Depressive Symptoms In Children Research Articles

Physical Activity Interventions to Alleviate Depressive Symptoms in Children and Adolescents

Depression is the second most prevalent mental disorder among children and adolescents, yet only a small proportion seek or receive disorder-specific treatment. Physical activity interventions hold promise as an alternative or adjunctive approach to clinical treatment for depression. To determine the association of physical activity interventions with depressive symptoms in children and adolescents. PubMed, CINAHL, PsycINFO, EMBASE, and SPORTDiscus were searched from inception to February 2022 for relevant studies written in English, Chinese, or Italian. Two independent researchers selected studies that assessed the effects of physical activity interventions on depressive symptoms in children and adolescents compared with a control condition. A random-effects meta-analysis using Hedges g was performed. Heterogeneity, risk of bias, and publication bias were assessed independently by multiple reviewers. Meta-regressions and sensitivity analyses were conducted to substantiate the overall results. The study followed the PRISMA reporting guideline. The main outcome was depressive symptoms as measured by validated depression scales at postintervention and follow-up. Twenty-one studies involving 2441 participants (1148 [47.0%] boys; 1293 [53.0%] girls; mean [SD] age, 14 [3] years) were included. Meta-analysis of the postintervention differences revealed that physical activity interventions were associated with a reduction in depressive symptoms compared with the control condition (g = -0.29; 95% CI, -0.47 to -0.10; P = .004). Analysis of the follow-up outcomes in 4 studies revealed no differences between the physical activity and control groups (g = -0.39; 95% CI, -1.01 to 0.24; P = .14). Moderate study heterogeneity was detected (Q = 53.92; df = 20; P < .001; I2 = 62.9% [95% CI, 40.7%-76.8%]). The primary moderator analysis accounting for total physical activity volume, study design, participant health status, and allocation and/or assessment concealment did not moderate the main treatment effect. Secondary analyses demonstrated that intervention (ie, <12 weeks in duration, 3 times per week, unsupervised) and participant characteristics (ie, aged ≥13 years, with a mental illness and/or depression diagnosis) may influence the overall treatment effect. Physical activity interventions may be used to reduce depressive symptoms in children and adolescents. Greater reductions in depressive symptoms were derived from participants older than 13 years and with a mental illness and/or depression diagnosis. The association with physical activity parameters such as frequency, duration, and supervision of the sessions remains unclear and needs further investigation.

Functional connectivity analysis of childhood depressive symptoms

BackgroundChildhood depression is a highly distinct and prevalent condition with an unknown neurobiological basis. We wish to explore the resting state fMRI data in children for potential associations between neural connectivity and childhood depressive symptoms. MethodsA longitudinal birth cohort study with neuroimaging data obtained at 4.5, 6.0 and 7.5 years of age and the Children Depression Inventory 2 (CDI) administered between 8.5 and 10.5 years was used. The CDI score was used as the dependent variable and tested for correlation, both simple Pearson and network based statistic, with the functional connectivity values obtained from the resting state fMRI. Cross-validated permutation testing with a general linear model was used to validate that the identified functional connections were indeed implicated in childhood depression. ResultsTen functional connections and four brain regions (Somatomotor Area B, Temporoparietal Junction, Orbitofrontal Cortex and Insula) were identified as significantly associated with childhood depressive symptoms for girls at 6.0 and 7.5 years. No significant functional connections were found in girls at 4.5 years or for boys at any timepoint. Network based statistic and permutation testing confirmed these findings. ConclusionsThis study revealed significant sex-dependent associations of neural connectivity and childhood depressive symptoms. The regions identified are implicated in speech/language, social cognition and information integration and suggest unique pathways to childhood depressive symptoms.

Examining Adolescents' Mental Health Before and During the COVID-19 Pandemic

Abstract: The current study characterized the impact of the COVID-19 pandemic and stay-at-home orders on adolescents' internalizing symptoms and assessed predictors of adolescents' internalizing symptoms during the pandemic. Seventy-nine adolescents (18 autistic, 61 nonautistic) and their parents who participated in a previous study and were at least 10 years old ( M = 13.8, SD = 1.7) were invited to participate in three online follow-up surveys post-stay-at-home order (May through November 2020). Measures of children's anxiety and depressive symptoms, parenting practices, family togetherness, conflict, financial problems, and parental mental health during the pandemic were collected. Nonautistic adolescents experienced a significant decrease in anxiety symptoms across the beginning of the pandemic and a significant increase in depressive symptoms from pre- to post-stay-at-home order. Permissive parenting and financial problems predicted adolescents' depressive symptoms. Parental mental health difficulties and permissive parenting predicted adolescents' anxiety symptoms. Results underscore the need to support parents and youth.

Children's Mental Health in a Pandemic-Altered World: Technology's Evolving Role

Children's Mental Health in a Pandemic-Altered World: Technology's Evolving Role

The Mediating Role of Meaning in Life in the Relationship between Adverse Childhood Experiences and Depressive Symptoms in Secondary Vocational School Students

The Mediating Role of Meaning in Life in the Relationship between Adverse Childhood Experiences and Depressive Symptoms in Secondary Vocational School Students

Traumatic Experiences in Childhood and Maternal Depressive Symptomatology: Their Impact on Parenting in Preschool.

The goal of this study is to describe and analyze the relationship between childhood trauma and depressive symptoms and its relation to the parental interactions of mothers (19-47 years) with their 3-4 year old preschool children. Parental interactions, traumatic experiences in mothers' childhood, and current depressive symptoms were measured using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO), the Childhood Trauma Questionnaire Short Form (CTQ), and the Beck Depression Inventory (BDI-I), respectively. A nonclinical sample of 81 Chilean mothers with their children was used. Results show that the presence of trauma in mothers' childhood has an impact on parenting; specifically, mothers with an emotional neglect experience showed greater difficulties in adequately promoting autonomy in their children.

Adverse Childhood Experiences, Inflammation, and Depressive Symptoms in Late Life: A Population-Based Study.

This study investigated the association and dose-response relationship between adverse childhood experiences (ACEs) and depressive symptoms in late life and explored the mediating roles of inflammatory markers in the ACEs-depressive symptom association among Chinese older adults. This study was conducted using 2014 life history survey data and 2015 follow-up data from the China Health and Retirement Longitudinal Study. Data on ACEs and depression, inflammatory markers of high-sensitivity C-reactive protein (CRP), and white blood cell were collected. The association between ACEs and depressive symptoms was examined using logistic regression, and the mediation effects of inflammatory markers were evaluated. A total of 6,518 individuals over 60 years were included in the analysis. Compared to no ACE exposure, the adjusted odd ratios ranged from 1.377 (95% confidence interval [CI], 1.133-1.673) when participants had been exposed to 2 ACEs to 1.809 (95% CI, 1.451-2.256) when participants were exposed to 4 or more ACEs. A significant dose-response relationship between cumulative ACE scores and depression was observed. Six of the 12 ACE exposures were related to increased odds of depressive symptoms. CRP appeared to partially mediate the ACE-depressive symptom association, and the proportion of the effect of ACEs on depression was 1.17% (P = 0.008). A dose-response association exists between ACEs and the prevalence of depressive symptoms among older Chinese adults. CRP partially mediated the ACE-depressive symptom association in late life. Emphasizing interventions targeting individuals with ACE exposure may minimize the burden of late-life depression in China.

The Effectiveness of Cognitive Behavioral Therapy on Symptoms of Depression among Syrian Children Refugees in Kurdistan Region of Iraq

Background: Cognitive behavioral therapy is helpful verbal therapy to reduce symptoms of depression in children. It always includes parent involvement, teaching skills that are practiced at home or school, and measures of progress that are tracked over time. Objective: This study aimed to assess the effectiveness of the psychoeducational program for reducing symptoms of depression in Syrian children. Methods: We used a quasi-experimental research design to survey 272 children living in Arbat Campus Refugee, Kurdistan Region-Iraq, from Nov. 5, 2020, until Nov. 20, 2021 (data collection and program intervention). Sociodemographic data were collected from the participants/parents using a specific questionnaire, and CBT was applied to the experimental group.Results: A non-probability, purposive sample size of 272 children were divided into experimental and control groups with 136 children each aged 5-13 years, using the simple random sampling approach. The socio-demographic data revealed that most children were 11-13 years, and most were females, and also appears that most of the families have 4-6 children. Additionally, most of the parents have a basic level of education with psychological distress among their parents very highly. Additionally, highly frequent behavioral characteristics were found in the sample response table 2 (88.2%).Conclusion: We concluded that the Cognitive behavioral therapy intervention is effective in reducing symptoms of depression among Syrian refugee children living on the Arbat campus that might be due to their parent's significant psychological distress.

Body mass index and childhood symptoms of depression, anxiety, and attention-deficit hyperactivity disorder: A within-family Mendelian randomization study.

Higher BMI in childhood is associated with emotional and behavioural problems, but these associations may not be causal. Results of previous genetic studies imply causal effects but may reflect influence of demography and the family environment. This study used data on 40,949 8-year-old children and their parents from the Norwegian Mother, Father and Child Cohort Study (MoBa) and Medical Birth Registry of Norway (MBRN). We investigated the impact of BMI on symptoms of depression, anxiety, and attention-deficit hyperactivity disorder (ADHD) at age 8. We applied within-family Mendelian randomization, which accounts for familial effects by controlling for parental genotype. Within-family Mendelian randomization estimates using genetic variants associated with BMI in adults suggested that a child's own BMI increased their depressive symptoms (per 5 kg/m2 increase in BMI, beta = 0.26 S.D., CI = -0.01,0.52, p=0.06) and ADHD symptoms (beta = 0.38 S.D., CI = 0.09,0.63, p=0.009). These estimates also suggested maternal BMI, or related factors, may independently affect a child's depressive symptoms (per 5 kg/m2 increase in maternal BMI, beta = 0.11 S.D., CI:0.02,0.09, p=0.01). However, within-family Mendelian randomization using genetic variants associated with retrospectively-reported childhood body size did not support an impact of BMI on these outcomes. There was little evidence from any estimate that the parents' BMI affected the child's ADHD symptoms, or that the child's or parents' BMI affected the child's anxiety symptoms. We found inconsistent evidence that a child's BMI affected their depressive and ADHD symptoms, and little evidence that a child's BMI affected their anxiety symptoms. There was limited evidence of an influence of parents' BMI. Genetic studies in samples of unrelated individuals, or using genetic variants associated with adult BMI, may have overestimated the causal effects of a child's own BMI. This research was funded by the Health Foundation. It is part of the HARVEST collaboration, supported by the Research Council of Norway. Individual co-author funding: the European Research Council, the South-Eastern Norway Regional Health Authority, the Research Council of Norway, Helse Vest, the Novo Nordisk Foundation, the University of Bergen, the South-Eastern Norway Regional Health Authority, the Trond Mohn Foundation, the Western Norway Regional Health Authority, the Norwegian Diabetes Association, the UK Medical Research Council. The Medical Research Council (MRC) and the University of Bristol support the MRC Integrative Epidemiology Unit.

Maternal anxiety and toddler depressive/anxiety behaviors: The direct and moderating role of children's focused attention

Attention mechanisms have a pertinent role in shaping developmental pathways to anxiety and depressive disorders. The current study examined the direct and interactive associations between maternal anxiety symptoms, children's focused attention, and children’s anxiety and depression behaviors in early toddlerhood. Participants were 150 mother-child dyads (50 % female) that were assessed at two time points. At 12 months of child age, mothers reported about their anxiety symptoms and children's focused attention. Children's focused attention was also observed and rated from an individual play task. At 18 months of age, mothers reported about children's anxiety and depression behaviors. Focused attention predicted child anxiety and depressive behaviors, with different patterns of associations between observed and reported measures of attention. There was also a significant interaction between maternal anxiety symptoms and observed children's focused attention. A positive association between maternal anxiety symptoms and child anxiety and depression symptoms was evident only for children with above-average levels of observed focused attention during play. Results suggest that different aspects of focused attention play a role in maternal reported anxiety and depression behaviors in early development and may modulate the intergenerational transmission of anxiety.

Social anxiety and depression symptoms in Chinese left-behind children after the lifting of COVID-19 lockdown: A network analysis.

Returning to social life after the lifting of COVID-19 lockdown may increase risk of social anxiety, which is highly co-morbid with depression. However, few studies have reported the association between them. To explore the complex relationship between social anxiety and depression symptoms in left-behind children after the lifting of the COVID-19 lockdown. A cross-sectional survey was conducted 6 months after the lockdown removal. A total of 3,107 left-behind children completed the survey with a mean age of 13.33 and a response rate of 87.77%. Depression and social anxiety severity were assessed by the DSM-5 Patient Health Questionnaire for Adolescents and the DSM-5 Social Anxiety Disorder Questionnaire, respectively. The symptom-level association between the two disorders was examined using network analysis. After the lifting of COVID-19 lockdown, the prevalence of depression and social anxiety in left-behind children was 19.57% and 12.36%, respectively, with a co-morbidity rate of 8.98%. Network analysis showed that "Social tension" and "Social avoidance" had the greatest expected influence; "Humiliation" and "Motor" were bridge symptom nodes in the network. The directed acyclic graph indicated that "Social fright" was at the upstream of all symptoms. Attention should be paid to social anxiety symptoms in left-behind children after the lifting of COVID-19 lockdown. Prevention and intervention measures should be taken promptly to reduce the comorbidity of social anxiety and depression symptoms in the left-behind children after the lifting of lockdown.

Rumination mediates the relationship between childhood trauma and depressive symptoms in schizophrenia patients.

Rumination and childhood trauma are related to depressive symptoms in clinical and non-clinical individuals. This is the first study aimed to test the mediating effect of rumination on the relationship between childhood trauma and depressive symptoms in schizophrenia patients. A total of 313 schizophrenia patients were recruited in the present study. The 17-item Hamilton Depression Rating Scale (HAMD-17) was adopted to evaluate depressive symptoms, the short-form Childhood Trauma Questionnaire (CTQ-SF) and the 10-item Ruminative response scale (RRS-10) were utilized to assess the childhood trauma and rumination in patients, respectively. Our results showed that 168 schizophrenia patients (53.67%) had comorbid depressive symptoms. These patients with depressive symptoms had higher levels of childhood trauma [both CTQ-SF total scores and emotional abuse (EA), emotional neglect (EN), physical neglect (PN) subscale scores] and rumination (both RRS-10 total scores and brooding, reflection subscale scores) compared to patients without depressive symptoms. The stepwise logistic regression analysis identified that EN (OR 1.196, P = 0.003), PN (OR 1.1294, P < 0.001), brooding (OR 1.291, P < 0.001) and reflection (OR 1.481, P < 0.001) could independently predict the depressive symptoms in schizophrenia patients. Moreover, RRS-10 and its subscale scores could mediate the relationship between depressive symptoms and childhood trauma, especially EA, EN and PN in schizophrenia. Our preliminary findings suggest that the rigorous assessment and psychosocial interventions of rumination are important to alleviate the influence of childhood trauma on depressive symptoms in schizophrenia patients.

Continuity and Stability of Child and Adolescent Depressive Symptoms in South Korea: A Meta-analysis of Longitudinal Studies.

Many adolescents in South Korea experience risk-level depressive symptoms due to stress caused by personal and environmental changes. Prior studies investigated various characteristics of depressive symptoms. However, it is unclear when the mean level of depression changes with the development of children and adolescents and whether it is stable relative to one another over time. Thus, it is necessary to closely understand the continuity and stability of depressive symptoms across developmental stages in children and adolescents. In this study, continuity refers to the consistency in a group's mean level of depressive symptoms over time; however, stability refers to the consistency in the relative placement of the levels of depressive symptoms of individuals within a group over time. To comprehensively understand previous studies, this meta-analysis compiled data from 95 South Korean longitudinal studies (N = 200,338; 49.7% females) published between 2000 and 2021. Data were analyzed using a three-level random effects model with a 1-year interval for each age group to integrate effect sizes, followed by a generalized additive mixed model integrating age as a continuous variable. The results indicate that the mean-level continuity of depressive symptoms was relatively high and the rank-order stability was low for the children in elementary school (including both upper and lower grades). Additionally, as the adolescents aged, the mean-level continuity of depressive symptoms slightly decreased while stability increased. When entering early adulthood, the continuity and stability of depressive symptoms converged without significant change. As a result of moderating effect, the female-only group indicated a high level of continuity and stability than the male-only or mixed group. The findings highlight that South Korean childhood is a period of relatively high continuity and low stability. Moreover, female students' depressive symptoms fluctuate more than those of males, suggesting the need for providing effective and appropriate help.

Occurrence of depressive symptoms related to changes in quality of life in students during the COVID-19 pandemic

Introduction: Mental health is one of the relevant parameters to assess the quality of life. Since the beginning of the COVID-19 pandemic, children make up one of the most fragile groups to mental health due to social isolation. Childhood mental disorders are a public health problem because of their impact on children's lives and the community. Objectives: To trace the occurrence of depressive symptoms in schoolchildren during the social isolation period to contain the viral spread and assess possible risk factors for these symptoms' emergence. Method: This study is a cross-sectional with 102 children aged 7 to 10 years who attended Elementary School I in a Municipal School in Belo Horizonte - MG. It was realized during the COVID-19 pandemic in 2021. Two questionnaires were applied, Socioeconomic Questionnaire to describe the sample profile and to evaluate possible risk factors related to depressive symptoms, and the Childhood Depression Inventory (CDI) tassesses depressive symptoms in children. Results: 2.9% of the children presented depressive symptoms. The profile was girls with unmarried parents, absence of father and mother as joint caregivers of the child, poor coexistence between close family members, the occurrence of family unemployment, and interference in lifestyle habits during the pandemic. However, these variables did not obtain a statistically significant association with probable depression. However, symptoms such as crying frequency, boredom, loneliness, and not feeling loved were significantly associated with potential depression. Conclusion: The rate of depression among students aged 7 to 10 years in a Municipal School was 2.9% during the pandemic. There was no association between sociodemographic characteristics and the presence or absence of symptoms of depression. There was a significant association between worsening symptoms such as crying, boredom, loneliness, and not feeling loved and the presence of depressive symptoms.

A disease-targeted picture book for children with Henoch-Schonlein purpura nephritis: A quasi-experimental study.

Children with Henoch-Schonlein purpura nephritis are frequently burdened with psychological problems besides disease treatment and adherence. Currently, there is a shortage of appropriate and effective educational materials to facilitate physical and psychological recovery. To examine a picture book for the effectiveness of disease-related knowledge, coping strategies, resilience, quality of lifeand depressive symptoms in children with Henoch-Schonlein purpura nephritis in China. A quasi-experimental design with repeated measures was adopted. The control group received standard care. The intervention group received the standard care plus a free picture book. This disease-specific picture book narrated the story of two rabbits diagnosed with Henoch-Schonlein purpura nephritis who underwent a series of examinations, faced difficulties taking medication, and eventually recovered. The study recruited 60 children diagnosed with Henoch-Schonlein purpura nephritis. Disease-related knowledge, resilience, coping strategies, depressionand paediatric quality of life were measured at baseline, the third day, the first monthand the third month after recruitment. The acceptability of the picture book was evaluated at the last data-collection point. The data showed that children in the intervention group demonstrated higher levels of knowledge (p < 0.001), less usage of emotional coping strategies (p = 0.003), reduced depressive symptoms (p = 0.003), improved psychological resilience (p < 0.001), and better quality of life (p < 0.046) than those in the control group in the third month. Most children (83.3%) in the intervention group were satisfied with the picture book. The targeted picture book is an effective educational tool for improving clinical outcomes and was highly accepted by children.

Effects of Positive Psychological Resources on the Relationship Between Adverse Childhood Experiences and Depressive Symptoms in University Students

Jongbin Kim, MD, Dae Kyung Yoo, Hyun-Ju Yang, MD, PhD,Duk-Soo Moon, MD, PhD , Na Ri Kang, MD, PhD, Joon Hyuk Park, MD, PhD,Moon-Doo Kim, MD, PhD, Young-Eun Jung, MD, PhD. Mood Emot 2022;20:52-8. https://doi.org/10.35986/me.2022.20.3.52

Interpersonal stress mediates the relationship between childhood trauma and depressive symptoms: Findings from two culturally different samples.

Childhood trauma is associated with adulthood depressive symptoms, but very few studies explored potential social and interpersonal mediators behind this association. This study made the first attempt to test the potential mediating effects of interpersonal stress in the associations between childhood betrayal and non-betrayal trauma and depressive symptoms. We analyzed data in a sample of English-speaking adults from diverse backgrounds (from 19 different countries, mainly from Western countries) (N = 468). We then replicated and compared the results with those in another convenience sample of Chinese-speaking younger adults with different cultural backgrounds and mental health status (N = 205). The results in both samples indicated that (1) childhood betrayal trauma had a stronger relationship with depressive symptoms than childhood non-betrayal trauma and that (2) interpersonal stress was a significant mediator in the relationship between childhood betrayal trauma and depressive symptoms, even when childhood non-betrayal trauma was included as a covariate. The indirect effect of childhood non-betrayal trauma on depressive symptoms through interpersonal stress was not consistent in two samples. Our findings point to the importance of taking social and interpersonal contexts into account when investigating, preventing and managing depression in trauma-exposed populations. Early social interventions such as family interventions, interpersonal skills training and building social resources may have the potential to change the trajectory of the development of mental health problems in trauma survivors.

Factor analysis of the stigma scale-child in pediatric inflammatory bowel disease

ObjectiveIllness stigma, or perceived stigma related to a chronic health condition, is pervasive among youth with inflammatory bowel disease (IBD). However, no studies exist examining the psychometric properties of illness stigma measures in this population. Using a modified version of the Child Stigma Scale originally developed for youth with epilepsy, the current study investigated the factor structure and validity of this adapted measure (i.e., Stigma Scale - Child; SS-C) in youth with IBD. MethodsFactor analyses were conducted to determine the most parsimonious factor structure for the adapted 8-item Stigma Scale – Child in a sample of 180 youth with IBD. Correlations were conducted to assess convergent validity, and a multiple regression was conducted to further evaluate the measure's predictive validity of child depressive symptoms. ResultsThe most parsimonious model for the SS-C is a one-factor solution with an error covariance between the two items assessing concealment/disclosure of IBD diagnosis. ConclusionsThe SS-C is a psychometrically sound illness stigma measure in pediatric IBD that demonstrates strong convergent validity with psychosocial adjustment factors such as thwarted belongingness, illness uncertainty, and illness intrusiveness, as well as strong predictive validity with youth depressive symptoms. The SS-C is a viable option for use as a brief screener in youth with IBD across clinical and research settings.

Associations Between Children's Depressive Symptoms, Life Events, and Family Factors Among School-Aged Children.

About 20-30% of children worldwide report depressive symptoms. This study examined associations between children's depressive symptoms, life events, and family factors. Nationally representative data (n=95,725) were drawn from the 2017 School Health Promotion Study in Finland. The respondents were 4th and 5th grade pupils (aged 10-12) in primary schools and their parents/guardians (n=33,726). Data were analyzed for child-parent dyads (n=32,181). Associations were studied using cross tabulation and logistic regression models. Children's reports of poor self-rated health, problems with family interactions, and the accumulation of life events were statistically significantly associated with depressive symptoms, also when controlling for sociodemographic factors. Financial situation and parent's depressed mood, both reported by parents, were associated with children's depressive symptoms when both were included in the regression model. However, this association disappeared when other predictors were added to the model. The results make apparent the complex associations between children's depressive symptoms and family factors. Further research is needed on the discrepancies between parent and child experiences.

Psychotherapy for co-occurring symptoms of depression, anxiety and obsessive-compulsive disorder in children and adults with autism spectrum disorder: a systematic review and meta-analysis.

Individuals with autism spectrum disorder (ASD) struggle accessing psychotherapy services for comorbidities, including anxiety-, depressive- and obsessive-compulsive disorders (OCD). Apart from cognitive behavioural therapy (CBT) for anxiety in children with ASD, it is unclear whether psychotherapy is effective for these comorbid disorders.We therefore systematically reviewed any form of psychotherapy for co-occurring symptoms of anxiety, depression and OCD in individuals with ASD.Database searches were conducted until February 2022 using EMBASE, PsycINFO and PubMed. Randomised controlled trials (RCT) were included investigating any form of psychotherapy for symptoms of anxiety, depression and OCD in individuals with ASD. Summary data were extracted, and random-effects meta-analyses were conducted.For CBT 26 RCTs (n = 1251), and for social skills training (SST) 11 RCTs (n = 475) met criteria for inclusion. Pooled effect sizes indicated a moderate reduction of anxiety in children (g = -0.70) and a small reduction of depressive symptoms in adults (g = -0.39). For SST overall effect sizes were small for reduction of anxiety in children (g = -0.35) and adults (g = -0.34) and moderate for reduction of depressive symptoms in children (g = -0.50). Risk of bias was high in 18, moderate in 16 and low in 3 RCTs.Our results provide new and age-specific evidence that: (1) CBT is effective for reducing anxiety in children and to a lesser extent for depressive symptoms in adults with ASD; and (2) social skills interventions are effective for reducing anxiety in children and adults and for depressive symptoms in children with ASD.