Mental health promotion and protection relating to key life events and transitions in adulthood: a rapid systematic review of systematic reviews

During the decades representing working-age adulthood, most people will experience one or several significant life events or transitions. These may present a challenge to mental health. The primary aim of this rapid systematic review of systematic reviews was to summarise available evidence on the effectiveness of interventions to promote and protect mental health relating to four key life events and transitions: pregnancy and early parenthood, bereavement, unemployment, and housing problems. This review was conducted to inform UK national policy on mental health support. We searched key databases for systematic reviews of interventions for working-age adults (19 to 64 years old) who had experienced or were at risk of experiencing one of four key life events. Titles and abstracts were screened by two reviewers in duplicate, as were full-text manuscripts of relevant records. We assessed the quality of included reviews and extracted data on the characteristics of each literature review. We prioritised high quality, recent systematic reviews for more detailed data extraction and synthesis. The search and screening of 3997 titles/abstracts and 239 full-text papers resulted in 134 relevant studies, 68 of which were included in a narrative synthesis. Evidence was strongest and of the highest quality for interventions to support women during pregnancy and after childbirth. For example, we found benefits of physical activity and psychological therapy for outcomes relating to mental health after birth. There was high quality evidence of positive effects of online bereavement interventions and psychological interventions on symptoms of grief, post-traumatic stress, and depression. Evidence was inconclusive and of lower quality for a range of other bereavement interventions, unemployment support interventions, and housing interventions. Whilst evidence based mental health prevention and promotion is available during pregnancy and early parenthood and for bereavement, it is unclear how best to support adults experiencing job loss, unemployment, and housing problems.

在代表工作年龄成年期的数十年间，大多数人都会经历一个或数个重要的生活事件或转变。这些事件可能对心理健康构成挑战。本次快速系统综述的系统综述的主要目的是总结与四个关键生活事件和转变相关的促进和保护心理健康干预措施的有效性证据：妊娠和早期育儿、丧亲之痛、失业以及住房问题。本次综述旨在为英国国家心理健康支持政策提供信息。我们检索了关键数据库中针对工作年龄成年人（19至64岁）的系统综述，这些成年人经历过或面临经历四个关键生活事件之一的风险。两位审稿人分别对标题和摘要进行了双重筛选，并对相关记录的全文进行了筛选。我们评估了所包含综述的质量，并提取了每篇文献综述的特征数据。我们优先考虑高质量、近期系统综述，以便进行更详细的数据提取和综合。对3997个标题/摘要和239篇全文论文的检索和筛选产生了134项相关研究，其中68项被纳入叙事综合。在支持妇女妊娠和分娩期间以及促进心理健康的结果方面，干预措施的证据最为充分且质量最高。例如，我们发现体育活动和心理治疗对分娩后心理健康相关结果有益。在线丧亲干预和心理干预对悲伤、创伤后应激障碍和抑郁症状的积极影响具有高质量证据。对于一系列其他丧亲干预措施、失业支持干预措施和住房干预措施，证据尚不明确且质量较低。尽管在妊娠和早期育儿以及丧亲之痛期间有基于证据的心理健康预防和促进措施，但对于经历失业、失业和住房问题的成年人，如何提供最佳支持尚不明确。