Comparative efficacy of task-sharing psychosocial interventions for preventing common mental disorders in low- and middle-income countries: A systematic review and network meta-analysis with 10,747 participants

Despite important research efforts devoted to testing the effectiveness of psychological interventions for the treatment of common mental disorders in low- and middle- income countries (LMICs), a gap remains in the field of prevention. We searched multiple databases up to May 7, 2026 for randomized controlled trials (RCTs) testing task-sharing psychological interventions for preventing common mental disorders in adults living in LMICs. Prevention interventions were classified into indicated, selective and universal. Primary outcomes were the diagnosis and symptom decrease of depression, PTSD, and anxiety at post-intervention. We estimated risk ratios (RRs) and standardized mean differences (SMDs) using random effects pairways and network meta-analyses (NMA). Protocol registration: CRD42023402399. We included 81 RCTs with 10,747 participants. 41 RCTs tested indicated, 34 selective and 7 universal prevention interventions. For preventing depression, wellbeing promotion, parental psychoeducation, yoga/mindfulness, and multi-component interventions were more effective than enhanced treatment as usual (ETAU/TAU) (RR 0.25 to 0.66). In head-to-head comparisons, wellbeing promotion and psychoeducation ranked highest (Surface Under the Cumulative Ranking, SUCRA>90%). In reducing depressive symptoms, parental psychoeducation, social support, wellbeing promotion, yoga-mindfulness, cognitive behavioral therapy, multicomponent interventions were more effective than ETAU/TAU (SMDs -0.94 to -0.36). For PTSD prevention, yoga-mindfulness, parental psychoeducation, CBT, and multicomponent interventions reduced symptoms. For anxiety diagnosis and symptoms, wellbeing promotion, social support, yoga-mindfulness, multicomponent interventions, and active waiting list were the most effective interventions. Extensive evidence supports the effectiveness of task-sharing psychosocial interventions in preventing mental disorders in LMICs, with stronger evidence for indicated and selective prevention.