Arnberg Alexandra, Ost Lars-Göran
a Department of Psychology , Stockholm University , Stockholm , Sweden.
Cogn Behav Ther. 2014;43(4):275-88. doi: 10.1080/16506073.2014.947316. Epub 2014 Sep 24.
Pediatric depression entails a higher risk for psychiatric disorders, somatic complaints, suicide, and functional impairment later in life. Cognitive behavior therapy (CBT) is recommended for the treatment of depression in children, yet research is based primarily on adolescents. The present meta-analysis investigated the efficacy of CBT in children aged 8-12 years with regard to depressive symptoms. We included randomized controlled trials of CBT with participants who had an average age of ≤ 12 years and were diagnosed with either depression or reported elevated depressive symptoms. The search resulted in 10 randomized controlled trials with 267 participants in intervention and 256 in comparison groups. The mean age of participants was 10.5 years. The weighted between-group effect size for CBT was moderate, Cohen's d = 0.66. CBT outperformed both attention placebo and wait-list, although there was a significant heterogeneity among studies with regard to effect sizes. The weighted within-group effect size for CBT was large, d = 1.02. Earlier publication year, older participants, and more treatment sessions were associated with a larger effect size. In conclusion, the efficacy of CBT in the treatment of pediatric depression symptoms was supported. Differences in efficacy, methodological shortcomings, and lack of follow-up data limit the present study and indicate areas in need of improvement.
儿童期抑郁症会使日后患精神疾病、躯体不适、自杀及功能受损的风险更高。认知行为疗法（CBT）被推荐用于治疗儿童抑郁症，但相关研究主要基于青少年。本荟萃分析调查了CBT对8至12岁儿童抑郁症状的疗效。我们纳入了CBT的随机对照试验，试验参与者的平均年龄≤12岁，且被诊断为患有抑郁症或报告有抑郁症状加重。检索结果得到10项随机对照试验，干预组有267名参与者，对照组有256名参与者。参与者的平均年龄为10.5岁。CBT的组间加权效应量中等，科恩d值为0.66。CBT的效果优于注意力安慰剂和等待名单组，尽管各研究在效应量方面存在显著异质性。CBT的组内加权效应量较大，d值为1.02。较早的发表年份、年龄较大的参与者以及更多的治疗疗程与较大的效应量相关。总之，CBT治疗儿童抑郁症状的疗效得到了支持。疗效差异、方法学缺陷以及缺乏随访数据限制了本研究，并指出了需要改进的方面。
