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

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.