Tian Elaine, Ho Margaret Kay, Chou Oscar Hou In, Chong Samantha, Kwan Chi Ting, Lam Athene Hoi-Ying, Chan Kai-Tai
Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR.
Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR.
Clin Child Psychol Psychiatry. 2025 Jul;30(3):537-561. doi: 10.1177/13591045251338475. Epub 2025 Apr 28.
ObjectiveSince the onset of the COVID-19 pandemic, rates of anxiety and depression in youth have risen. Telepsychiatry is a potential mode of intervention for such digital natives. This systematic review aims to examine the effectiveness of telepsychiatry for youth with depression and/or anxiety.MethodsFour electronic databases, PubMed, MEDLINE, Embase, PsycINFO, were searched from their inception to May 12, 2024. Included studies were assessed for study quality and risk of bias.ResultsA search returning 29,944 records yielded 26 included studies, comprising 1,558 youths. Of 13 studies comparing depressive symptoms pre- and post-telepsychiatry intervention, symptom severity was significantly lower post-intervention compared to baseline (Hedges' g: 0.83; 95% CI: 0.59, 1.08). Similarly, of six studies comparing pre- and post-telepsychiatry intervention anxiety symptoms, anxiety scores were significantly lower post-intervention (Hedges' g: 1.15; 95% CI: 0.79, 1.50). Patients undergoing telepsychiatry also had superior outcomes when compared to waitlist control groups for depression (Hedges' g: 0.54; 95% CI: 0.23, 0.85) but not anxiety (Hedges' g: 0.50; 95% CI: -0.09, 1.10). Certainty of these estimates ranged from moderate to very low. Qualitative feedback noted subjective improvement in symptoms and high levels of satisfaction.ConclusionTelepsychiatry has potential as a therapeutic intervention for youth anxiety and depression. Further research with more controlled methodology is needed for development of recommendations that can guide growing use of this technology.
目的
自新冠疫情爆发以来,青少年焦虑和抑郁的发生率有所上升。远程精神病学是针对这些数字原生代的一种潜在干预方式。本系统评价旨在探讨远程精神病学对患有抑郁症和/或焦虑症的青少年的有效性。
方法
检索了四个电子数据库,即PubMed、MEDLINE、Embase和PsycINFO,检索时间从各数据库建立至2024年5月12日。对纳入的研究进行研究质量和偏倚风险评估。
结果
检索得到29,944条记录,其中26项研究被纳入,涉及1558名青少年。在13项比较远程精神病学干预前后抑郁症状的研究中,干预后症状严重程度明显低于基线(Hedges' g:0.83;95%置信区间:0.59,1.08)。同样,在6项比较远程精神病学干预前后焦虑症状的研究中,干预后焦虑评分明显降低(Hedges' g:1.15;95%置信区间:0.79,1.50)。与等待名单对照组相比,接受远程精神病学治疗的患者在抑郁症方面也有更好的结果(Hedges' g:0.54;95%置信区间:0.23,0.85),但在焦虑症方面没有(Hedges' g:0.50;95%置信区间:-0.09,1.10)。这些估计的确定性从中度到非常低不等。定性反馈指出症状有主观改善且满意度很高。
结论
远程精神病学有潜力作为青少年焦虑和抑郁的一种治疗干预方式。需要采用更具控制性的方法进行进一步研究,以制定能够指导该技术日益广泛应用的建议。