Tetkovic Irena, Anderson Joanna K, Brocklebank Danielle, O'Logbon Jessica, Burn Anne-Marie, Ford Tamsin J
Department of Psychiatry University of Cambridge Cambridge UK.
JCPP Adv. 2025 Jan 23;5(2):e12300. doi: 10.1002/jcv2.12300. eCollection 2025 Jun.
Childhood mental health conditions typically affect the entire family, including siblings, however there is a lack of research investigating interventions supporting siblings.
The review was prospectively registered with PROSPERO (CRD42022377163). We conducted systematic searches of 7 databases (Medline, EMBASE, PsycINFO, Child and Developmental and Adolescent Studies, Applied Social Science Index and Abstracts, Education Research Information Centre, and British Eduction Index) for studies evaluating interventions for children and young people (CYP) with siblings presenting with mental health conditions from January 1980 to August 2024. We included interventions for young people aged 4 to 24 years who have a sibling with a mental health condition, with symptoms and impact lasting at least 3 months. Quality of reporting was assessed using the Critical Appraisal Skills Programme qualitative checklist for qualitative and the Effective Public Health Project Practice quality assessment Tool for quantitative studies.
We identified 4 eligible studies; 2 of family-based treatment and the other of drop-in group support from 2469 studies that were screened in total. Quantitative results were rated weak for three out of four studies, while qualitative results were rated moderate for two studies, and high for one study. The two studies of sibling support groups reported high acceptability.
The evidence for the effectiveness of interventions for siblings of CYP with mental health conditions is limited in both size and quality, highlighting a significant gap in research and practice. We cannot draw definitive conclusions from the available evidence, but it suggests support groups have potential to improve sibling outcomes. Additional research is required to determine sibling mental health trajectories and to identify risk and resilience factors possibly influencing poorer mental health outcomes. Clinicians should be mindful of potential effects of mental health conditions on other family members and encourage parents to communicate openly with siblings about family dynamics and the challenges they may face.
儿童心理健康状况通常会影响整个家庭，包括兄弟姐妹，但缺乏对支持兄弟姐妹的干预措施的研究。
该综述已在PROSPERO（CRD42022377163）上进行前瞻性注册。我们对7个数据库（Medline、EMBASE、PsycINFO、儿童与发展及青少年研究、应用社会科学索引与摘要、教育研究信息中心和英国教育索引）进行了系统检索，以查找1980年1月至2024年8月期间评估针对患有心理健康状况的儿童和青少年（CYP）及其兄弟姐妹的干预措施的研究。我们纳入了针对4至24岁、有心理健康状况的兄弟姐妹且症状和影响持续至少3个月的青少年的干预措施。使用批判性评估技能计划定性清单对定性研究的报告质量进行评估，使用有效公共卫生项目实践质量评估工具对定量研究进行评估。
我们共筛选了2469项研究，确定了4项符合条件的研究；其中2项为基于家庭的治疗，另外1项为即席小组支持。四项研究中有三项的定量结果被评为较弱，而两项研究的定性结果被评为中等，一项研究的定性结果被评为较高。两项关于兄弟姐妹支持小组的研究报告了较高的可接受性。
针对患有心理健康状况的CYP的兄弟姐妹的干预措施有效性的证据在规模和质量上都很有限，凸显了研究和实践中的重大差距。我们无法从现有证据中得出明确结论，但这表明支持小组有可能改善兄弟姐妹的状况。需要进一步研究以确定兄弟姐妹的心理健康轨迹，并识别可能影响较差心理健康结果的风险和恢复力因素。临床医生应注意心理健康状况对其他家庭成员的潜在影响，并鼓励父母与兄弟姐妹就家庭动态和他们可能面临的挑战进行坦诚沟通。
