Harrington R, Whittaker J, Shoebridge P, Campbell F
Department of Child and Adolescent Psychiatry, Royal Manchester Children's Hospital, Manchester M27 1HA.
BMJ. 1998 May 23;316(7144):1559-63. doi: 10.1136/bmj.316.7144.1559.
To determine whether cognitive behaviour therapy is an effective treatment for childhood and adolescent depressive disorder.
Systematic review of six randomised trials comparing the efficacy of cognitive behaviour therapy with inactive interventions in subjects aged 8 to 19 years with depressive disorder.
Remission from depressive disorder.
The rate of remission from depressive disorder was higher in the therapy group (129/208; 62%) than in the comparison group (61/168; 36%). The pooled odds ratio was 3.2 (95% confidence interval 1.9 to 5.2), suggesting a significant benefit of active treatment. Most studies, however, were based on relatively mild cases of depression and were of only moderate quality.
Cognitive behaviour therapy may be of benefit for depressive disorder of moderate severity in children and adolescents. It cannot, however, yet be recommended for severe depression. Definitive large trials will be required to determine whether the results of this systematic review are reliable.
确定认知行为疗法是否为治疗儿童及青少年抑郁症的有效方法。
对六项随机试验进行系统评价,比较认知行为疗法与非活性干预措施对8至19岁抑郁症患者的疗效。
抑郁症缓解情况。
治疗组抑郁症缓解率(129/208;62%)高于对照组(61/168;36%)。合并优势比为3.2(95%置信区间1.9至5.2),表明积极治疗有显著益处。然而,大多数研究基于相对轻度的抑郁症病例,质量仅为中等。
认知行为疗法可能对儿童及青少年中度抑郁症有益。然而,目前还不能推荐用于重度抑郁症。需要进行确定性的大型试验来确定该系统评价的结果是否可靠。