Cognitive-behavioral therapy for adolescent depression: A meta-analytic investigation of changes in effect-size estimates
Cognitive-behavioral therapy for adolescent depression: A meta-analytic investigation of changes in effect-size estimates
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DOI：
10.1097/chi.0b013e3180592aaa
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发表时间：
2007-11-01
影响因子：
13.3
通讯作者：
Reinecke, Mark A.
中科院分区：
文献类型：
--
作者：
Klein, Jesse B.;Jacobs, Rachel H.;Reinecke, Mark A.
目的：阐明认知行为疗法(CBT)对青少年抑郁症疗效的早期元分析估计和近期元分析估计的差异。方法：采用荟萃分析方法，在11项针对符合单相抑郁诊断标准的青少年的CBT随机对照试验中，研究方法学特征是否影响平均效应大小。结果：累积Meta分析表明，CBT的效应已从早期试验的大效应下降，可信区间变窄。在使用意向治疗分析策略的研究中，效果规模明显较小，将CBT与积极治疗进行比较，在临床环境中进行，并基于COSORT(报告试验综合标准)标准具有更高的方法学严格性。治疗后的平均效应大小为0.53，具有统计学意义。结论：CBT对抑郁青少年疗效的估计差异可能源于早期和最近研究之间的方法学差异。总体而言，结果支持CBT治疗青少年抑郁症的有效性。
Objective: To explicate differences between early and recent meta-analytic estimates of the effects of cognitive-behavioral therapy (CBT) for adolescent depression. Method: Meta-analytic procedures were used to investigate whether methodological characteristics moderated mean effect sizes among 11 randomized, controlled trials of CBT focusing on adolescents meeting diagnostic criteria for unipolar depression. Results: Cumulative meta-analyses indicated that effects of CBT have decreased from large effects in early trials, and confidence intervals have become narrower. Effect sizes were significantly smaller among studies that used intent-to-treat analytic strategies, compared CBT to active treatments, were conducted in clinical settings, and featured greater methodological rigor based on CONSORT (Consolidated Standards of Reporting Trials) criteria. The mean posttreatment effect size of 0.53 was statistically significant. Conclusions: Differences in estimates of the efficacy of CBT for depressed adolescents may stem from methodological differences between early and more recent investigations. Overall, results support the effectiveness of CBT for the treatment of adolescent depression.