Stichting De Jutters, Postbus 61452, 2506, AL Den Haag, The Netherlands.
Soc Psychiatry Psychiatr Epidemiol. 2013 Apr;48(4):595-611. doi: 10.1007/s00127-012-0566-x. Epub 2012 Sep 9.
Child and adolescent mental health (CAMH) problems are common and serious all over the world and are linked to pre-mature deaths and serious dysfunction in adult life. Effective interventions have been developed in high income countries (HIC), but evidence from low income settings is scarce and scattered. The aim of this paper is to identify the most promising interventions in the area of global CAMH.
A systematic review of all randomised controlled trials in CAMH in low and middle income countries (LAMIC) was carried out and supplemented by 1a level evidence from HIC as well as suitable information from child programme evaluations and adult studies in LAMIC.
In behavioural disorders parent training is a highly promising intervention, which can successfully improve children's compliance and bring down rates of conduct problems significantly. In young children cognitive, emotional and behavioural development can be enhanced through nutritional supplements and by stimulation through play, praise and reading. Trauma treatments can bring positive results even in severely traumatised children, who remain in unstable living conditions. In developmental disorders, there are successful prevention strategies as well as programmes that bring children out of isolation and improve their independence. Some classroom-based interventions for adolescents have reduced symptoms of common mental disorders as well as risk taking behaviours.
While many results are still tentative the evidence suggests that it is possible to develop affordable and feasible interventions that significantly improve the lives of affected children, their families and their communities around the world.
儿童和青少年心理健康问题在世界各地都很常见且严重，并与成年人早逝和严重功能障碍有关。高收入国家（HIC）已经开发出有效的干预措施，但来自低收入环境的证据稀缺且分散。本文旨在确定全球儿童和青少年心理健康领域最有前途的干预措施。
对中低收入国家（LAMIC）的儿童和青少年心理健康领域的所有随机对照试验进行了系统评价，并补充了来自 HIC 的 1a 级证据以及来自 LAMIC 的儿童计划评估和成人研究的适当信息。
在行为障碍方面，家长培训是一种非常有前途的干预措施，它可以成功地提高孩子的依从性，并显著降低行为问题的发生率。在幼儿中，可以通过营养补充剂和通过游戏、表扬和阅读进行刺激来增强认知、情感和行为发展。即使在仍处于不稳定生活环境中的严重创伤儿童中，创伤治疗也能带来积极的结果。在发育障碍方面，有成功的预防策略以及使儿童摆脱孤立和提高独立性的方案。一些针对青少年的课堂干预措施已经减少了常见精神障碍和冒险行为的症状。
虽然许多结果仍不确定，但有证据表明，可以开发出负担得起且可行的干预措施，这些干预措施可以显著改善受影响儿童及其家庭以及世界各地社区的生活。
