Kathrin Dolle1, Gerd Schulte-Körne. 1. Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich.
Abstract
BACKGROUND: Depressive disorders are among the more common mental illnesses around the world. About 3% of prepubertal children and 6% of postpubertal children and adolescents are affected. Many physicians are unsure about which treatment approaches are effective and how the treatment should be planned. METHOD: A systematic literature search was carried out in electronic databases and study registries and as a manual search. More than 450 studies (mostly randomized controlled trials [RCTs]) were identified and summarized in five evidence tables. The ensuing recommendations were agreed upon in a consensus conference in which 23 organizations were represented. RESULTS: The recommended treatment of first choice for children from age 8 onward and for adolescents is either cognitive behavioral therapy (CBT) (Cohen's d [effect strength]: 0.5-2) or interpersonal psychotherapy (Cohen's d: 0.5-0.6). Fluoxetine is recommended for drug treatment (Cohen's d: 0.3-5.6), either alone or in combination with CBT. The analysis revealed a lower level of evidence for psychodynamic or systemic psychotherapy or for drug treatment with escitalopram, citalopram, or sertraline. For mild or moderate depression, psychotherapy is recommended; for severe depression, combination therapy. Particularly for children, there is a lack of adequately informative comparative studies on these treatment approaches as well as on other, complementary interventions (e.g., art therapy, sleep deprivation, youth welfare services). CONCLUSION: There is adequate evidence to support some recommendations for the treatment of depressive disorders in adolescents, but evidence for children is lacking. There is a pressing need for intervention research in this area for both children and adolescents.
BACKGROUND:Depressive disorders are among the more common mental illnesses around the world. About 3% of prepubertal children and 6% of postpubertal children and adolescents are affected. Many physicians are unsure about which treatment approaches are effective and how the treatment should be planned. METHOD: A systematic literature search was carried out in electronic databases and study registries and as a manual search. More than 450 studies (mostly randomized controlled trials [RCTs]) were identified and summarized in five evidence tables. The ensuing recommendations were agreed upon in a consensus conference in which 23 organizations were represented. RESULTS: The recommended treatment of first choice for children from age 8 onward and for adolescents is either cognitive behavioral therapy (CBT) (Cohen's d [effect strength]: 0.5-2) or interpersonal psychotherapy (Cohen's d: 0.5-0.6). Fluoxetine is recommended for drug treatment (Cohen's d: 0.3-5.6), either alone or in combination with CBT. The analysis revealed a lower level of evidence for psychodynamic or systemic psychotherapy or for drug treatment with escitalopram, citalopram, or sertraline. For mild or moderate depression, psychotherapy is recommended; for severe depression, combination therapy. Particularly for children, there is a lack of adequately informative comparative studies on these treatment approaches as well as on other, complementary interventions (e.g., art therapy, sleep deprivation, youth welfare services). CONCLUSION: There is adequate evidence to support some recommendations for the treatment of depressive disorders in adolescents, but evidence for children is lacking. There is a pressing need for intervention research in this area for both children and adolescents.
Authors: N Ghaziuddin; C A King; M W Naylor; M Ghaziuddin; N Chaudhary; B Giordani; J R Dequardo; R Tandon; J Greden Journal: J Child Adolesc Psychopharmacol Date: 1996 Impact factor: 2.576
Authors: Anne-Liis von Knorring; Gunilla Ingrid Olsson; Per Hove Thomsen; Ole Michael Lemming; Agnes Hultén Journal: J Clin Psychopharmacol Date: 2006-06 Impact factor: 3.153
Authors: Heidrun Lioba Wunram; Max Oberste; Stefanie Hamacher; Susanne Neufang; Nils Grote; Maya Kristina Krischer; Wilhelm Bloch; Eckhard Schönau; Stephan Bender; Oliver Fricke Journal: Int J Environ Res Public Health Date: 2021-06-17 Impact factor: 3.390