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Psychotherapy for depression among children and adolescents: a systematic review

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Abstract:

Watanabe N, Hunot V, Omori IM, Churchill R, Furukawa TA. Psychotherapy for depression among children and adolescents: a systematic review. Objective: 

To examine the clinical benefit, the harm and the cost-effectiveness of psychotherapies in comparison with no treatment, waiting-list controls, attention-placebos, and treatment as usual in depressed youths. Method: 

Meta-analyses were undertaken by using data from all relevant randomized-controlled trials identified by a comprehensive literature search. The primary outcome was relative risk (RR) of response. Results: 

We identified 27 studies containing 35 comparisons and 1744 participants. At post-treatment, psychotherapy was significantly superior (RR = 1.39, 95% CI 1.18–1.65, P = 0.0001, number-needed to treat 4.3). There was an evidence of the existence of small study effects, including a publication bias (P < 0.001). The superiority of psychotherapy was no longer statistically significant (1.18 [0.94–1.47], P = 0.15) at 6-month follow-up. None of the studies reported adverse effects or cost-effectiveness outcomes. Conclusion: 

Although the findings were biased by some small positive trials, psychotherapies appear to help depressed youths for the short term, but are no longer significantly favourable at 6-month follow-up.

Keywords: adolescent; child; depressive disorder; meta-analysis; psychotherapy; review

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0447.2007.01018.x

Affiliations: 1: Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan 2: Section of Evidence-Based Mental Health, Health Service and Population Research Department, Institute of Psychiatry, London, UK

Publication date: August 1, 2007

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