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各种心理社会疗法治疗儿童和青少年抑郁症的效果比较:贝叶斯网络荟萃分析。

Effectiveness comparisons of various psychosocial therapies for children and adolescents with depression: a Bayesian network meta-analysis.

机构信息

Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, 215123, Jiangsu, People's Republic of China.

Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, No. 199 Ren Ai Road, Suzhou, 215123, Jiangsu, People's Republic of China.

出版信息

Eur Child Adolesc Psychiatry. 2021 May;30(5):685-697. doi: 10.1007/s00787-020-01492-w. Epub 2020 Feb 19.

Abstract

The existence of depression among children or adolescents can trigger a sequence of burdens on themselves, their families and even the whole society, which cause both physical and economic impacts. Our network meta-analysis (NMA) was aimed at comparing them with each other for evaluating the optimal psychosocial therapy to help children and adolescents with depression to improve their mental health. Based on several biomedical databases, a system of search strategies was conducted for searching randomized controlled trials (RCTs) which published from their inception on October, 1st 2018 without language restriction. We carried out an expression analysis for comparing the efficacy of various psychosocial therapies using Bayesian NMA. A battery of analyses and assessments, such as conventional meta-analysis and risk of bias, were performed concurrently. Only 32 of RCTs which involved 2677 participants were eventually included in our analyses from the 19,176 of initial citation screening. In addition, in terms of various valid assessment instruments, interpersonal psychotherapy [standard mean difference (SMD) = -1.38, Credible interval (CrI) - 2.5, - 0.20)], computer cognitive-behavioral therapy (SMD = -1.36, CrI - 2.59, - 0.14), cognitive-behavioral therapy (SMD = -1.16, CrI - 2.15, - 0.18), had significantly better effects than the named control group. All together, these results suggest that interpersonal psychotherapy might be the best approach to improve the depressive state among children and adolescents. This study may provide an excellent resource for future endeavors to utilize psychosocial interventions and may also serve as a springboard for creative undertakings as yet unknown.

摘要

儿童或青少年抑郁症的存在会引发一系列自身、家庭甚至整个社会的负担,造成身体和经济方面的影响。我们的网络荟萃分析(NMA)旨在相互比较,以评估最佳的心理社会治疗方法,帮助患有抑郁症的儿童和青少年改善心理健康。我们基于几个生物医学数据库,制定了一套搜索策略,以搜索从 2018 年 10 月 1 日起发表的、无语言限制的随机对照试验(RCT)。我们使用贝叶斯 NMA 进行表达分析,以比较各种心理社会疗法的疗效。同时进行了一系列分析和评估,如常规荟萃分析和偏倚风险评估。仅从最初的引文筛选的 19176 项中,最终纳入了 32 项 RCT,涉及 2677 名参与者。此外,在各种有效的评估工具方面,人际心理治疗[标准均数差(SMD)= -1.38,可信区间(CrI)-2.5,-0.20)]、计算机认知行为疗法(SMD = -1.36,CrI -2.59,-0.14)、认知行为疗法(SMD = -1.16,CrI -2.15,-0.18),效果明显优于对照组。总之,这些结果表明人际心理治疗可能是改善儿童和青少年抑郁状态的最佳方法。本研究可为未来利用心理社会干预提供宝贵资源,也可为未知的创新性研究提供跳板。

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