Havinga Petra J, Maciejewski Dominique F, Hartman Catharina A, Hillegers Manon H J, Schoevers Robert A, Penninx Brenda W J H
Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, The Netherlands.
Department of Developmental Psychopathology, Behavioural Science Institute, Nijmegen, The Netherlands.
Br J Clin Psychol. 2021 Jun;60(2):212-251. doi: 10.1111/bjc.12277. Epub 2021 Jan 6.
To systematically describe the characteristics and techniques of prevention programmes for children of parents with mood/anxiety disorders. In addition, recruitment approaches and difficulties were identified and a meta-analysis was conducted to examine the efficacy of these prevention programmes.
Randomized controlled trials assessing the efficacy of a prevention programme for children (6-25 years) of parents with mood and/or anxiety disorders were included. A systematic literature search was conducted in PubMed, PsychINFO, and CENTRAL from the earliest record to March 2019. In addition, programme manuals of identified prevention programmes were requested for a content analysis.
Twenty-two articles containing eight unique prevention programmes involving 1,325 subjects were identified. Programmes varied in the number and types of techniques, but all provided psychoeducation. Results suggested that recruitment via clinicians was more successful than recruitment via health maintenance organization databases. In a meta-analysis, a significant risk difference was found in favour of prevention programmes on the risk of developing a depressive/anxiety disorder in offspring at short-term (9-18 months follow-up; RR = 0.37, 95% CI [0.21; 0.66]) and long-term follow-up (24 months or longer follow-up; RR = 0.71, 95% CI [0.57; 0.87] and on symptom levels in offspring at post-intervention (SMD = -0.19, 95% CI [-0.36; -0.02]) and at 12-months follow-up (SMD = -0.31, 95% CI [-0.57; -0.06]).
The prevention programmes combined psychoeducational elements with skills training and/or cognitive-behavioural therapy elements. The recruitment process and the content of these programmes are sometimes insufficiently described. Nevertheless, they appear to be effective, indicating a need to further examine how these programmes exactly work and for whom.
Preventive interventions for children of parents with mood/anxiety disorders appear to be effective in preventing these disorders in offspring. Available preventive intervention programmes focus mostly on psychoeducation, cognitive-behavioural therapy, and family processes. More effort should be made into describing preventive interventions so that they can be easily implemented by practitioners. Studies should further examine why and for whom preventive interventions for children of parents with mood/anxiety disorders are effective.
系统描述针对患有情绪/焦虑障碍父母的子女的预防项目的特点和技术。此外，确定招募方法和困难，并进行荟萃分析以检验这些预防项目的效果。
纳入评估针对患有情绪和/或焦虑障碍父母的子女（6至25岁）的预防项目效果的随机对照试验。从最早记录到2019年3月在PubMed、PsychINFO和CENTRAL进行了系统的文献检索。此外，索取已确定的预防项目的项目手册进行内容分析。
确定了22篇文章，其中包含8个独特的预防项目，涉及1325名受试者。各项目在技术的数量和类型上有所不同，但均提供了心理教育。结果表明，通过临床医生招募比通过健康维护组织数据库招募更成功。在一项荟萃分析中，发现有显著的风险差异，表明预防项目在短期（9至18个月随访；RR = 0.37，95%CI [0.21；0.66]）和长期随访（24个月或更长时间随访；RR = 0.71，95%CI [0.57；0.87]）对后代患抑郁/焦虑障碍的风险有优势，并且在干预后（SMD = -0.19，95%CI [-0.36；-0.02]）和12个月随访时（SMD = -0.31，95%CI [-0.57；-0.06]）对后代的症状水平有优势。
预防项目将心理教育元素与技能培训和/或认知行为治疗元素相结合。这些项目的招募过程和内容有时描述得不够充分。然而，它们似乎是有效的，这表明需要进一步研究这些项目究竟如何起作用以及对谁起作用。
针对患有情绪/焦虑障碍父母的子女的预防性干预措施似乎在预防后代患这些疾病方面是有效的。现有的预防性干预项目主要侧重于心理教育、认知行为治疗和家庭过程。应更加努力描述预防性干预措施，以便从业者能够轻松实施。研究应进一步探讨为什么以及对谁而言针对患有情绪/焦虑障碍父母的子女的预防性干预措施是有效的。
