The effects of psychological treatments of depression in children and adolescents on response, reliable change, and deterioration:a systematic review and meta-analysis
| Autor: | Pim Cuijpers, Clara Miguel, Yvonne Stikkelbroek, Toshi A. Furukawa, Eirini Karyotaki, Marketa Ciharova, John R. Weisz, Hisashi Noma |
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| Přispěvatelé: | Clinical Psychology, APH - Global Health, APH - Mental Health, World Health Organization (WHO) Collaborating Center, APH - Digital Health, APH - Methodology |
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
medicine.medical_specialty
business.industry Depression Cognitive behaviour therapy General Medicine Major depressive disorder medicine.disease Psychotherapy Psychiatry and Mental health Meta-analysis Overall response rate SDG 3 - Good Health and Well-being Internal medicine Pediatrics Perinatology and Child Health Developmental and Educational Psychology Child and adolescent psychiatry Medicine Treatment strategy business Trial registration Depression (differential diagnoses) |
| Zdroj: | Cuijpers, P, Karyotaki, E, Ciharova, M, Miguel, C, Noma, H, Stikkelbroek, Y, Weisz, J R & Furukawa, T A 2023, ' The effects of psychological treatments of depression in children and adolescents on response, reliable change, and deterioration : a systematic review and meta-analysis ', European Child and Adolescent Psychiatry, vol. 32, no. 1, pp. 177-192 . https://doi.org/10.1007/s00787-021-01884-6 European Child and Adolescent Psychiatry, 32(1), 177-192. D. Steinkopff-Verlag |
| ISSN: | 1018-8827 |
| Popis: | 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 registrationhttps://osf.io/84xka |
| Databáze: | OpenAIRE |
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