Domhardt Matthias, Steubl Lena, Baumeister Harald
Department of Clinical Psychology and Psychotherapy, University of Ulm, Germany.
Z Kinder Jugendpsychiatr Psychother. 2020 Jan;48(1):33-46. doi: 10.1024/1422-4917/a000625. Epub 2018 Nov 13.
This meta-review integrates the current meta-analysis literature on the efficacy of internet- and mobile-based interventions (IMIs) for mental disorders and somatic diseases in children and adolescents. Further, it summarizes the moderators of treatment effects in this age group. Using a systematic literature search of PsycINFO and MEDLINE/PubMed, we identified eight meta-analyses ( = 8,417) that met all inclusion criteria. Current meta-analytical evidence of IMIs exists for depression (range of standardized mean differences, SMDs = .16 to .76; 95 % CI: -.12 to 1.12; k = 3 meta-analyses), anxiety (SMDs = .30 to 1.4; 95 % CI: -.53 to 2.44; = 5) and chronic pain (SMD = .41; 95 % CI: .07 to .74; = 1) with predominantly nonactive control conditions (waiting-list; placebo). The effect size for IMIs across mental disorders reported in one meta-analysis is SMD = 1.27 (95 % CI: .96 to 1.59; = 1), the effect size of IMIs for different somatic conditions is SMD = .49 (95 % CI: .33 to .64; = 1). Moderators of treatment effects are age ( = 3), symptom severity ( = 1), and source of outcome assessment ( = 1). Quality ratings with the AMSTAR-2-checklist indicate acceptable methodological rigor of meta-analyses included. Taken together, this meta-review suggests that IMIs are efficacious in some health conditions in youths, with evidence existing primarily for depression and anxiety so far. The findings point to the potential of IMIs to augment evidence based mental healthcare for children and adolescents.
本元综述整合了当前关于基于互联网和移动设备的干预措施(IMIs)对儿童和青少年精神障碍及躯体疾病疗效的元分析文献。此外,它总结了该年龄组治疗效果的调节因素。通过对PsycINFO和MEDLINE/PubMed进行系统的文献检索,我们确定了八项符合所有纳入标准的元分析(n = 8417)。目前关于IMIs的元分析证据存在于抑郁症(标准化均数差范围,SMDs = 0.16至0.76;95%置信区间:-0.12至1.12;k = 3项元分析)、焦虑症(SMDs = 0.30至1.4;95%置信区间:-0.53至2.44;n = 5)和慢性疼痛(SMD = 0.41;95%置信区间:0.07至0.74;n = 1),主要采用非活性对照条件(等待名单;安慰剂)。一项元分析报告的IMIs对所有精神障碍的效应量为SMD = 1.27(95%置信区间:0.96至1.59;n = 1),IMIs对不同躯体状况的效应量为SMD = 0.49(95%置信区间:0.33至0.64;n = 1)。治疗效果的调节因素包括年龄(n = 3)、症状严重程度(n = 1)和结局评估来源(n = 1)。使用AMSTAR - 2检查表进行的质量评级表明纳入的元分析在方法学上具有可接受的严谨性。综上所述,本元综述表明IMIs在青少年的某些健康状况中是有效的,目前主要有抑郁症和焦虑症的证据。研究结果指出了IMIs在增强儿童和青少年循证心理保健方面的潜力。