Baving L, Schmidt M H
Klinik für Kinder- und Jugendpsychiatrie, Otto-von-Guericke-Universität Magdeburg.
Z Kinder Jugendpsychiatr Psychother. 2001 Aug;29(3):206-20. doi: 10.1024//1422-4917.29.3.206.
The principle of evidence-based medicine is to integrate data concerning the efficacy of interventions into clinical practice. This article assesses the level of evaluation of psychosocial, psychopharmacological and combined interventions for mental disorders in childhood and adolescence (schizophrenic disorders, affective disorders, phobias and anxiety disorders, obsessive-compulsive disorder, posttraumatic stress disorder, anorexia nervosa, and bulimia nervosa).
Three different levels of evaluation were defined for both psychosocial and psychopharmacological interventions: A (> or = 2 randomized controlled studies), B (1 randomized controlled study), and C (open studies and case studies). The level of evaluation was judged on the basis of original papers found in a comprehensive literature search.
The number of controlled studies examining these disorders in children and adolescents is small, especially with regard to pharmacotherapy. However, the efficacy of (cognitive) behavior therapy for depressive disorders, phobias and anxiety disorders, as well as posttraumatic stress disorder has been demonstrated.
There is still a considerable need to evaluate pharmacological treatment approaches for schizophrenic and affective disorders. Looking at psychosocial interventions in schizophrenic disorders, obsessive-compulsive disorder and eating disorders, specific aspects of treatment for young patients should be examined. Overall, the psychotherapy approach evaluated best is (cognitive) behavioral therapy.
循证医学的原则是将有关干预措施疗效的数据整合到临床实践中。本文评估了针对儿童和青少年精神障碍（精神分裂症、情感障碍、恐惧症和焦虑症、强迫症、创伤后应激障碍、神经性厌食症和神经性贪食症）的心理社会、心理药物及联合干预措施的评估水平。
为心理社会和心理药物干预措施定义了三种不同的评估水平：A（≥2项随机对照研究）、B（1项随机对照研究）和C（开放研究和病例研究）。评估水平是根据在全面文献检索中找到的原始论文来判断的。
针对儿童和青少年这些疾病的对照研究数量较少，尤其是在药物治疗方面。然而，（认知）行为疗法对抑郁症、恐惧症和焦虑症以及创伤后应激障碍的疗效已得到证实。
对于精神分裂症和情感障碍的药物治疗方法，仍有相当大的评估需求。在精神分裂症、强迫症和饮食障碍的心理社会干预方面，应研究针对年轻患者治疗的具体方面。总体而言，评估最佳的心理治疗方法是（认知）行为疗法。
