The effects of psychological treatments of depression in children and adolescents on response, reliable change, and deterioration: a systematic review and meta-analysis.
The effects of psychological treatments of depression in children and adolescents on response, reliable change, and deterioration: a systematic review and meta-analysis.
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DOI：
10.1007/s00787-021-01884-6
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发表时间：
2023-01
影响因子：
6.4
通讯作者：
Furukawa, Toshi A.
中科院分区：
文献类型：
--
作者：
Cuijpers, Pim;Karyotaki, Eirini;Ciharova, Marketa;Miguel, Clara;Noma, Hisashi;Stikkelbroek, Yvonne;Weisz, John R.;Furukawa, Toshi A.
荟萃分析表明，心理治疗是有效的治疗抑郁症的儿童和青少年。然而，这些影响通常以效应量的形式报告。对于患者和临床医生来说，重要的是要知道患者是否达到临床显著的改善或恶化。我们进行了这样一项荟萃分析，以检查缓解、临床显著变化、临床显著恶化和恢复作为结局。我们检索了四个文献数据库，并纳入了40个随机试验，比较了心理治疗对青年抑郁症的控制条件。我们使用了一种有效的方法来估计结果率，基于基线和测试后的平均值，标准差和N。我们还计算了需要治疗的人数（NNT）。基线后2（±1）个月心理治疗的总体缓解率为39%（95% CI：34-45），对照组为24%（95% CI：0.19-28）（NNT：6.2）。基线后6-12个月，治疗组和对照组之间的差异仍然显著（NNT=7.8）。治疗组中54%的青年患者临床显著改善，对照组为32%（NNT=5.3）;治疗组中6%的患者临床显著恶化，对照组为13%（NNT=5.1）;治疗组中58%的患者恢复，对照组为36%（NNT=3.3）。在偏倚风险较低的研究中发现了较小的影响。与对照组相比，青年抑郁症的心理治疗是有效的，但超过60%的接受治疗的青年没有反应。显然需要更有效的治疗和治疗策略。试用注册https://osf.io/84xka
Meta-analyses show that psychotherapies are effective in the treatment of depression in children and adolescents. However, these effects are usually reported in terms of effect sizes. For patients and clinicians, it is important to know whether patients achieve a clinically significant improvement or deterioration. We conducted such a meta-analysis to examine response, clinically significant change, clinically significant deterioration and recovery as outcomes. We searched four bibliographic databases and included 40 randomised trials comparing psychotherapy for youth depression against control conditions. We used a validated method to estimate outcome rates, based on means, standard deviation and N at baseline and post-test. We also calculated numbers-need-to- treat (NNT). The overall response rate in psychotherapies at 2 (±1) months after baseline was 39% (95% CI: 34–45) and 24% (95% CI: 0.19–28) in control conditions (NNT: 6.2). The difference between therapy and control was still significant at 6–12 months after baseline (NNT=7.8). Clinically significant improvement was found in 54% of youth in therapy, compared with 32% in control groups (NNT=5.3); clinically significant deterioration was 6% in therapy, 13% in controls (NNT=5.1); recovery was 58% in therapy, 36% in controls (NNT=3.3). Smaller effects were found in studies with low risk of bias. Psychotherapies for depression in youth are effective compared to control conditions, but more than 60% of youth receiving therapy do not respond. More effective treatments and treatment strategies are clearly needed. Trial registration https://osf.io/84xka
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影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
5.9
作者：
JACOBSON, NS;TRUAX, P
通讯作者：
TRUAX, P
影响因子：
6.1
作者：
Kitchen, Charlotte E. W.;Tiffin, Paul A.;Ekers, David
通讯作者：
Ekers, David
DOI：
10.1016/j.jaac.2010.05.017
发表时间：
2010-10
影响因子：
13.3
作者：
Merikangas KR;He JP;Burstein M;Swanson SA;Avenevoli S;Cui L;Benjet C;Georgiades K;Swendsen J
通讯作者：
Swendsen J
影响因子：
73.3
作者：
Cuijpers, Pim;Noma, Hisashi;Furukawa, Toshi A.
通讯作者：
Furukawa, Toshi A.