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Background <p>Early intervention following mental health symptom onset has great potential in reducing the long-term burden on individuals, families and friends, and society. The main focus in service development and research has been on early intervention in psychosis, but advances have been made for some other mental health difficulties. We aimed to take stock of existing evidence regarding effectiveness, implementation and experiences of care for early intervention approaches through a systematic umbrella review.</p> Methods <p>We included systematic reviews of complex early intervention strategies including more than one component for early symptoms of mental health conditions with typical onset in young people under 25. We searched four databases (January 2019–May 2025) and synthesised results narratively. Quality was assessed using AMSTAR 2.</p> Results <p>Twenty-one reviews were included: eleven covering early intervention for psychosis already meeting diagnostic thresholds, four on early intervention for ‘at risk’ states for psychosis, three on eating disorders, one on bipolar disorder, and two on transdiagnostic approaches. Reviews of early intervention for psychosis suggest that intensive approaches can improve outcomes following first presentation to services, although the success of initiatives to reduce duration of untreated symptoms is less consistent. When most recently reviewed, interventions for those at high risk of psychosis appeared to have limited effectiveness in preventing transition, possibly because comparisons were often made with good-quality case management controls. We found little high-quality evidence regarding other diagnoses, although some early indications of success with eating disorders were reported. No reviews were found on early intervention for depression, anxiety, or ‘personality disorders’. Stigma and lack of knowledge or support were barriers to rapid access, while insufficient service resources and staffing hindered effective delivery.</p> Conclusions <p>Despite its great importance in reducing the global burden of mental ill-health, review evidence on early intervention following symptom onset remains limited, especially for conditions other than psychosis. For psychosis, some approaches now warrant attention to widespread implementation. Innovative approaches for eating disorders have emerged, but treatments supported by substantial and robust trials are urgently needed. Further evidence is also required for conditions including depression, anxiety, bipolar disorder, and ‘personality disorder’.</p>

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Early interventions for first onset of symptoms of mental health conditions: an umbrella review of systematic reviews

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月29日

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  • Jasmine Lee,
  • Phoebe Barnett,
  • Lucy P. Goldsmith,
  • Jialin Yang,
  • Rebecca Appleton,
  • Brynmor Lloyd-Evans,
  • Jane Sungmin Hahn,
  • Nathalie Rich,
  • Emma Francis,
  • Lizzie Mitchell,
  • Eva Driskell,
  • Alina Unkelbach,
  • Sonia Johnson

摘要

Background

Early intervention following mental health symptom onset has great potential in reducing the long-term burden on individuals, families and friends, and society. The main focus in service development and research has been on early intervention in psychosis, but advances have been made for some other mental health difficulties. We aimed to take stock of existing evidence regarding effectiveness, implementation and experiences of care for early intervention approaches through a systematic umbrella review.

Methods

We included systematic reviews of complex early intervention strategies including more than one component for early symptoms of mental health conditions with typical onset in young people under 25. We searched four databases (January 2019–May 2025) and synthesised results narratively. Quality was assessed using AMSTAR 2.

Results

Twenty-one reviews were included: eleven covering early intervention for psychosis already meeting diagnostic thresholds, four on early intervention for ‘at risk’ states for psychosis, three on eating disorders, one on bipolar disorder, and two on transdiagnostic approaches. Reviews of early intervention for psychosis suggest that intensive approaches can improve outcomes following first presentation to services, although the success of initiatives to reduce duration of untreated symptoms is less consistent. When most recently reviewed, interventions for those at high risk of psychosis appeared to have limited effectiveness in preventing transition, possibly because comparisons were often made with good-quality case management controls. We found little high-quality evidence regarding other diagnoses, although some early indications of success with eating disorders were reported. No reviews were found on early intervention for depression, anxiety, or ‘personality disorders’. Stigma and lack of knowledge or support were barriers to rapid access, while insufficient service resources and staffing hindered effective delivery.

Conclusions

Despite its great importance in reducing the global burden of mental ill-health, review evidence on early intervention following symptom onset remains limited, especially for conditions other than psychosis. For psychosis, some approaches now warrant attention to widespread implementation. Innovative approaches for eating disorders have emerged, but treatments supported by substantial and robust trials are urgently needed. Further evidence is also required for conditions including depression, anxiety, bipolar disorder, and ‘personality disorder’.