Problem-solving interventions and depression among adolescents and young adults: A systematic review of the effectiveness of problem-solving interventions in preventing or treating depression

Kristina Metz; Jane Lewis; Jade Mitchell; Sangita Chakraborty; Bryce D. McLeod; Ludvig Bjørndal; Robyn Mildon; Aron Shlonsky

doi:10.1371/journal.pone.0285949

Peer Review History

Original SubmissionJanuary 2, 2023
8 Mar 2023 Decision Letter - Thiago P. Fernandes, Editor PONE-D-23-00042Problem-solving interventions and depression among adolescents and young adults: A systematic review of the effectiveness of problem-solving interventions in preventing or treating depression among 13-25-year-oldsPLOS ONE Dear Dr. Metz, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== Please submit your revised manuscript by Apr 22 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. 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Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings as either Supporting Information files or to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. We will update your Data Availability statement on your behalf to reflect the information you provide. Additional Editor Comments: Please respond each comment AND highlight each of them. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Thank you for providing a very well-written, clear, and detailed manuscript of a very interesting and worthwhile study. It was a pleasure to read and I commend you on your work. I have only a few minor comments which are mostly just points of proofreading: - Some abbreviations in Table 1 are either not detailed before usage here, or in fact aren't expanded upon at all. Please check and detail abbreviations in your notes section (namely PST, PCT, PST-PC, NST, DSM). I recognise that readers may be familiar with some of these or could hazard a well-educated guess, but for ease of readability and for clarity it would be beneficial to amend this. - It would be beneficial, if possible from your data, to add more detail about the ages of participant in Table 1, or to provide more details in your results section. You explained that some studies included under 13s and/or over 25s, but it is unclear which studies did so. It would also help the reader to assess the included literature more effectively if the mean/median age of participants (as per your inclusion criteria) was noted in the table. - Lines 200-202 are unclear and confusing to read - While I recognise the need for your review, I'm not entirely sold on your research question by your introduction section. Particularly, why you have chosen this specific intervention for this population. It may be beneficial to expand on the final paragraph (lines 83-95). - It may be beneficial to also add your thoughts on what your results mean for clinical practitioners in your discussion. You provide some good recommendations for research, but general expansion here would be helpful. These are the only minor edits I see as being required as your paper is strong. The results and conclusion are well written and thorough. Thank you also for providing detailed supplementary materials. Best of luck with your ongoing work Reviewer #2: The systematic review summarizes 25 studies concerning the efficacy of problem-solving interventions for preventing or treating depression. The topic is thoroughly examined, and the results provide insight into the development of evidence-based interventions and the enhancement of mental health outcomes for adolescents and young adults. I have some minor concerns which I will elaborate on below: Title: 1. The use of "13-25 years olds" in the title can be misleading as it implies a full age range rather than the mean or median age. Introduction: 2. While the introduction is logically structured, it would be beneficial to introduce problem-solving (PS) as a technique for depression treatment early on. PS intervention is a key concept, yet it is not mentioned until the last paragraph. 3. The rationale for focusing on the effect of PS interventions on depression needs further clarification. What makes PS a more relevant technique than other techniques? I agree that maladaptive PS is associated with depressive symptoms (line 84), while the construct of PS as a coping strategy may be different from PS as an intervention technique. 4. The relationship between PS technique and evidence-based treatments is slightly confusing. EBTs such as CBT have shown small to moderate effects in preventing and treating depression (line 66), so emphasis might move to discrete treatment techniques such as PS (line 75). However, PS is usually a component of CBT, a technique used in multiple sessions. What might account for a part of the therapy being more effective than the entire therapy? 5. Line 90 refers to the complex relationship between PS and depression. Although details can be found in the results section, it would be clearer to provide a specific explanation here for “complex.” Discussion: 6. In line 381, the authors “sought to determine in what way, in which contexts, and for whom PS appears to work in addressing depression.” However, outcomes are not discussed by context or study population. Studies conducted among students could differ from those conducted among peripartum women. Did the comparisons between contexts/populations bring forth any conclusions? 7. Among studies that found a significant reduction in depression, some reported that the effect was not sustained (e.g., line 262, line 268, line 302) while others reported the opposite (e.g., line 311, line 350). Is there a possible explanation for this discrepancy? ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: Yes: Tianyue Mi ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. 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Revision 1
24 Apr 2023 Author Response See below. Also replicated in the "Response to Reviewers" document. Thank you to the two reviewers for their thoughtful and comprehensive review of our manuscript. We have carefully considered all the comments and made requested modifications. As a result, we believe that the manuscript is improved. Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: Yes 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Response to Reviewer 1 comments: Reviewer #1: Thank you for providing a very well-written, clear, and detailed manuscript of a very interesting and worthwhile study. It was a pleasure to read and I commend you on your work. I have only a few minor comments which are mostly just points of proofreading: - Some abbreviations in Table 1 are either not detailed before usage here, or in fact aren't expanded upon at all. Please check and detail abbreviations in your notes section (namely PST, PCT, PST-PC, NST, DSM). I recognise that readers may be familiar with some of these or could hazard a well-educated guess, but for ease of readability and for clarity it would be beneficial to amend this. Thank you for your keen eye and this suggestion. We have updated the manuscript to ensure that all acronyms in the table are in the notes section. - It would be beneficial, if possible from your data, to add more detail about the ages of participant in Table 1, or to provide more details in your results section. You explained that some studies included under 13s and/or over 25s, but it is unclear which studies did so. It would also help the reader to assess the included literature more effectively if the mean/median age of participants (as per your inclusion criteria) was noted in the table. Thank you for this suggestion. We have added this information into the Table 1 under the “study population” information. - Lines 200-202 are unclear and confusing to read Thank you for this feedback. We have adjusted the sentence to hopefully increase comprehension. Please let us know if the sentence (now lines 198-199) is still unclear and/or confusing to read. - While I recognise the need for your review, I'm not entirely sold on your research question by your introduction section. Particularly, why you have chosen this specific intervention for this population. It may be beneficial to expand on the final paragraph (lines 83-95). Thank you for this feedback. We have re-worked the introduction section to include more information on PS and its potential as an active ingredient for AYA depression treatment. Please see lines 71-94. - It may be beneficial to also add your thoughts on what your results mean for clinical practitioners in your discussion. You provide some good recommendations for research, but general expansion here would be helpful. Thank you for this feedback. We have summarized the recommendations more clearly at the end of the paper. Please see lines 436-437 for clinical implications. These are the only minor edits I see as being required as your paper is strong. The results and conclusion are well written and thorough. Thank you also for providing detailed supplementary materials. Best of luck with your ongoing work Thank you so much for the thorough and thoughtful review. We believe your comments aided to the creation of an improved manuscript. Response to Reviewer 2 comments: Reviewer #2: The systematic review summarizes 25 studies concerning the efficacy of problem-solving interventions for preventing or treating depression. The topic is thoroughly examined, and the results provide insight into the development of evidence-based interventions and the enhancement of mental health outcomes for adolescents and young adults. I have some minor concerns which I will elaborate on below: Title: 1. The use of "13-25 years olds" in the title can be misleading as it implies a full age range rather than the mean or median age. Thank you for this suggestion. We have edited the title to only include the reference to adolescents and young adults to be more fitting. Introduction: 2. While the introduction is logically structured, it would be beneficial to introduce problem-solving (PS) as a technique for depression treatment early on. PS intervention is a key concept, yet it is not mentioned until the last paragraph. Thank you for this feedback. We have re-worked the introduction section to have PS introduced earlier in the introduction. 3. The rationale for focusing on the effect of PS interventions on depression needs further clarification. What makes PS a more relevant technique than other techniques? I agree that maladaptive PS is associated with depressive symptoms (line 84), while the construct of PS as a coping strategy may be different from PS as an intervention technique. Thank you for this feedback. We have re-worked the introduction section to include more information on background treatments using PS amongst adults and its potential as an active ingredient for AYA depression treatment. Please see lines 71-94. 4. The relationship between PS technique and evidence-based treatments is slightly confusing. EBTs such as CBT have shown small to moderate effects in preventing and treating depression (line 66), so emphasis might move to discrete treatment techniques such as PS (line 75). However, PS is usually a component of CBT, a technique used in multiple sessions. What might account for a part of the therapy being more effective than the entire therapy? Thank you for this feedback and question. We have added information to the manuscript that discusses a meta-analysis on PS within adult populations that found Problem Solving Therapy (PST) to be as effective as CBT and IPT, and more effective than WLC. We have additionally added information around the potential benefits of distilling common elements with this AYA population. Please see lines 71-94. 5. Line 90 refers to the complex relationship between PS and depression. Although details can be found in the results section, it would be clearer to provide a specific explanation here for “complex.” Thank you for this feedback and question. Due to all the additional PS information added to the introduction, we removed this statement and only addressed in the discussion section. Discussion: 6. In line 381, the authors “sought to determine in what way, in which contexts, and for whom PS appears to work in addressing depression.” However, outcomes are not discussed by context or study population. Studies conducted among students could differ from those conducted among peripartum women. Did the comparisons between contexts/populations bring forth any conclusions? Thank you for this feedback and question. Unfortunately, due to the heterogeneity in the study samples and settings as well as limited implementation factors discussed in the publications, these factors were unable to be explored. I added this limitation to lines 412-423. 7. Among studies that found a significant reduction in depression, some reported that the effect was not sustained (e.g., line 262, line 268, line 302) while others reported the opposite (e.g., line 311, line 350). Is there a possible explanation for this discrepancy? Thank you for this question. Unfortunately, the heterogeneity of study populations, problem severity, comparison conditions, outcome measures, and study designs, along with a relatively small number of included studies, limits confidence in what we can say about implementation and treatment outcomes. This includes an explanation for the discrepancies in sustained effects. 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: Yes: Tianyue Mi Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0285949.r002
5 May 2023 Decision Letter - Thiago P. Fernandes, Editor Problem-solving interventions and depression among adolescents and young adults: A systematic review of the effectiveness of problem-solving interventions in preventing or treating depression PONE-D-23-00042R1 Dear Dr. Metz, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Thiago P. Fernandes, PhD Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Thank you for returning the manuscript with all comments addressed. I feel this manuscript is now strong and of good quality and details an interesting, well articulated, and important piece of research. Reviewer #2: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Leah Attwell Reviewer #2: No ******** https://doi.org/10.1371/journal.pone.0285949.r003
Formally Accepted
11 May 2023 Acceptance Letter - Thiago P. Fernandes, Editor PONE-D-23-00042R1 Problem-solving interventions and depression among adolescents and young adults: A systematic review of the effectiveness of problem-solving interventions in preventing or treating depression Dear Dr. Metz: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Thiago P. Fernandes Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0285949.r004

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