Vermeulen-Smit Evelien, Verdurmen J E E, Engels R C M E
Monitoring and Epidemiology Department, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, 3500 AS, Utrecht, The Netherlands,
Clin Child Fam Psychol Rev. 2015 Sep;18(3):218-39. doi: 10.1007/s10567-015-0185-7.
In order to quantify the effectiveness of family interventions in preventing and reducing adolescent illicit drug use, we conducted a systematic review and meta-analysis of randomized controlled trials. We searched the Cochrane Database of Systematic Reviews, Educational Research Information Centre (ERIC), MEDLINE, Embase, and PsycINFO for studies published between 1995 and 2013. Results were described separately for different outcomes (marijuana vs. other illicit drugs) and intervention types (universal, selective, and indicated prevention). Meta-analyses were performed when data were sufficient (e.g., marijuana and other illicit drug initiation in universal samples), using random effect models. Otherwise, we provided narrative reviews (e.g., regarding selective and indicated prevention). Thirty-nine papers describing 22 RCTs were eligible for inclusion. Universal family interventions targeting parent-child dyads are likely to be effective in preventing (OR 0.72; 95 % CI 0.56, 0.94) and reducing adolescent marijuana use, but not in preventing other illicit drugs (OR 0.90; 95 % CI 0.60, 1.34). Among high-risk groups, there is no clear evidence for the effectiveness of family interventions in preventing and reducing illicit drug use and drug disorders. The three small RCTs among substance-(ab)using adolescents gave some indication that programs might reduce the frequency of illicit drug use. Family interventions targeting parent-child dyads are likely to be effective in preventing and reducing adolescent marijuana use in general populations, but no evidence for other illicit drug use was found. We underline the need to strengthen the evidence base with more trials, especially among at-risk populations.
为了量化家庭干预在预防和减少青少年非法药物使用方面的有效性，我们对随机对照试验进行了系统评价和荟萃分析。我们检索了考科蓝系统评价数据库、教育研究信息中心（ERIC）、医学索引数据库（MEDLINE）、荷兰医学文摘数据库（Embase）和心理学文摘数据库（PsycINFO），以查找1995年至2013年期间发表的研究。针对不同结果（大麻与其他非法药物）和干预类型（普遍预防、选择性预防和针对性预防）分别描述结果。当数据充足时（如普遍样本中的大麻和其他非法药物起始使用情况），使用随机效应模型进行荟萃分析。否则，我们提供描述性综述（如关于选择性预防和针对性预防）。39篇描述22项随机对照试验的论文符合纳入标准。针对亲子二元组的普遍家庭干预可能在预防（比值比0.72；95%置信区间0.56，0.94）和减少青少年大麻使用方面有效，但在预防其他非法药物使用方面无效（比值比0.90；95%置信区间0.60，1.34）。在高危人群中，没有明确证据表明家庭干预在预防和减少非法药物使用及药物紊乱方面有效。在药物滥用青少年中的三项小型随机对照试验表明，相关项目可能会减少非法药物使用的频率。针对亲子二元组的家庭干预总体上可能在预防和减少普通人群青少年大麻使用方面有效，但未发现预防其他非法药物使用的证据。我们强调需要通过更多试验加强证据基础，尤其是在高危人群中。
