Evidence Base Update of Psychosocial Treatments for Child and Adolescent Depression.
Evidence Base Update of Psychosocial Treatments for Child and Adolescent Depression.
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DOI：
10.1080/15374416.2016.1220310
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发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Bolano C
中科院分区：
文献类型：
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作者：
Weersing VR;Jeffreys M;Do MT;Schwartz KT;Bolano C
青年抑郁症是一种普遍的致残性疾病，往往预示着成年后的慢性和复发性疾病和障碍。青少年抑郁症的临床试验研究已有30年的历史，循证治疗综述出现于1998年和2008年。目前对42项随机对照试验（RCT）的综述更新了这些综述，纳入了2008年至2014年期间发表的RCT（N = 14），并重新评价了先前综述的文献。鉴于该领域的日益成熟，本综述采用了一套严格的试验纳入方法标准，最值得注意的是排除了基于先前综述中纳入的青年亚临床样本的试验（N = 12），并包括设计良好的RCT（N = 8）。本次审查的结果表明，儿童治疗的证据明显弱于青少年干预措施，没有儿童治疗达到完善的地位和证据基础的治疗降级从以前的报告。临床抑郁症儿童的认知行为疗法（CBT）似乎是可能有效的，在试验中的结果喜忧参半。对于抑郁的青少年，CBT和人际心理治疗（IPT）都是行之有效的干预措施，独立调查小组的多项试验证明了其有效性。这一积极的结论受到IPT文献（N = 6）规模较小的影响，并担心CBT效应在临床复杂样本中以及与活性对照条件相比时可能会减弱。最后，数据的预测，主持人和调解人进行检查和优先事项为未来的研究进行了讨论。
Depression in youth is prevalent and disabling and tends to presage a chronic and recurrent course of illness and impairment in adulthood. Clinical trial research in youth depression has a 30 year history, and evidence-based treatment reviews appeared in 1998 and 2008. The current review of 42 randomized controlled trials (RCTs) updates these reviews to include RCTs published between 2008 and 2014 (N = 14) and re-evaluates previously reviewed literature. Given the growing maturity of the field, this review utilized a stringent set of methodological criteria for trial inclusion, most notable for excluding trials based in sub-clinical samples of youth that had been included in previous reviews (N = 12) and including well-designed RCTs with null and negative findings (N = 8). Findings from the current review suggest that evidence for child treatments is notably weaker than for adolescent interventions, with no child treatments achieving well-established status and the evidentiary basis of treatments downgraded from previous reports. Cognitive behavioral therapy (CBT) for clinically depressed children appears to be possibly efficacious, with mixed findings across trials. For depressed adolescents, both CBT and Interpersonal Psychotherapy (IPT) are well-established interventions, with evidence of efficacy in multiple trials by independent investigative teams. This positive conclusion is tempered by the small size of the IPT literature (N = 6) and concern that CBT effects may be attenuated in clinically complicated samples and when compared against active control conditions. In conclusion, data on predictors, moderators, and mediators are examined and priorities for future research discussed.