University of Alberta, Edmonton, AB, Canada.
IWK Health, Halifax, NS, Canada.
Child Adolesc Ment Health. 2023 Sep;28(3):425-437. doi: 10.1111/camh.12661. Epub 2023 Jul 18.
Adverse event monitoring in studies of psychotherapy is crucial to clinical decision-making, particularly for weighing of benefits and harms of treatment approaches. In this systematic review, we identified how adverse events are defined, measured, and reported in studies of psychosocial interventions for children with mental disorders.
Medline, PsycINFO, Embase, ProQuest Dissertations and Theses Global, and the Cochrane Library were searched from January 2011-January 2023, and Google Scholar from January 2011-February 2023. English language experimental and quasi-experimental studies that evaluated the efficacy or effectiveness of psychosocial interventions for childhood mental disorders were included. Information on the definition, assessment, and report of adverse events was extracted using a checklist based on Good Clinical Practice guidelines.
In this review, 117 studies were included. Studies most commonly involved treating anxiety disorders or obsessive-compulsive disorder (32/117; 27%); 44% of the experimental interventions tested (52/117) were cognitive behavioral therapies. Adverse events were monitored in 36 studies (36/117; 31%) with a protocol used in 19 of these studies to guide monitoring (19/36; 53%). Twenty-seven different events were monitored across the studies with hospitalization the most frequently monitored (3/36; 8%). Event severity was fully assessed in 6 studies (17%) and partially assessed in 12 studies (33%). Only 4/36 studies (11%) included assessing events for cause.
To date, adverse events have been inconsistently defined, measured and reported in psychosocial intervention studies of childhood mental health disorders. Information on adverse events is an essential knowledge component for understanding the potential impacts and risks of therapeutic interventions.
在心理治疗研究中进行不良事件监测对于临床决策至关重要,尤其是在权衡治疗方法的利弊方面。在本系统评价中,我们确定了在针对儿童精神障碍的心理社会干预研究中,不良事件是如何定义、测量和报告的。
从 2011 年 1 月至 2023 年 1 月,检索了 Medline、PsycINFO、Embase、ProQuest Dissertations and Theses Global 和 Cochrane Library,并从 2011 年 1 月至 2023 年 2 月检索了 Google Scholar。纳入了评估儿童精神障碍心理社会干预有效性或效果的英语实验和准实验研究。使用基于良好临床实践指南的检查表提取关于不良事件的定义、评估和报告信息。
本综述纳入了 117 项研究。研究最常涉及治疗焦虑症或强迫症(32/117;27%);44%的实验干预措施(52/117)为认知行为疗法。有 36 项研究(36/117;31%)监测了不良事件,其中 19 项研究(19/36;53%)使用方案来指导监测。在这些研究中监测了 27 种不同的事件,其中住院治疗是最常监测的事件(3/36;8%)。在 6 项研究(17%)中对事件的严重程度进行了全面评估,在 12 项研究(33%)中进行了部分评估。只有 4/36 项研究(11%)包括对事件原因进行评估。
迄今为止,在儿童心理健康障碍的心理社会干预研究中,不良事件的定义、测量和报告不一致。不良事件的信息是了解治疗干预潜在影响和风险的重要知识组成部分。