Digital single-session interventions for depression and self-injurious thoughts and behaviours in young people: a systematic review and meta-analysis.

Abstract

Adolescents and young adults are an at-risk population for self-injurious thoughts and behaviours (SITBs) and depression. Single-session interventions (SSIs) offer a promising solution for at-risk young people, particularly for early intervention. Digital formats of SSIs (D-SSIs) have emerged, which show promise for scalable prevention and early intervention. This systematic review primarily aimed to examine the effectiveness of existing D-SSIs for reducing SITBs and/or depression, and their proximal risk factors. This review was registered on PROSPERO (CRD42025636566). PsycINFO, Medline, Embase, and Web of Science were searched from database inception to April 14, 2025. Included studies described original research outlining the effectiveness, acceptability, and/or feasibility of individual-level D-SSIs for young people (aged 10-24) intended to reduce SITBs and/or depressive symptoms, or proximal risk factors for these conditions. Summary data were extracted from published reports, and missing information requested from authors prior to analysis. From 1694 potential studies, 22 articles describing 18 unique D-SSIs were eligible for inclusion (total participants <i>N</i> = 9353). Limited studies reported on outcomes for depressive symptoms post-intervention, however, meta-analysis of outcomes at longest point of follow-up (<i>n</i> = 9, mean duration follow-up = 3.05 months) indicated greater reduction in the intervention condition compared to control at follow-up, with a small effect size (Hedge's <i>g</i> = -0.18, 95% CI = -0.24 to -0.11, <i>p</i> < 0.00, τ² = 0.00, <i>I</i> ² = 0%; CI = -0.034 to 0.034%). Narrative synthesis indicates that at present there is limited evidence for efficacy of D-SSIs for SITBs, and some evidence for their effectiveness for reducing proximal risk for depression and SITBS by reducing hopelessness, self-hatred, and improving emotion regulation. Overall, most studies met a high proportion of the quality appraisal criteria (mean = 90.8% of quality criteria being fully met, median = 86.0%, 57.1-100%). There is evidence that D-SSIs yield significant and sustained reductions in depressive symptoms among young people. While evidence for reducing SITBs is limited, D-SSIs demonstrate acceptability and feasibility for young people, and therefore potential for enhancing prevention and early intervention efforts. The study was supported by funding from Suicide Prevention Australia (Grant Number: #RG00182) and Michelle Torok is funded by a NHMRC Investigator Grant (GNT2007731).