{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:50:28Z","timestamp":1787021428334,"version":"build-2736575974"},"update-to":[{"DOI":"10.12688\/f1000research.123561.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000}}],"reference-count":28,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    Background Young people with mental disorders should be offered evidence-based treatments. In 2018, we developed a national evidence portal in Norway providing access to living evidence summaries. This work has been an important contribution to mental health care in Norway but is also a rich data source for exploring the existing research. At the time of this study, eight overviews of overviews (OoO) were published addressing the effects of treatments for attention deficit \/ hyperactivity disorder (ADHD), anxiety, depression, bipolar disorder, psychosis, obsessive compulsive disorder, self-harm and trauma \/ post-traumatic stress disorder. The objective of this study was to do a secondary analysis of this evidence to describe the state-of-the art in this field, and to map:\n                    <ns3:list list-type=\"bullet\">\n                      <ns3:list-item>\n                        <ns3:p>treatments evaluated for each diagnostic group and the longest time of follow-up<\/ns3:p>\n                      <\/ns3:list-item>\n                      <ns3:list-item>\n                        <ns3:p>treatment comparisons evaluated for more than one diagnostic group<\/ns3:p>\n                      <\/ns3:list-item>\n                    <\/ns3:list>\n                    Methods We performed a mapping review. Data extraction was performed independently by two authors. All data was entered into Excel. Unique treatment comparisons were visualised in Sunburst diagrams. The longest time of follow-up and treatments evaluated across diagnostic groups were reported in descriptive tables. Results We identified 200 treatment comparisons including a wide variety of interventions. Some diagnoses are treated mostly with pharmaceutical therapies (such as bipolar disorder) or psychological therapy alone or in combination (such as anxiety and psychosis). Others are treated with a broader spectrum of therapeutic approaches (such as depression and ADHD). The evidence supporting most treatments is of low to very low certainty. Ten percent of the comparisons included follow-up assessments beyond 12 months. Cognitive behavioural therapy, dialectic behavioural therapy, physical activity and mindfulness interventions were effective across populations. Conclusions The evidence supporting treatment of mental disorders in young people has important limitations. Future research efforts should address these evidence gaps.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.123561.2","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T05:50:10Z","timestamp":1746683410000},"page":"2","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mental health interventions targeting children and young people: A mapping review of interventions, follow-up, and evidence gaps"],"prefix":"10.12688","volume":"12","author":[{"given":"Astrid","family":"Dahlgren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7514-1743","authenticated-orcid":false,"given":"Ingrid","family":"Borren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4369-4175","authenticated-orcid":false,"given":"Brynhildur","family":"Axelsdottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Elvs\u00e5shagen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karianne Hammerstr\u00f8m","family":"Nilsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"ref2","doi-asserted-by":"publisher","first-page":"7-20","DOI":"10.31887\/DCNS.2009.11.1\/krmerikangas","article-title":"Epidemiology of mental disorders in children and adolescents.","volume":"11","author":"K Merikangas","year":"2009","journal-title":"Dialogues Clin. 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Dataset."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/12-2\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/12-2\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/12-2\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:49:09Z","timestamp":1770292149000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/12-2\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,8]]},"references-count":28,"URL":"https:\/\/doi.org\/10.12688\/f1000research.123561.2","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.123561.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.181260.r449641","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.181260.r449641","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,8]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/12-2\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.135677.r199270, Hiran Thabrew, University of Auckland, Auckland Hospital, Auckland, 06 Sep 2023, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/12-2\/v1#referee-response-199270","order":0,"name":"referee-response-199270","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Astrid Dahlgren<\/b>; \n<i>Posted: 28 Apr 2025<\/i>; Peer-reviewer .1 Hiran Thabrew  My main concern about this paper is the limitation of included studies to those which had used an active comparator (not placebo). This is despite the source OoOs including studies with any type of comparator:  \n<b>Author response:<\/b> This limitation was only for pharmaceutical therapy compared with placebo- not other mental health interventions. The reason for this was that the evidence base for this review was a series of overviews of systematic reviews (OoO) conducted as part of the development of a national evidence portal commissioned by the Norwegian directorate of health to inform clinical practice in Norway as part of the launching of Clinical Pathways mental health for children and young people. In this context the relevance of placebo-controlled pharmaceutical studies was judged by policymakers and mental health practitioners to be low as pharmaceutical treatment are only advised to be considered when other treatments are found not to be effective. Therefore, the focus was on pharmaceutical treatments compared to other active treatments used alone or in combination with other treatments. As the peer-reviewer rightly states, the OoOs &nbsp;searched for and included placebo-controlled comparisons for pharmaceutical therapies, but the findings of these comparisons were only reported descriptively as supplemental material in the OoOs without full data extraction and GRADE-assessments. In regard to the peer- reviewer\u2019s comments about Methylphenidate, we agree that this is a treatment of relevance to clinical practice and is also one of the most commonly used pharmaceutical treatments in Norway for young people under 18 with ADHD. Methylphenidate is included in the review as 1 of 57 unique treatments for ADHD in figure 2: Unique intervention categories evaluated for attention deficit \/ hyperactivity disorder (ADHD). Table 5 reports treatment comparisons that have been tested for more than 1 diagnosis and on a higher aggregated level as evaluated in the systematic reviews (in this case \u201cstimulants\u201d or in the broader term \u201cpharmacological treatment\u201d). Where type of pharmaceutical treatment is reported in the systematic reviews this has been described by us in the notes to table 5. See for example under \u201cCombination therapies\u201d. We hope this helps to clarify the peer-reviewers concerns.  2. Please explain the colors and question marks used in Table 5. \n<b>Author response:<\/b> Explanation for colour-coding is as follows: Yellow is used for low certainty, red for very low certainty and green for moderate certainty. &nbsp;A sentence has been added to the manuscript.","URL":"https:\/\/f1000research.com\/articles\/12-2\/v2#referee-comment-13813","order":1,"name":"referee-comment-13813","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.135677.r367865, Heather Eileen Menzies Munthe-Kaas, Norwegian Institute of Public Health, Oslo, 22 Mar 2025, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/12-2\/v1#referee-response-367865","order":2,"name":"referee-response-367865","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Astrid Dahlgren<\/b>; \n<i>Posted: 28 Apr 2025<\/i>; \n<b>Peer-reviewer 2 Heather Eileen Menzies Munthe-Kaas<\/b>  Terminology \u2013 in this manuscript the terms \u201cmental health\u201d mental illness\u201d and \u201cmental disorders\u201d are used. Best to choose one, and consider carefully the term \u201cmental illness\u201d since ADHD at least, is not considered a mental illness, but rather a neurodevelopmental disorder (paragraph 2)&nbsp;&nbsp;\n<b>Author response: <\/b>This is a very valid point, and we agree that this should have been more carefully formulated. ADHD is indeed a neurodevelopment disorder of which some people with this condition will need therapy, training or support.&nbsp;We have now used \u201cmental health\u201d and \u201cmental disorder\u201d throughout the manuscript which are terminology that encompass both mental illness and neurodevelopment disorders. Consider acknowledging that this group of conditions are not in the same category. For example, ADHD (neurodevelopmental disorder) and anxiety, depression, bipolar disorder (mood disorders) and the reason for grouping them in this paper (which is not problematic in itself, and is probably representative of the literature, but needs acknowledgment of here). The introduction would benefit from one or two additional sentences about why these specific mental health and neurodevelopmental disorders are included (e.g., they are grouped in existing reviews and OoOs).&nbsp;\n<b>Author response:&nbsp;<\/b>The diagnostic groups included in this paper are under the common descriptor \u201cmental disorder\u201d and is defined by the World Health Organisation as \u201ca clinically significant disturbance of an individual\u2019s cognition, emotional regulation, or behaviour\u201d https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/mental-disorders.&nbsp;Although the etiology of the included disorders may be different, they are in many cases associated with distress or impairment in important areas of functioning and are often treated for their symptoms by methodologies with shared epistemology and by the same services and professionals. To make this clearer we have added a sentence to the introduction. Decision making only has a \u201c-\u201c when it is used as an adjective (e.g., decision-making tools)\n<b>Author response:<\/b>&nbsp;Thank you, this has been corrected. Consider using the term \u201cuser\u201d or \u201cclient\u201d instead of \u201cpatient\u201d&nbsp;\n<b>Author response:<\/b>&nbsp;We have changed \u201cpatient groups\u201d to diagnostic groups to be more precise and have used \u201cpatient\u201d where patient rights or roles are described. Define \u201cliving evidence summaries\u201d.&nbsp;\n<b>Author response:&nbsp;<\/b>A definition has been added to the manuscript.&nbsp; Explain why \u201coverviews of systematic reviews\u201d is shortened to \u201cOoOs\u201d (e.g., also referred to as overview of overviews; OoOs). Also can make more clear that the authors have also conducted and published the included OoOs.&nbsp;\n<b>Author response:&nbsp;<\/b>We have now rephased to using overviews of overviews throughout the manuscript. We have stated under the sub-heading: \u201cThe evidence: Inclusion criteria and search strategy \u201c that we authored the OoOs. Missing at the end of the introduction a sentence situating this work in the greater picture of work and what gap this study is addressing.&nbsp;\n<b>Author response: <\/b>This has now been added.   \n<b>Methods:<\/b>  Overall this section could use a bit more details and explanation as well as structure to better distinguish from what was done during OoOs and what is done here (and what was carried over from original SRs) perhaps using a flow chart or diagram to show information\/data flow?&nbsp;\n<b>Author response:&nbsp;<\/b>The flowchart of data is shown in Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. We agree that this section needed to be restructured and have now done so to accommodate the peer-reviewers feedback.&nbsp; Since the most recent of the OoOs is from February 2021, and this is a very active research field, is this mapping review really the best overview of all treatments (and longest follow up)? Can you explain this approach to summarizing and mapping the evidence when there is likely a large chunk of systematic reviews from the last 4-5 years missing here? Could you also write more about how far back the included SRs in the included OoOs go back to?&nbsp;\n<b>Author response: <\/b>Our mapping review was first published in this journal in January 2023, and as stated in the manuscript, the data collection took place between September 2021 and December 2022. Thus, our report was published very briefly after the data collection was completed.&nbsp;The OoOs we used for our synthesis were considered up-to date at the point of our data collection (these were either new first editions or had been semi-annually or annually updated) at the time. The database from which the OoO include their systematic reviews were updated monthly. To be included, a systematic review should be newer than five years but would not be replaced unless a systematic review considered to be more updated was identified- following the principle of the best available evidence to inform practice.&nbsp;All literature reviews suffer the risk of being outdated once they are published. Judgements about the relevance of the evidence and to what extent new research would change the conclusions is dependent on the research question, the intended use and the robustness of the existing evidence.&nbsp;At the time of the publication of this paper, we were interested in exploring the diversity of treatment interventions for the included mental disorders but also to describe the follow-up times in the existing studies. We also wanted to provide an overview of the effects of these interventions and their associated certainty of the evidence across diagnostic groups.&nbsp;Our conclusion is based on a very large evidence base of 116 systematic reviews including 200 treatment comparisons. Even though we expect new primary studies to have been published from the time our review was first published- we are confident that our conclusions have not been changed substantially:  Some mental illnesses are treated mostly with pharmacological, or psychological therapies or a combination of these. Some are treated with a broader spectrum of therapies.&nbsp; The evidence supporting most treatments is of low to very low certainty.&nbsp; Very few treatment evaluations include follow-up assessments beyond 12 months.&nbsp; Some treatments are effective across populations, such as cognitive behavioral therapy&nbsp;   Data collection \u2013 could you describe sunburst diagrams and what exactly will be presented in them?&nbsp;\n<b>Author response: <\/b>A sentence has been added to improve clarity.&nbsp; The members of this research team made the OoO GRADE assessments? How were the GRADE assessments taken from the original systematic reviews used?&nbsp;\n<b>Author response: <\/b>Yes, one or more of the author team was involved in the OoO published in the evidence portal. We extracted the GRADE-judgements for the primary outcome (in other words- we did not make any further assessments as part of this mapping review considering GRADE). In the methods section we also state that: The primary outcome was conceptualised as overall symptomatology associated with the relevant condition, such as anxiety symptoms for those with anxiety and depression symptoms for those with depression. In cases where the same outcome was assessed using different outcome measures, we extracted the outcome with the longest follow up and highest certainty.\n<sup> <\/sup>If a review did not report findings on overall symptoms, we reported other symptoms as proxy, for example inattention in treatment of ADHD when total symptoms were not available.   \n<b>Results<\/b>  Table 5 \u2013 the table is likely perfectly accurate, but it does seem strange that all \u201cvery low certainty\u201d are related to uncertain effects (assuming \u201c?\u201d means uncertain effects?) and no other effect estimates are \u201cvery low certainty\u201d (e.g., it is possible to have very low certainty in an effect estimate that shows a moderate observed effect size).&nbsp;&nbsp;Also , where ** is used to indicate that it is difficult to assess the size of effect but the review authors report the intervention as effective \u2013 this is not rated as very low certainty as compared to low certainty?&nbsp;\u200b\u200b\u200b\u200b\u200b\u200b\u200b\n<b>Author response: <\/b>The GRADE-framework recommends that outcomes of very low certainty are not reported as the confidence in the findings is too low. In our table this is indicated as \u201c?\u201d (https:\/\/www.gradeworkinggroup.org\/publications.html).&nbsp;For two of the comparisons, there was uncertainty about the \n<i>size<\/i> of the effect, but not \n<i>direction. <\/i>Thus, we were not able to classify the size of effect according to the pre-defined thresholds. These outcomes have been highlighted in the table, both of these were downgraded for precision in the GRADE-assessments and considered to be of low certainty in the original OoOs","URL":"https:\/\/f1000research.com\/articles\/12-2\/v2#referee-comment-13814","order":3,"name":"referee-comment-13814","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.181260.r449641, Claire Van Der Westhuizen, University of Cape Town, Rondebosch, Western Cape, 05 Feb 2026, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/12-2\/v2#referee-response-449641","order":4,"name":"referee-response-449641","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}