly validated. This compromises the ability of clinicians who care for them to compare studies across centres for both treated and untreated children. We have sought to highlight those criteria which are relevant, measurable and reproducible and which might be combined into an easily applied assessment.