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儿童和青少年社交焦虑障碍的心理干预措施:系统评价和网络荟萃分析。

Psychological interventions for social anxiety disorder in children and adolescents: A systematic review and network meta-analysis.

机构信息

School of Education Science, Jiangsu Second Normal University, Nanjing, China.

School of Education Science, Jiangsu Second Normal University, Nanjing, China.

出版信息

J Affect Disord. 2024 Nov 15;365:614-627. doi: 10.1016/j.jad.2024.08.097. Epub 2024 Aug 22.

Abstract

BACKGROUND

Social anxiety disorder (SAD) is a high-prevalence mental disorder among children and adolescents. The aim of this study is to compare and rank the effectiveness of several psychotherapies for SAD among children and adolescents.

METHODS

Only randomized controlled trials (RCTs) were utilized by searching PubMed, Embase, Cochrane Library, and Web of Science. We used network meta-analysis in the Bayesian framework to analyze the data. This study is registered with PROSPERO, number CRD42023476829.

RESULTS

In total, 30 RCTs with 1547 individuals were included, and nine psychotherapies with three control conditions were compared and ranked in this study. The findings revealed that internet-delivered cognitive behavioural therapy (surface under the cumulative ranking curve [SUCRA: 71.2 %]), group cognitive behavioural therapy (SUCRA: 68.4 %), and individual cognitive behavioural therapy (SUCRA: 66.0 %) significantly reduced social anxiety symptoms; internet-delivered cognitive behavioural therapy also significantly decreased depression symptoms in these patients (SUCRA: 92.2 %). In addition, group cognitive behavioural therapy can enhance functioning in these patients (SUCRA: 89.6 %).

CONCLUSION

These results suggest that internet-delivered cognitive behavioural therapy is the optimal type of psychotherapy for reducing social anxiety and depression symptoms in children and adolescents with SAD, internet-delivered parent-child interaction therapy and cognitive bias modification of interpretation have relatively poor treatment effects on social anxiety symptoms in children than other psychological interventions, and group cognitive behavioural therapy has better benefits in enhancing the functioning among children and adolescents with SAD. Further studies are needed to ascertain these results due to the limited number of included studies.

摘要

背景

社交焦虑障碍(SAD)是儿童和青少年中一种高发的精神障碍。本研究旨在比较和排列几种针对儿童和青少年 SAD 的心理疗法的效果。

方法

仅使用搜索 PubMed、Embase、Cochrane 图书馆和 Web of Science 的随机对照试验(RCT)。我们使用贝叶斯框架中的网络荟萃分析来分析数据。本研究已在 PROSPERO 注册,编号为 CRD42023476829。

结果

共纳入 30 项 RCT,涉及 1547 人,本研究比较和排列了 9 种心理疗法和 3 种对照条件。研究结果显示,互联网提供的认知行为疗法(表面累积排序曲线下面积 [SUCRA:71.2%])、团体认知行为疗法(SUCRA:68.4%)和个体认知行为疗法(SUCRA:66.0%)可显著减轻社交焦虑症状;互联网提供的认知行为疗法还可显著降低这些患者的抑郁症状(SUCRA:92.2%)。此外,团体认知行为疗法可增强这些患者的功能(SUCRA:89.6%)。

结论

这些结果表明,互联网提供的认知行为疗法是治疗儿童和青少年 SAD 患者减轻社交焦虑和抑郁症状的最佳心理疗法,互联网提供的亲子互动疗法和解释认知偏差修正对儿童社交焦虑症状的治疗效果相对较差,而团体认知行为疗法在增强 SAD 儿童和青少年的功能方面具有更好的益处。由于纳入研究数量有限,需要进一步的研究来证实这些结果。

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