Perzow Sarah E D, Hu Junxiao, Bristol Madison, Ruzicka Elizabeth B, Clementi Michelle A, Handing Elizabeth P, Vargas Elizabeth, Gutierrez-Colina Ana M, Gulley Lauren D, Shomaker Lauren B
Department of Human Development and Family Studies, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado, United States.
Department of Pediatrics, Section of Endocrinology, Section of Nutrition, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado, United States.
J Pediatr Psychol. 2025 Jul 1;50(7):699-714. doi: 10.1093/jpepsy/jsaf049.
Depression is prevalent, impairing, and detrimental to health. The objective of this systematic review and meta-analysis was to assess the efficacy of psychological interventions for decreasing symptoms of depression among young people with long-term physical health conditions.
CENTRAL, MEDLINE, PsycINFO, PubMed, clinicaltrials.gov, and WHO ICTRIP were searched through July 1, 2023. Selection criteria were randomized controlled trials of psychological interventions targeting depression symptoms among people ≤29 years diagnosed with long-term physical health conditions. Risk of bias was assessed using the Cochrane RoB version 2 tool. Outcome data were analyzed using fixed-effects models. Pooled standardized mean difference (SMD) between experimental and control was calculated using an inverse variance approach with a linear model. Heterogeneity was assessed by χ2 test on Cochran's Q statistic and quantified with I2 statistic.
Results included six trials (N = 376) of 11- to 18-year-olds (Mfemale=80%), recruited from pediatric clinics in the United States. Two of six eligible studies had an inclusion criterion related to elevated depression symptoms; the remainder included youth with heterogeneous depression levels. Psychological interventions were more efficacious than controls for reducing depression symptoms and functional disability. Pooled SMD for depression symptoms was -.30 (-.51, -.10), with a significant overall effect (Z = 2.92, p = .004). Pooled SMD for functional disability was -.35 (-.66, -.05), with a significant overall effect (Z = 2.28, p = .02). Moderate study heterogeneity was noted in two study outcomes.
Psychological interventions reduce depression symptoms and functional disability among youth with long-term physical health conditions. Research is needed to elucidate participant/trial characteristics contributing to outcomes.
抑郁症普遍存在，会造成损害且对健康有害。本系统评价和荟萃分析的目的是评估心理干预对减轻患有长期身体健康问题的年轻人抑郁症状的疗效。
检索截至2023年7月1日的CENTRAL、MEDLINE、PsycINFO、PubMed、clinicaltrials.gov和世界卫生组织国际临床试验注册平台。纳入标准为针对诊断患有长期身体健康问题的29岁及以下人群抑郁症状的心理干预随机对照试验。使用Cochrane偏倚风险评估工具第2版评估偏倚风险。使用固定效应模型分析结果数据。采用逆方差法和线性模型计算实验组和对照组之间的合并标准化平均差（SMD）。通过对Cochrane Q统计量进行χ²检验评估异质性，并用I²统计量进行量化。
结果包括6项试验（N = 376），研究对象为11至18岁青少年（女性占80%），从美国儿科诊所招募。6项符合条件的研究中有2项纳入标准与抑郁症状升高有关；其余研究纳入了抑郁水平各异的青少年。心理干预在减轻抑郁症状和功能残疾方面比对照组更有效。抑郁症状的合并SMD为-.30（-.51，-.10），总体效果显著（Z = 2.92，p = .004）。功能残疾的合并SMD为-.35（-.66，-.05），总体效果显著（Z = 2.28，p = .02）。在两项研究结果中发现了中度研究异质性。
心理干预可减轻患有长期身体健康问题的青少年的抑郁症状和功能残疾。需要开展研究以阐明影响结果的参与者/试验特征。
