A systematic review of evidence-based interventions for child and adolescent mental health problems in low- and middle-income countries
A systematic review of evidence-based interventions for child and adolescent mental health problems in low- and middle-income countries
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对低收入和中等收入国家儿童和青少年心理健康问题的循证干预措施的系统回顾
DOI：
10.1016/j.comppsych.2022.152358
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发表时间：
2023
影响因子：
7.3
通讯作者：
Ribeiro W
中科院分区：
文献类型：
--
作者：
Ribeiro W
背景在过去的15年里，儿童和青少年心理健康问题的治疗取得了进展。尽管研究取得了进展，但关于有效干预措施的大部分证据来自高收入国家，而在世界上90%的儿童和青少年生活在低收入和中等收入国家(LMIC)，证据很少。本综述的目的是确定在LMIC中测试的循证干预措施，以治疗或预防儿童和青少年心理健康问题。方法从2007年1月至2019年7月，我们对七个主要的电子数据库进行了系统的审查。我们包括随机或非随机临床试验，评估针对生活在LMIC中的6至18岁儿童或青少年的干预措施，这些儿童或青少年患有或面临发展一个或多个心理健康问题的风险。根据研究条件对结果进行分组。由于条件、干预措施和结果的异质性，我们进行了叙事合成。通过我们的搜索策略找到的127,466篇参考文献中，107篇研究在资格验证过程后被纳入叙述性综合。综述中的研究涉及19种不同的情况和9种类型的干预措施。超过三分之一的研究干预措施优于参照者，其中心理教育和心理治疗的阳性结果比例最高。三分之一的研究被归类为存在低偏见风险。这篇综述表明，不同的干预措施在低收入群体中是有效的，并有可能缩小低资源环境下儿童和青少年之间的心理卫生保健差距。
BackgroundTreatments for mental health problems in childhood and adolescence have advanced in the last 15 years. Despite advances in research, most of the evidence on effective interventions comes from high-income countries, while evidence is scarce in low- and middle-income countries (LMICs), where 90% of world's children and adolescents live. The aim of this review was to identify evidence-based interventions tested in LMICs to treat or prevent child and adolescent mental health problems.MethodsWe conducted a systematic review of seven major electronic databases, from January 2007 to July 2019. We included randomised or non-randomised clinical trials that evaluated interventions for children or adolescents aged 6 to 18 years living in LMICs and who had, or were at risk of developing, one or more mental health problems. Results were grouped according to the studied conditions. Due to the heterogeneity of conditions, interventions and outcomes, we performed a narrative synthesis. The review was registered at PROSPERO under the number CRD42019129376.FindingsOf 127,466 references found through our search strategy, 107 studies were included in narrative synthesis after the eligibility verification processes. Nineteen different conditions and nine types of interventions were addressed by studies included in the review. Over 1/3 of studied interventions were superior to comparators, with psychoeducation and psychotherapy having the highest proportion of positive results. One-third of studies were classified as presenting low risk of bias.InterpretationThis review shows that different interventions have been effective in LMICs and have the potential to close the mental health care gap among children and adolescents in low-resource settings.