Eligibility criteria
| PICOS | Inclusion criteria | Exclusion criteria |
| Population | Study participants must have been parents or carers (any adult in a parenting role, including foster carers and adoptive parents) of CYP, where at least 70% of the CYP were aged 5–18 years with an anxiety and/or depression disorder. The term CYP was used here as our PPI group recommended this term, owing to their view that teenagers may find the term children applicable to them. The decision for the age range was due to that in many contexts, child mental health services serve between the ages of 5 and 18.55
The CYP must have had a clinical level of anxiety and/or depression, as measured by a validated measure or based on medical diagnosis (eg, young people have been assessed by general practitioner and referred to specialist mental health services with anxiety and/or depression). Anxiety disorders, including generalised anxiety, obsessive compulsive disorder and social phobia, were included. Depressive disorders at any clinical level were included. | PTSD was excluded as the experience of the traumatic event may have caused trauma in the parent and PTSD is no longer considered an anxiety disorder.56 Bipolar disorders were excluded based on the clinical classifications of these difficulties.57
Procedural anxiety (eg, deriving from a medical paediatric setting) If the primary diagnosis for inclusion in the study is related to intellectual disability, neurodiversity, attention deficit diagnoses or physical problems. This decision was based on that it is not possible to separate the impact of other diagnoses on the parents from the impact of their young person having anxiety and/or depression. |
| Intervention | Interventions must include at least one component that directly seeks to support the parent with the impact of having a young person with anxiety and/or depression. Educational interventions were included where the education also extends to discussing the impact on parents and how they can manage this. | The following interventions were excluded: focused on primary prevention, only offered parent training, trained the parent to deliver therapy to the young person or only provided education about anxiety/depression as they do not focus on supporting the parent with their distress. |
| Comparison | Studies with or without a comparison group were included | No exclusion criteria |
| Outcomes | Outcomes that focused on the parents/carers that included but not limited to the following: parental mental health, mental well-being, stress, burden, burnout or satisfaction. All relevant outcomes must have been measured with a validated measure. For example, Parent Health Questionnaire-958 to measure depression. | Outcomes that solely focused on the young person. |
| Study type | Both peer-reviewed and non-peer-reviewed evidence sources included the following quantitative and mixed-method research designs: randomised controlled trials, quasi-experimental designs and controlled trials. | Non-experimental and qualitative study designs. |
CYP, children and young people; PPI, patient and public involvement; PTSD, Post-traumatic stress disorder.