Lee, Jasmine;
Barnett, Phoebe;
Goldsmith, Lucy P;
Yang, Jialin;
Appleton, Rebecca;
Lloyd-Evans, Brynmor;
Hahn, Jane Sungmin;
... Johnson, Sonia; + view all
(2026)
Early interventions for first onset of symptoms of mental health conditions: an umbrella review of systematic reviews.
BMC Medicine
10.1186/s12916-026-04617-1.
(In press).
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Abstract
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'.
| Type: | Article |
|---|---|
| Title: | Early interventions for first onset of symptoms of mental health conditions: an umbrella review of systematic reviews |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s12916-026-04617-1 |
| Publisher version: | https://doi.org/10.1186/s12916-026-04617-1 |
| Language: | English |
| Additional information: | This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. |
| Keywords: | Early intervention, Mental health, Psychosis, Umbrella review |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Experimental Psychology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Epidemiology and Applied Clinical Research |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10220918 |
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