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抑郁症筛查与儿童和青少年的健康结局:系统评价。

Depression Screening and Health Outcomes in Children and Adolescents: A Systematic Review.

机构信息

1 Department of Family and Community Medicine, University of Toronto, Ontario.

2 Lady Davis Institute, Jewish General Hospital, Montréal, Québec.

出版信息

Can J Psychiatry. 2017 Dec;62(12):813-817. doi: 10.1177/0706743717727243. Epub 2017 Aug 29.

Abstract

OBJECTIVE

Depression screening among children and adolescents is controversial. In 2009, the United States Preventive Services Task Force first recommended routine depression screening for adolescents, and this recommendation was reiterated in 2016. However, no randomized controlled trials (RCTs) of screening were identified in the original 2009 systematic review or in an updated review through February 2015. The objective of this systematic review was to provide a current evaluation to determine whether there is evidence from RCTs that depression screening in childhood and adolescence improves depression outcomes.

METHOD

Data sources included the MEDLINE, MEDLINE In-Process, EMBASE, PsycINFO, Cochrane CENTRAL and LILACS databases searched February 2, 2017. Eligible studies had to be RCTs that compared depression outcomes between children or adolescents aged 6 to 18 years who underwent depression screening and those who did not.

RESULTS

Of 552 unique title/abstracts, none received full-text review. No RCTs that investigated the effects of screening on depression outcomes in children or adolescents were identified.

CONCLUSIONS

There is no direct RCT evidence that supports depression screening among children and adolescents. Groups that consider recommending screening should carefully consider potential harms, as well as the use of scarce health resources, that would occur with the implementation of screening programs.

摘要

目的

儿童和青少年的抑郁筛查存在争议。2009 年,美国预防服务工作组首次建议对青少年进行常规抑郁筛查,2016 年再次重申了这一建议。然而,在最初的 2009 年系统评价或截至 2015 年 2 月的更新评价中,均未发现筛查的随机对照试验(RCT)。本系统评价的目的是提供当前的评估,以确定是否有 RCT 证据表明儿童和青少年的抑郁筛查可以改善抑郁结局。

方法

数据来源包括 2017 年 2 月 2 日检索的 MEDLINE、MEDLINE In-Process、EMBASE、PsycINFO、Cochrane CENTRAL 和 LILACS 数据库。合格的研究必须是 RCT,比较接受抑郁筛查的 6 至 18 岁儿童或青少年与未接受筛查的儿童或青少年之间的抑郁结局。

结果

在 552 篇独特的标题/摘要中,没有一篇进行了全文审查。没有 RCT 研究调查了筛查对儿童或青少年抑郁结局的影响。

结论

没有直接的 RCT 证据支持对儿童和青少年进行抑郁筛查。考虑推荐筛查的团体应仔细考虑潜在的危害,以及实施筛查计划将导致的稀缺卫生资源的利用。

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