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基于网络的青少年内化问题干预措施:系统评价。

Web-based interventions for youth internalizing problems: a systematic review.

机构信息

New York State Psychiatric Institute (NYSPI)/Columbia University Medical Center, New York City.

New York State Psychiatric Institute (NYSPI)/Columbia University Medical Center, New York City.

出版信息

J Am Acad Child Adolesc Psychiatry. 2014 Dec;53(12):1254-1270.e5. doi: 10.1016/j.jaac.2014.09.005. Epub 2014 Sep 28.

Abstract

OBJECTIVE

To review published reports on Web-based treatment and prevention programs for depression, anxiety, and suicide prevention in children, adolescents, and emerging adults.

METHOD

A systematic search of the PsycINFO, PubMed, Medline, and Web of Science databases was conducted in December 2013. Programs were classified according to evidence-base level (Well-Established, Probably Efficacious, Possibly Efficacious, Experimental, and Of Questionable Efficacy).

RESULTS

Of the 14,001 citations initially identified, 25 articles met inclusion criteria for Web-based interventions. These described 9 programs, of which 8 were Internet based and 1 was a mobile application. No Web-based interventions for suicide prevention were identified. Of the randomized controlled trials (n = 14) and open trials (n = 3) identified, 10 reported significant postintervention reductions in symptoms of depression and/or anxiety or improvements in diagnostic ratings, with small to large effect sizes. Many of these studies also reported significant improvements at follow-up. The methodological quality of the studies varied. Many programs were limited by their small sample sizes and use of waitlist or no-treatment control groups.

CONCLUSION

There is limited evidence for the effectiveness of Web-based interventions for youth depression and anxiety. Additional research and program development are needed to fill the current gaps in the literature.

摘要

目的

回顾已发表的关于儿童、青少年和新兴成年人基于网络的抑郁、焦虑和自杀预防治疗和预防计划的报告。

方法

2013 年 12 月,对 PsycINFO、PubMed、Medline 和 Web of Science 数据库进行了系统检索。根据证据基础水平(充分确立、可能有效、可能有效、实验和疗效可疑)对方案进行分类。

结果

在最初确定的 14001 条引文中,有 25 篇文章符合基于网络的干预措施的纳入标准。这些文章描述了 9 个项目,其中 8 个是基于互联网的,1 个是移动应用程序。没有发现针对自杀预防的基于网络的干预措施。在确定的随机对照试验(n=14)和开放试验(n=3)中,有 10 项报告称干预后抑郁和/或焦虑症状显著减轻或诊断评分有所改善,效果大小为小至大。其中许多研究还报告了随访时的显著改善。研究的方法学质量各不相同。许多方案受到样本量小以及使用候补名单或无治疗对照组的限制。

结论

基于网络的干预措施对青少年抑郁和焦虑的有效性的证据有限。需要进一步的研究和方案开发来填补文献中的当前空白。

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