Psychological treatments for depression in pre-adolescent children (12 years and younger): systematic review and meta-analysis of randomised controlled trials

Abstract

(250 words)Objective: To evaluate the efficacy of psychological treatments for depression in pre-adolescent children, a disorder affecting 1-2% of children in this age-range. Design:Systematic review of studies of psychological interventions to treat depressive disorder in preadolescent children (aged up to 12 years old). The primary outcome was level of depressive symptoms.Data Sources: Studies were found using Medline, PsycINFO, EMBASE and Web of Knowledge databases and selected on several criteria.Eligibility criteria for selecting studies: Only randomised controlled trials were included. Where individual studies covered a broader age range (usually including adolescents up to age 18 years), authors of those studies were contacted and requested to provide individual patient level data for those aged 12 years and younger.Results: 2822 abstracts were reviewed, and from these 124 full text articles were reviewed, yielding 7 studies for which we were able to access appropriate data for this review. 5 of these studies evaluated cognitive behaviour therapy (CBT). Combined results from these studies suggest that there is a lack of evidence that CBT is better than no treatment (Standard Mean Difference -0.342 (95% Confidence Interval -0.961, 0.278), although the number of participants included in the trials was relatively small. The evidence for efficacy of family therapy and psychodynamic therapy is even more limited. Conclusion:The very limited number of participants in randomised controlled trials means that there is inconclusive evidence for the psychological treatment of depression in children aged 12 years and under. Given the prevalence and significant impact of this disorder, there is an urgent need to establish the effectiveness or otherwise of psychological intervention.Final accepted version -Published version is in European of Child and Adolescent Psychiatry, 2016. Please cite as: Forti-Burratti A, Sakhia R, Wilkinson E, Ramchandani PG. Psychological treatments for depression in preadolescent children (12 years and younger): systematic review and meta-analysis of randomised controlled trials. European of Child and Adolescent Psychiatry.

Eficacia de la terapia cognitivo conductual transdiagnóstica en el tratamiento de la ansiedad y la depresión en adultos, niños y adolescentes: Un meta-análisis

“…Similar results were found concerning depression outcomes (overall g = 0.50, p < .001). This effect is similar to pooled effect sizes found in recent meta-analyses of disorderspecifi c CBT for depression in children (Forti-Buratti, Saikia, Wilkinson, & Ramchandani, 2016), although the small number of studies included in the meta-analysis makes this result diffi cult to interpret meaningfully. Although the evidence is still inconclusive, it appears that the effi cacy of transdiagnostic CBT protocols applied to children and/or adolescents is somewhat lower than the effi cacy of the protocols applied to adults.…”

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

“…16 The effectiveness of Internet-based psychotherapeutic interventions in children/adolescents has also been explored. One meta-analysis found no significant benefit to Internetbased interventions in 7-to 25-year-olds on depression symptoms (although anxiety was reduced) compared with waitlist controls.…”

Family Therapy for Child and Youth Mental Health: A Scoping Literature Review

“…Further systematic reviews have found certain types of family therapy to be effective in treating externalising disorders (von Sydow et al, 2013) and in improving functioning and reducing hospitalisation (Shepperd et al, 2009) in child and youth mental health. Despite varied evidence to support the efficacy of family therapy for depression in children and adolescents (Forti-Buratti, Saikia, Wilkinson, & Ramchandani, 2016;Hazell, 2009), family therapy has been cited as an effective (Carr, 2008) and clinically useful (Paz Pruitt, 2007) treatment in reviews of treatments for young people with depression. Various family therapy models have been shown to be effective in reducing mental health symptomatology and improving family function for children and youth with eating disorders, and those with externalising mental health problems (Jewell et al, 2016;Lock & Gowers, 2009;Porter & Nuntavisit, 2016).…”