Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis.
Identifieur interne : 002C56 ( PubMed/Corpus ); précédent : 002C55; suivant : 002C57Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis.
Auteurs : Xinyu Zhou ; Sarah E. Hetrick ; Pim Cuijpers ; Bin Qin ; Jürgen Barth ; Craig J. Whittington ; David Cohen ; Cinzia Del Giovane ; Yiyun Liu ; Kurt D. Michael ; Yuqing Zhang ; John R. Weisz ; Peng XieSource :
- World psychiatry : official journal of the World Psychiatric Association (WPA) [ 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.
DOI: 10.1002/wps.20217
PubMed: 26043339
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<record><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><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation></affiliation></author><author><name sortKey="Hetrick, Sarah E" sort="Hetrick, Sarah E" uniqKey="Hetrick S" first="Sarah E" last="Hetrick">Sarah E. 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Weisz</name><affiliation><nlm:affiliation>Department of Psychology, Harvard University, Cambridge, MA, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Xie, Peng" sort="Xie, Peng" uniqKey="Xie P" first="Peng" last="Xie">Peng Xie</name><affiliation><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2015">2015</date><idno type="RBID">pubmed:26043339</idno><idno type="pmid">26043339</idno><idno type="doi">10.1002/wps.20217</idno><idno type="wicri:Area/PubMed/Corpus">002C56</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002C56</idno></publicationStmt><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><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation></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><nlm:affiliation>Orygen National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Cuijpers, Pim" sort="Cuijpers, Pim" uniqKey="Cuijpers P" first="Pim" last="Cuijpers">Pim Cuijpers</name><affiliation><nlm:affiliation>Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Qin, Bin" sort="Qin, Bin" uniqKey="Qin B" first="Bin" last="Qin">Bin Qin</name><affiliation><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation></affiliation></author><author><name sortKey="Barth, Jurgen" sort="Barth, Jurgen" uniqKey="Barth J" first="Jürgen" last="Barth">Jürgen Barth</name><affiliation><nlm:affiliation>Institute of Complementary and Integrative Medicine, University Hospital and University of Zurich, Zurich, Switzerland.</nlm:affiliation></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><nlm:affiliation>Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Cohen, David" sort="Cohen, David" uniqKey="Cohen D" first="David" last="Cohen">David Cohen</name><affiliation><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></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><nlm:affiliation>Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Yiyun" sort="Liu, Yiyun" uniqKey="Liu Y" first="Yiyun" last="Liu">Yiyun Liu</name><affiliation><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation></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><nlm:affiliation>Department of Psychology, Appalachian State University, Boone, NC, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Zhang, Yuqing" sort="Zhang, Yuqing" uniqKey="Zhang Y" first="Yuqing" last="Zhang">Yuqing Zhang</name><affiliation><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation></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><nlm:affiliation>Department of Psychology, Harvard University, Cambridge, MA, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Xie, Peng" sort="Xie, Peng" uniqKey="Xie P" first="Peng" last="Xie">Peng Xie</name><affiliation><nlm:affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</nlm:affiliation></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></fileDesc><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><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">26043339</PMID><DateCreated><Year>2015</Year><Month>06</Month><Day>05</Day></DateCreated><DateCompleted><Year>2015</Year><Month>06</Month><Day>05</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1723-8617</ISSN><JournalIssue CitedMedium="Print"><Volume>14</Volume><Issue>2</Issue><PubDate><Year>2015</Year><Month>Jun</Month></PubDate></JournalIssue><Title>World psychiatry : official journal of the World Psychiatric Association (WPA)</Title><ISOAbbreviation>World Psychiatry</ISOAbbreviation></Journal><ArticleTitle>Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis.</ArticleTitle><Pagination><MedlinePgn>207-22</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/wps.20217</ELocationID><Abstract><AbstractText>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.</AbstractText><CopyrightInformation>© 2015 World Psychiatric Association.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Zhou</LastName><ForeName>Xinyu</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hetrick</LastName><ForeName>Sarah E</ForeName><Initials>SE</Initials><AffiliationInfo><Affiliation>Orygen National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cuijpers</LastName><ForeName>Pim</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Qin</LastName><ForeName>Bin</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barth</LastName><ForeName>Jürgen</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Institute of Complementary and Integrative Medicine, University Hospital and University of Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Whittington</LastName><ForeName>Craig J</ForeName><Initials>CJ</Initials><AffiliationInfo><Affiliation>Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cohen</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpétrière, Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie Curie, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Del Giovane</LastName><ForeName>Cinzia</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Yiyun</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Michael</LastName><ForeName>Kurt D</ForeName><Initials>KD</Initials><AffiliationInfo><Affiliation>Department of Psychology, Appalachian State University, Boone, NC, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Yuqing</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weisz</LastName><ForeName>John R</ForeName><Initials>JR</Initials><AffiliationInfo><Affiliation>Department of Psychology, Harvard University, Cambridge, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xie</LastName><ForeName>Peng</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Italy</Country><MedlineTA>World Psychiatry</MedlineTA><NlmUniqueID>101189643</NlmUniqueID><ISSNLinking>1723-8617</ISSNLinking></MedlineJournalInfo><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Psychother Psychosom. 2007;76(1):5-14</RefSource><PMID Version="1">17170559</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Arch Gen Psychiatry. 1997 Sep;54(9):877-85</RefSource><PMID Version="1">9294380</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Consult Clin Psychol. 2010 Dec;78(6):856-67</RefSource><PMID Version="1">20873893</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Cochrane Database Syst Rev. 2012 Nov 14;11:CD004851</RefSource><PMID 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