Comparative short-term efficacy and acceptability of a combination of pharmacotherapy and psychotherapy for depressive disorder in children and adolescents: a systematic review and meta-analysis.
Comparative short-term efficacy and acceptability of a combination of pharmacotherapy and psychotherapy for depressive disorder in children and adolescents: a systematic review and meta-analysis.
复制标题
药物治疗和心理治疗联合治疗儿童和青少年抑郁症的短期疗效和可接受性比较：系统评价和荟萃分析
DOI：
10.1186/s12888-022-03760-2
复制
发表时间：
2022-02-22
期刊：
影响因子：
4.4
通讯作者：
Xie P
中科院分区：
文献类型：
--
作者：
Xiang Y;Cuijpers P;Teng T;Li X;Fan L;Liu X;Jiang Y;Du K;Lin J;Zhou X;Xie P
虽然药物治疗和心理治疗联合治疗儿童和青少年抑郁症的临床疗效和安全性已有研究，但结果仍存在争议。本荟萃分析旨在研究儿童和青少年抑郁症联合治疗的短期疗效和可接受性。截至2020年12月31日，我们在多个数据库中进行了随机对照试验（RCTs）的系统检索，评估了药物治疗和心理治疗联合治疗与其他积极治疗方案（药物治疗、心理治疗和安慰剂联合心理治疗）对儿童和青少年（≤18岁）抑郁症的影响。本研究已在PROSPERO注册（CRD42020196701）。共纳入14项随机对照试验，涉及1325例患者。对于主要和次要结局，比较的干预措施在缓解（优势比[OR] = 1.37； 95%可信区间[CI]: 0.93至2.04）、可接受性（OR = 0.99; 95% CI: 0.72至1.38）、疗效（标准化平均差异= -0.07;95% CI: -0.32至0.19）和自杀（OR = 1.17; 95% CI: 0.67至2.06）方面没有统计学上的显著差异。有限的证据表明，氟西汀（OR = 1.90, 95% CI: 1.10至3.29）或非选择性5 -羟色胺再摄取抑制剂（非ssri） （OR = 2.46, 95% CI: 1.06至5.72）联合认知行为疗法（CBT）优于其他积极治疗方案。大多数纳入的试验在偏倚风险评估方面被评为“一些关注”。从有限的现有数据来看，没有证据表明所有联合疗法在儿童和青少年抑郁症的急性治疗中都优于其他积极治疗方案。然而，它表明氟西汀或非ssri药物治疗联合CBT可能在短期内优于其他治疗。非ssri联合治疗的混合特征（如年龄）和小样本量可能影响结果的普遍性。在线版本包含补充材料，可在10.1186/s12888-022-03760-2获得。
Although the clinical efficacy and safety of combination of pharmacotherapy and psychotherapy in the treatment of depressive disorders in children and adolescents have been studied, the results remain controversial. This meta-analysis aimed to study the short-term efficacy and acceptability of combined therapy for children and adolescents with depressive disorders. We conducted a systematic search in multiple databases for randomised controlled trials (RCTs), up to 31 December 2020, that assessed the combination of pharmacotherapy and psychotherapy against other active treatment options (pharmacotherapy, psychotherapy and placebo combined psychotherapy) in children and adolescents ( ≤ 18 years old) with depressive disorder. This study was registered with PROSPERO (CRD42020196701). A total of 14 RCTs involving 1,325 patients were included. For the primary and secondary outcomes, there were no statistically significant differences between the compared interventions in terms of remission (odds ratios [OR] = 1.37; 95% confidence interval [CI]: 0.93 to 2.04), acceptability (OR = 0.99; 95% CI: 0.72 to 1.38), efficacy (standardised mean differences = -0.07; 95% CI: -0.32 to 0.19), and suicidality (OR = 1.17; 95% CI: 0.67 to 2.06). Limited evidence showed that the combination of fluoxetine (OR = 1.90, 95% CI: 1.10 to 3.29) or non-selective serotonin reuptake inhibitors (non-SSRI) (OR = 2.46, 95% CI: 1.06 to 5.72) with cognitive-behavioural therapy (CBT) was superior to other active treatment options. Most included trials were rated as ‘some concerns’ in terms of risk of bias assessment. There is no evidence from the limited available data that all combined therapies are superior to other active treatment options for the acute treatment of depressive disorder in children and adolescents. However, it showed that fluoxetine or non-SSRI pharmacotherapies combined with CBT might be superior to other therapies in short-term. Mixed characteristics (e.g. age) and small sample size of non-SSRI combined therapy may influence the generalisability of the results. The online version contains supplementary material available at 10.1186/s12888-022-03760-2.
登录
查看更多内容
DOI：
10.1016/j.jpeds.2018.09.021
发表时间：
2019-03
期刊：
The Journal of pediatrics
影响因子：
--
作者：
Ghandour RM;Sherman LJ;Vladutiu CJ;Ali MM;Lynch SE;Bitsko RH;Blumberg SJ
通讯作者：
Blumberg SJ
影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
168.9
作者：
Cipriani, Andrea;Zhou, Xinyu;Xie, Peng
通讯作者：
Xie, Peng
DOI：
10.1097/01.chi.0000233157.21925.71
发表时间：
2006-10-01
影响因子：
13.3
作者：
Melvin, Glenn A.;Tonge, Bruce J.;Klimkeit, Ester
通讯作者：
Klimkeit, Ester
影响因子：
64.3
作者：
Davey, Christopher G.;Chanen, Andrew M.;Berk, Michael
通讯作者：
Berk, Michael