Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK.
Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK.
J Psychosom Res. 2020 Sep;136:110187. doi: 10.1016/j.jpsychores.2020.110187. Epub 2020 Jul 6.
Rates of psychiatric disorders are considerably elevated in young people with long term physical health conditions. Currently few children obtain effective mental health treatments in the context of long term physical health conditions, and ways to improve access to evidence-based mental health interventions are urgently needed. One approach is to deploy briefer, more economical, yet still evidence-based, treatments. The objective of this review was to evaluate the efficacy of brief interventions targeting psychiatric disorders in children and young people with long term physical health conditions.
Predefined terms relating to brief psychological interventions for psychiatric disorders in children with long term physical health conditions were used to search relevant databases. A systematic review and meta-analysis was carried out in accordance with the Cochrane guidelines. Two reviewers independently screened titles and abstracts, extracted the data and conducted risk of bias assessments.
A total of 12 randomised controlled trials were found to meet the inclusion criteria of the review. Of those, three studies were suitable for meta-analysis. A large effect size in favour of brief cognitive behavioural therapy for anxiety was found (g = - 0.95, CI -1.49 to -0.041; p < .001) with non-significant moderate-substantial heterogeneity (I = 58%; p = .09).
This review suggests there is preliminary evidence that brief interventions, based on cognitive behavioural principles, may benefit young people with an anxiety disorder in the context of a long term physical health condition. There was insufficient evidence to assess whether this held true for depression and disruptive behaviour.
患有长期身体健康问题的年轻人中,精神障碍的发病率相当高。目前,很少有儿童在长期身体健康的情况下获得有效的心理健康治疗,因此迫切需要找到改善获得循证心理健康干预措施的途径。一种方法是部署更简短、更经济但仍然基于证据的治疗方法。本综述的目的是评估针对患有长期身体健康问题的儿童和青少年的精神障碍的简短干预措施的疗效。
使用与针对患有长期身体健康问题的儿童的精神障碍的简短心理干预相关的预定义术语来搜索相关数据库。按照 Cochrane 指南进行了系统综述和荟萃分析。两位审阅者独立筛选标题和摘要,提取数据并进行偏倚风险评估。
共发现 12 项符合本综述纳入标准的随机对照试验。其中,有 3 项研究适合进行荟萃分析。发现简短认知行为疗法对焦虑症有很大的疗效(g = -0.95,CI -1.49 至 -0.041;p < 0.001),异质性中度显著(I = 58%;p = 0.09)。
本综述表明,基于认知行为原则的简短干预措施可能对患有长期身体健康问题的焦虑症青年有益,这方面有初步证据。但对于抑郁症和行为障碍,尚无足够的证据来评估这是否成立。