Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis
Identifieur interne : 002666 ( Ncbi/Merge ); précédent : 002665; suivant : 002667Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis
Auteurs : Xinyu Zhou [République populaire de Chine] ; Sarah E. Hetrick [Australie] ; Pim Cuijpers [Pays-Bas] ; Bin Qin [République populaire de Chine] ; Jürgen Barth [Suisse] ; Craig J. Whittington [Royaume-Uni] ; David Cohen [France] ; Cinzia Del Giovane [Italie] ; Yiyun Liu [République populaire de Chine] ; Kurt D. Michael [États-Unis] ; Yuqing Zhang [République populaire de Chine] ; John R. Weisz [États-Unis] ; Peng Xie [République populaire de Chine]Source :
- World Psychiatry [ 1723-8617 ] ; 2015.
Abstract
Previous meta-analyses of psychotherapies for child and adolescent depression were limited because of the small number of trials with direct comparisons between two treatments. A network meta-analysis, a novel approach that integrates direct and indirect evidence from randomized controlled studies, was undertaken to investigate the comparative efficacy and acceptability of psychotherapies for depression in children and adolescents. Systematic searches resulted in 52 studies (total N=3805) of nine psychotherapies and four control conditions. We assessed the efficacy at post-treatment and at follow-up, as well as the acceptability (all-cause discontinuation) of psychotherapies and control conditions. At post-treatment, only interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT) were significantly more effective than most control conditions (standardized mean differences, SMDs ranged from −0.47 to −0.96). Also, IPT and CBT were more beneficial than play therapy. Only psychodynamic therapy and play therapy were not significantly superior to waitlist. At follow-up, IPT and CBT were significantly more effective than most control conditions (SMDs ranged from −0.26 to −1.05), although only IPT retained this superiority at both short-term and long-term follow-up. In addition, IPT and CBT were more beneficial than problem-solving therapy. Waitlist was significantly inferior to other control conditions. With regard to acceptability, IPT and problem-solving therapy had significantly fewer all-cause discontinuations than cognitive therapy and CBT (ORs ranged from 0.06 to 0.33). These data suggest that IPT and CBT should be considered as the best available psychotherapies for depression in children and adolescents. However, several alternative psychotherapies are understudied in this age group. Waitlist may inflate the effect of psychotherapies, so that psychological placebo or treatment-as-usual may be preferable as a control condition in psychotherapy trials.
Url:
DOI: 10.1002/wps.20217
PubMed: 26043339
PubMed Central: 4471978
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<front><div type="abstract" xml:lang="en"><p>Previous meta-analyses of psychotherapies for child and adolescent depression were limited because of the small number of trials with direct comparisons between two treatments. A network meta-analysis, a novel approach that integrates direct and indirect evidence from randomized controlled studies, was undertaken to investigate the comparative efficacy and acceptability of psychotherapies for depression in children and adolescents. Systematic searches resulted in 52 studies (total N=3805) of nine psychotherapies and four control conditions. We assessed the efficacy at post-treatment and at follow-up, as well as the acceptability (all-cause discontinuation) of psychotherapies and control conditions. At post-treatment, only interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT) were significantly more effective than most control conditions (standardized mean differences, SMDs ranged from −0.47 to −0.96). Also, IPT and CBT were more beneficial than play therapy. Only psychodynamic therapy and play therapy were not significantly superior to waitlist. At follow-up, IPT and CBT were significantly more effective than most control conditions (SMDs ranged from −0.26 to −1.05), although only IPT retained this superiority at both short-term and long-term follow-up. In addition, IPT and CBT were more beneficial than problem-solving therapy. Waitlist was significantly inferior to other control conditions. With regard to acceptability, IPT and problem-solving therapy had significantly fewer all-cause discontinuations than cognitive therapy and CBT (ORs ranged from 0.06 to 0.33). These data suggest that IPT and CBT should be considered as the best available psychotherapies for depression in children and adolescents. However, several alternative psychotherapies are understudied in this age group. Waitlist may inflate the effect of psychotherapies, so that psychological placebo or treatment-as-usual may be preferable as a control condition in psychotherapy trials.</p>
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<author><name sortKey="Michael, Kurt D" sort="Michael, Kurt D" uniqKey="Michael K" first="Kurt D" last="Michael">Kurt D. Michael</name>
<affiliation wicri:level="2"><nlm:aff id="au8"><institution>Department of Psychology, Appalachian State University</institution>
<addr-line>Boone, NC, USA</addr-line>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Boone, NC</wicri:regionArea>
<placeName><region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Zhang, Yuqing" sort="Zhang, Yuqing" uniqKey="Zhang Y" first="Yuqing" last="Zhang">Yuqing Zhang</name>
<affiliation wicri:level="1"><nlm:aff id="au1"><institution>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University</institution>
<addr-line>Chongqing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Chongqing</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Weisz, John R" sort="Weisz, John R" uniqKey="Weisz J" first="John R" last="Weisz">John R. Weisz</name>
<affiliation wicri:level="2"><nlm:aff id="au9"><institution>Department of Psychology, Harvard University</institution>
<addr-line>Cambridge, MA, USA</addr-line>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Cambridge, MA</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Xie, Peng" sort="Xie, Peng" uniqKey="Xie P" first="Peng" last="Xie">Peng Xie</name>
<affiliation wicri:level="1"><nlm:aff id="au1"><institution>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University</institution>
<addr-line>Chongqing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Chongqing</wicri:regionArea>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">26043339</idno>
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<idno type="doi">10.1002/wps.20217</idno>
<date when="2015">2015</date>
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<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001111</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis</title>
<author><name sortKey="Zhou, Xinyu" sort="Zhou, Xinyu" uniqKey="Zhou X" first="Xinyu" last="Zhou">Xinyu Zhou</name>
<affiliation wicri:level="1"><nlm:aff id="au1"><institution>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University</institution>
<addr-line>Chongqing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Chongqing</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Hetrick, Sarah E" sort="Hetrick, Sarah E" uniqKey="Hetrick S" first="Sarah E" last="Hetrick">Sarah E. Hetrick</name>
<affiliation wicri:level="1"><nlm:aff id="au2"><institution>Orygen National Centre of Excellence in Youth Mental Health, University of Melbourne</institution>
<addr-line>Melbourne, Australia</addr-line>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Melbourne</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Cuijpers, Pim" sort="Cuijpers, Pim" uniqKey="Cuijpers P" first="Pim" last="Cuijpers">Pim Cuijpers</name>
<affiliation wicri:level="1"><nlm:aff id="au3"><institution>Department of Clinical Psychology, VU University Amsterdam</institution>
<addr-line>Amsterdam, The Netherlands</addr-line>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Amsterdam</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Qin, Bin" sort="Qin, Bin" uniqKey="Qin B" first="Bin" last="Qin">Bin Qin</name>
<affiliation wicri:level="1"><nlm:aff id="au1"><institution>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University</institution>
<addr-line>Chongqing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Chongqing</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Barth, Jurgen" sort="Barth, Jurgen" uniqKey="Barth J" first="Jürgen" last="Barth">Jürgen Barth</name>
<affiliation wicri:level="1"><nlm:aff id="au4"><institution>Institute of Complementary and Integrative Medicine, University Hospital and University of Zurich</institution>
<addr-line>Zurich, Switzerland</addr-line>
</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Zurich</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Whittington, Craig J" sort="Whittington, Craig J" uniqKey="Whittington C" first="Craig J" last="Whittington">Craig J. Whittington</name>
<affiliation wicri:level="1"><nlm:aff id="au5"><institution>Research Department of Clinical, Educational and Health Psychology, University College London</institution>
<addr-line>London, UK</addr-line>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>London</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Cohen, David" sort="Cohen, David" uniqKey="Cohen D" first="David" last="Cohen">David Cohen</name>
<affiliation wicri:level="1"><nlm:aff id="au6"><institution>Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpétrière, Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie Curie</institution>
<addr-line>Paris, France</addr-line>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Del Giovane, Cinzia" sort="Del Giovane, Cinzia" uniqKey="Del Giovane C" first="Cinzia" last="Del Giovane">Cinzia Del Giovane</name>
<affiliation wicri:level="1"><nlm:aff id="au7"><institution>Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia</institution>
<addr-line>Modena, Italy</addr-line>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Modena</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Liu, Yiyun" sort="Liu, Yiyun" uniqKey="Liu Y" first="Yiyun" last="Liu">Yiyun Liu</name>
<affiliation wicri:level="1"><nlm:aff id="au1"><institution>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University</institution>
<addr-line>Chongqing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Chongqing</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Michael, Kurt D" sort="Michael, Kurt D" uniqKey="Michael K" first="Kurt D" last="Michael">Kurt D. Michael</name>
<affiliation wicri:level="2"><nlm:aff id="au8"><institution>Department of Psychology, Appalachian State University</institution>
<addr-line>Boone, NC, USA</addr-line>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Boone, NC</wicri:regionArea>
<placeName><region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Zhang, Yuqing" sort="Zhang, Yuqing" uniqKey="Zhang Y" first="Yuqing" last="Zhang">Yuqing Zhang</name>
<affiliation wicri:level="1"><nlm:aff id="au1"><institution>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University</institution>
<addr-line>Chongqing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Chongqing</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Weisz, John R" sort="Weisz, John R" uniqKey="Weisz J" first="John R" last="Weisz">John R. Weisz</name>
<affiliation wicri:level="2"><nlm:aff id="au9"><institution>Department of Psychology, Harvard University</institution>
<addr-line>Cambridge, MA, USA</addr-line>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Cambridge, MA</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Xie, Peng" sort="Xie, Peng" uniqKey="Xie P" first="Peng" last="Xie">Peng Xie</name>
<affiliation wicri:level="1"><nlm:aff id="au1"><institution>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University</institution>
<addr-line>Chongqing, China</addr-line>
</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Chongqing</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">World Psychiatry</title>
<idno type="ISSN">1723-8617</idno>
<idno type="eISSN">2051-5545</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>Previous meta-analyses of psychotherapies for child and adolescent depression were limited because of the small number of trials with direct comparisons between two treatments. A network meta-analysis, a novel approach that integrates direct and indirect evidence from randomized controlled studies, was undertaken to investigate the comparative efficacy and acceptability of psychotherapies for depression in children and adolescents. Systematic searches resulted in 52 studies (total N=3805) of nine psychotherapies and four control conditions. We assessed the efficacy at post-treatment and at follow-up, as well as the acceptability (all-cause discontinuation) of psychotherapies and control conditions. At post-treatment, only interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT) were significantly more effective than most control conditions (standardized mean differences, SMDs ranged from −0.47 to −0.96). Also, IPT and CBT were more beneficial than play therapy. Only psychodynamic therapy and play therapy were not significantly superior to waitlist. At follow-up, IPT and CBT were significantly more effective than most control conditions (SMDs ranged from −0.26 to −1.05), although only IPT retained this superiority at both short-term and long-term follow-up. In addition, IPT and CBT were more beneficial than problem-solving therapy. Waitlist was significantly inferior to other control conditions. With regard to acceptability, IPT and problem-solving therapy had significantly fewer all-cause discontinuations than cognitive therapy and CBT (ORs ranged from 0.06 to 0.33). These data suggest that IPT and CBT should be considered as the best available psychotherapies for depression in children and adolescents. However, several alternative psychotherapies are understudied in this age group. Waitlist may inflate the effect of psychotherapies, so that psychological placebo or treatment-as-usual may be preferable as a control condition in psychotherapy trials.</p>
</div>
</front>
</TEI>
</pmc>
<pubmed><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis.</title>
<author><name sortKey="Zhou, Xinyu" sort="Zhou, Xinyu" uniqKey="Zhou X" first="Xinyu" last="Zhou">Xinyu Zhou</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing</wicri:regionArea>
<wicri:noRegion>Chongqing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Hetrick, Sarah E" sort="Hetrick, Sarah E" uniqKey="Hetrick S" first="Sarah E" last="Hetrick">Sarah E. Hetrick</name>
<affiliation wicri:level="4"><nlm:affiliation>Orygen National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Orygen National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne</wicri:regionArea>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
<settlement type="city">Melbourne</settlement>
</placeName>
<orgName type="university">Université de Melbourne</orgName>
</affiliation>
</author>
<author><name sortKey="Cuijpers, Pim" sort="Cuijpers, Pim" uniqKey="Cuijpers P" first="Pim" last="Cuijpers">Pim Cuijpers</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Clinical Psychology, VU University Amsterdam, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Qin, Bin" sort="Qin, Bin" uniqKey="Qin B" first="Bin" last="Qin">Bin Qin</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing</wicri:regionArea>
<wicri:noRegion>Chongqing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Barth, Jurgen" sort="Barth, Jurgen" uniqKey="Barth J" first="Jürgen" last="Barth">Jürgen Barth</name>
<affiliation wicri:level="1"><nlm:affiliation>Institute of Complementary and Integrative Medicine, University Hospital and University of Zurich, Zurich, Switzerland.</nlm:affiliation>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Complementary and Integrative Medicine, University Hospital and University of Zurich, Zurich</wicri:regionArea>
<wicri:noRegion>Zurich</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Whittington, Craig J" sort="Whittington, Craig J" uniqKey="Whittington C" first="Craig J" last="Whittington">Craig J. Whittington</name>
<affiliation wicri:level="4"><nlm:affiliation>Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Research Department of Clinical, Educational and Health Psychology, University College London, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
<settlement type="city">Londres</settlement>
</placeName>
<orgName type="university">University College de Londres</orgName>
</affiliation>
</author>
<author><name sortKey="Cohen, David" sort="Cohen, David" uniqKey="Cohen D" first="David" last="Cohen">David Cohen</name>
<affiliation wicri:level="4"><nlm:affiliation>Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpétrière, Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie Curie, Paris, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpétrière, Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie Curie, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
<settlement type="city">Paris</settlement>
</placeName>
<orgName type="university">Université Pierre-et-Marie-Curie</orgName>
</affiliation>
</author>
<author><name sortKey="Del Giovane, Cinzia" sort="Del Giovane, Cinzia" uniqKey="Del Giovane C" first="Cinzia" last="Del Giovane">Cinzia Del Giovane</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena</wicri:regionArea>
<wicri:noRegion>Modena</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Liu, Yiyun" sort="Liu, Yiyun" uniqKey="Liu Y" first="Yiyun" last="Liu">Yiyun Liu</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing</wicri:regionArea>
<wicri:noRegion>Chongqing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Michael, Kurt D" sort="Michael, Kurt D" uniqKey="Michael K" first="Kurt D" last="Michael">Kurt D. Michael</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Psychology, Appalachian State University, Boone, NC, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Psychology, Appalachian State University, Boone, NC</wicri:regionArea>
<placeName><region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Zhang, Yuqing" sort="Zhang, Yuqing" uniqKey="Zhang Y" first="Yuqing" last="Zhang">Yuqing Zhang</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing</wicri:regionArea>
<wicri:noRegion>Chongqing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Weisz, John R" sort="Weisz, John R" uniqKey="Weisz J" first="John R" last="Weisz">John R. Weisz</name>
<affiliation wicri:level="4"><nlm:affiliation>Department of Psychology, Harvard University, Cambridge, MA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Psychology, Harvard University, Cambridge, MA</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
<settlement type="city">Cambridge (Massachusetts)</settlement>
</placeName>
<orgName type="university">Université Harvard</orgName>
</affiliation>
</author>
<author><name sortKey="Xie, Peng" sort="Xie, Peng" uniqKey="Xie P" first="Peng" last="Xie">Peng Xie</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing</wicri:regionArea>
<wicri:noRegion>Chongqing</wicri:noRegion>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PubMed</idno>
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<idno type="RBID">pubmed:26043339</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis.</title>
<author><name sortKey="Zhou, Xinyu" sort="Zhou, Xinyu" uniqKey="Zhou X" first="Xinyu" last="Zhou">Xinyu Zhou</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing</wicri:regionArea>
<wicri:noRegion>Chongqing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Hetrick, Sarah E" sort="Hetrick, Sarah E" uniqKey="Hetrick S" first="Sarah E" last="Hetrick">Sarah E. Hetrick</name>
<affiliation wicri:level="4"><nlm:affiliation>Orygen National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Orygen National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne</wicri:regionArea>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
<settlement type="city">Melbourne</settlement>
</placeName>
<orgName type="university">Université de Melbourne</orgName>
</affiliation>
</author>
<author><name sortKey="Cuijpers, Pim" sort="Cuijpers, Pim" uniqKey="Cuijpers P" first="Pim" last="Cuijpers">Pim Cuijpers</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Clinical Psychology, VU University Amsterdam, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Qin, Bin" sort="Qin, Bin" uniqKey="Qin B" first="Bin" last="Qin">Bin Qin</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing</wicri:regionArea>
<wicri:noRegion>Chongqing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Barth, Jurgen" sort="Barth, Jurgen" uniqKey="Barth J" first="Jürgen" last="Barth">Jürgen Barth</name>
<affiliation wicri:level="1"><nlm:affiliation>Institute of Complementary and Integrative Medicine, University Hospital and University of Zurich, Zurich, Switzerland.</nlm:affiliation>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Institute of Complementary and Integrative Medicine, University Hospital and University of Zurich, Zurich</wicri:regionArea>
<wicri:noRegion>Zurich</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Whittington, Craig J" sort="Whittington, Craig J" uniqKey="Whittington C" first="Craig J" last="Whittington">Craig J. Whittington</name>
<affiliation wicri:level="4"><nlm:affiliation>Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Research Department of Clinical, Educational and Health Psychology, University College London, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
<settlement type="city">Londres</settlement>
</placeName>
<orgName type="university">University College de Londres</orgName>
</affiliation>
</author>
<author><name sortKey="Cohen, David" sort="Cohen, David" uniqKey="Cohen D" first="David" last="Cohen">David Cohen</name>
<affiliation wicri:level="4"><nlm:affiliation>Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpétrière, Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie Curie, Paris, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpétrière, Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie Curie, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
<settlement type="city">Paris</settlement>
</placeName>
<orgName type="university">Université Pierre-et-Marie-Curie</orgName>
</affiliation>
</author>
<author><name sortKey="Del Giovane, Cinzia" sort="Del Giovane, Cinzia" uniqKey="Del Giovane C" first="Cinzia" last="Del Giovane">Cinzia Del Giovane</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena</wicri:regionArea>
<wicri:noRegion>Modena</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Liu, Yiyun" sort="Liu, Yiyun" uniqKey="Liu Y" first="Yiyun" last="Liu">Yiyun Liu</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing</wicri:regionArea>
<wicri:noRegion>Chongqing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Michael, Kurt D" sort="Michael, Kurt D" uniqKey="Michael K" first="Kurt D" last="Michael">Kurt D. Michael</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Psychology, Appalachian State University, Boone, NC, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Psychology, Appalachian State University, Boone, NC</wicri:regionArea>
<placeName><region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Zhang, Yuqing" sort="Zhang, Yuqing" uniqKey="Zhang Y" first="Yuqing" last="Zhang">Yuqing Zhang</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing</wicri:regionArea>
<wicri:noRegion>Chongqing</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Weisz, John R" sort="Weisz, John R" uniqKey="Weisz J" first="John R" last="Weisz">John R. Weisz</name>
<affiliation wicri:level="4"><nlm:affiliation>Department of Psychology, Harvard University, Cambridge, MA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Psychology, Harvard University, Cambridge, MA</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
<settlement type="city">Cambridge (Massachusetts)</settlement>
</placeName>
<orgName type="university">Université Harvard</orgName>
</affiliation>
</author>
<author><name sortKey="Xie, Peng" sort="Xie, Peng" uniqKey="Xie P" first="Peng" last="Xie">Peng Xie</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing</wicri:regionArea>
<wicri:noRegion>Chongqing</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">World psychiatry : official journal of the World Psychiatric Association (WPA)</title>
<idno type="ISSN">1723-8617</idno>
<imprint><date when="2015" type="published">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
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<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Previous meta-analyses of psychotherapies for child and adolescent depression were limited because of the small number of trials with direct comparisons between two treatments. A network meta-analysis, a novel approach that integrates direct and indirect evidence from randomized controlled studies, was undertaken to investigate the comparative efficacy and acceptability of psychotherapies for depression in children and adolescents. Systematic searches resulted in 52 studies (total N=3805) of nine psychotherapies and four control conditions. We assessed the efficacy at post-treatment and at follow-up, as well as the acceptability (all-cause discontinuation) of psychotherapies and control conditions. At post-treatment, only interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT) were significantly more effective than most control conditions (standardized mean differences, SMDs ranged from -0.47 to -0.96). Also, IPT and CBT were more beneficial than play therapy. Only psychodynamic therapy and play therapy were not significantly superior to waitlist. At follow-up, IPT and CBT were significantly more effective than most control conditions (SMDs ranged from -0.26 to -1.05), although only IPT retained this superiority at both short-term and long-term follow-up. In addition, IPT and CBT were more beneficial than problem-solving therapy. Waitlist was significantly inferior to other control conditions. With regard to acceptability, IPT and problem-solving therapy had significantly fewer all-cause discontinuations than cognitive therapy and CBT (ORs ranged from 0.06 to 0.33). These data suggest that IPT and CBT should be considered as the best available psychotherapies for depression in children and adolescents. However, several alternative psychotherapies are understudied in this age group. Waitlist may inflate the effect of psychotherapies, so that psychological placebo or treatment-as-usual may be preferable as a control condition in psychotherapy trials.</div>
</front>
</TEI>
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