Campisi Susan C, Krause Karolin R, Chan Benjamin W C, Courtney Darren B, Bennett Kathryn, Korczak Daphne J, Szatmari Peter
Department of Psychiatry, Hospital for Sick Children, Canada.
Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Canada; Evidence-Based Practice Unit, University College London, UK; and Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, UK.
BJPsych Open. 2021 Oct 5;7(6):e185. doi: 10.1192/bjo.2021.1020.
Current first-line treatments for paediatric depression demonstrate mild-to-moderate effectiveness. This has spurred a growing body of literature on lifestyle recommendations pertaining to nutrition, sleep and exercise for treating paediatric depression.
Paediatric depression clinical practice guidelines (CPGs) were reviewed for quality and to catalogue recommendations on nutrition, sleep and exercise made by higher-quality CPGs.
Searches were conducted in Medline, EMBASE, PsycINFO, Web of Science and CINAHL, and grey literature CPGs databases for relevant CPGs. Eligible CPGs with a minimum or high-quality level, as determined by the Appraisal of Guidelines for Research and Evaluation, Second Edition instrument, were included if they were (a) paediatric; (b) CPGs, practice parameter or consensus or expert committee recommendations; (c) for depression; (d) the latest version and (e) lifestyle recommendations for nutrition, sleep or exercise. Key information extracted included author(s), language, year of publication, country, the institutional body issuing the CPG, target disorder, age group, lifestyle recommendation and the methods used to determine CPG lifestyle recommendations.
Ten paediatric CPGs for depression with a minimum or high-quality level contained recommendations on nutrition, sleep or exercise. Lifestyle recommendations were predominately qualitative, with quantitative details only outlined in two CPGs for exercise. Most recommendations were brief general statements, with 50% lacking supporting evidence from the literature.
Interest in lifestyle interventions for treatment in child and youth depression is growing. However, current CPG lifestyle recommendations for nutrition, sleep or exercise are based on expert opinion rather than clinical trials.
目前用于治疗儿童抑郁症的一线疗法显示出轻度至中度的疗效。这激发了越来越多关于营养、睡眠和运动等生活方式建议对治疗儿童抑郁症的文献。
对儿童抑郁症临床实践指南（CPG）进行质量审查，并梳理高质量CPG中关于营养、睡眠和运动的建议。
在医学文献数据库（Medline）、荷兰医学文摘数据库（EMBASE）、心理学文摘数据库（PsycINFO）、科学引文索引数据库（Web of Science）和护理学与健康领域数据库（CINAHL）以及灰色文献CPG数据库中检索相关CPG。符合条件的CPG若具有由《研究与评价指南评估第二版》工具确定的最低或高质量水平，且满足以下条件则纳入：（a）针对儿科；（b）CPG、实践参数或共识或专家委员会建议；（c）针对抑郁症；（d）最新版本；（e）关于营养、睡眠或运动的生活方式建议。提取的关键信息包括作者、语言、出版年份、国家、发布CPG的机构主体、目标疾病、年龄组、生活方式建议以及用于确定CPG生活方式建议的方法。
十份具有最低或高质量水平的儿童抑郁症CPG包含了关于营养、睡眠或运动的建议。生活方式建议主要是定性的，只有两份关于运动的CPG概述了定量细节。大多数建议是简短的一般性陈述，50%缺乏文献支持证据。
儿童和青少年抑郁症治疗中对生活方式干预的兴趣日益增长。然而，目前CPG中关于营养、睡眠或运动的生活方式建议是基于专家意见而非临床试验。
