University College London and the Anna Freud National Centre for Children and Families, London, UK.
University College London and the Anna Freud National Centre for Children and Families, London, UK.
J Am Acad Child Adolesc Psychiatry. 2019 Jan;58(1):61-71. doi: 10.1016/j.jaac.2018.07.893. Epub 2018 Oct 29.
Measurement of treatment outcomes in childhood depression has traditionally focused on assessing symptoms from the clinician's perspective, without exploring other outcome domains or considering young people's perspectives. This systematic review explored the extent to which multidimensional and multi-informant outcome measurements have been used in clinical research for adolescent depression in the past decade and how patterns have evolved over time.
Embase, Medline, and PsycINFO were searched, and studies that were published from 2007 through 2017 and assessed the effectiveness of treatments or service provision for adolescent depression were included. Of 7,483 studies screened, 95 met the inclusion criteria and were included for data extraction and analysis.
Ten outcomes domains were identified, 2 of which were assessed on average using 4 outcome measures. Most studies (94%) measured symptoms, followed by functioning (52%). Other domains such as personal growth, relationships, quality of life, and service satisfaction were each considered by less than 1 in 10 studies. Youth self-report was considered by 54% but tended to focus on secondary outcomes. Multidimensional and multi-informant measurements were more frequent in studies published since 2015.
Recent clinical research continues to prioritize symptoms measurement based on clinician report and has not yet fully embraced multidimensional and multi-informant approaches. In the context of significant policy shifts toward patient-centered and evidence-based care, measuring what matters most to patients has become a priority, but this is not yet widely reflected in clinical research.
儿童抑郁症的治疗结果评估传统上侧重于从临床医生的角度评估症状,而没有探索其他结果领域或考虑年轻人的观点。本系统综述探讨了在过去十年中,多维和多信息源的结果测量在青少年抑郁症的临床研究中被应用的程度,以及随着时间的推移模式如何演变。
对 Embase、Medline 和 PsycINFO 进行了检索,纳入了 2007 年至 2017 年发表的评估青少年抑郁症治疗或服务提供效果的研究。在筛选出的 7483 项研究中,有 95 项符合纳入标准,并纳入进行数据提取和分析。
确定了 10 个结果领域,其中 2 个领域平均使用 4 种结果测量方法进行评估。大多数研究(94%)测量症状,其次是功能(52%)。其他领域,如个人成长、人际关系、生活质量和服务满意度,每个领域被不到 10%的研究考虑。青年自我报告被 54%的研究考虑,但往往侧重于次要结果。多维和多信息源测量在 2015 年以后发表的研究中更为常见。
最近的临床研究继续基于临床医生报告优先考虑症状测量,尚未完全采用多维和多信息源方法。在向以患者为中心和以证据为基础的护理的重大政策转变的背景下,衡量对患者最重要的内容已成为当务之急,但这在临床研究中尚未得到广泛体现。