Effekt av CBT for barn og ungdom med depresjon: Systematisk oversikt

Effectiveness of CBT for children and adolescents with depression: A systematic review and meta-regression analysis

Forfattere
Oud, M. de Winter, L. Vermeulen-Smit, E. Bodden, D. Nauta, M. Stone, L. van den Heuvel, M. Taher, R. A. de Graaf, I. Kendall, T. Engels, R. Stikkelbroek, Y.
Årstall
2019
Tidsskrift
European Psychiatry: the Journal of the Association of European Psychiatrists
Volum
57
Sider
33-45
BACKGROUND: Cognitive-behavioral therapy (CBT) is first choice of treatment for depressive symptoms and disorders in adolescents, however improvements are necessary because overall efficacy is low. Insights on CBT components and contextual and structural characteristics might increase the efficacy. The aim of our approach is to evaluate the efficacy of CBT for youth with depression and investigate the influence of specific components, contextual and structural factors that could improve effects. METHODS: A systematic review of randomized controlled trials was conducted, searches were undertaken in CINAHL, CENTRAL, EMBASE, MEDLINE/PubMed and PsycINFO. Outcomes were meta-analyzed and confidence in results was assessed using the GRADE-method. Meta-regression was used to pinpoint components or other factors that were associated with an in- or decrease of effects of CBT. RESULTS: We included 31 trials with 4335 participants. Moderate-quality evidence was found for CBT reducing depressive symptoms at the end of treatment and at follow-up, and CBT as indicated prevention resulted in 63% less risk of being depressed at follow-up. CBT containing a combination of behavioral activation and challenging thoughts component (as part of cognitive restructuring) or the involvement of caregiver(s) in intervention were associated with better outcomes for youth on the long term. CONCLUSIONS: There is evidence that CBT is effective for youth with a (subclinical) depression. Our analyses show that effects might improve when CBT contains the components behavioral activation and challenging thoughts and also when the caregiver(s) are involved. However, the influential effects of these three moderators should be further tested in RCTs.

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Følelsesmessige problemer

Depresjon og nedstemthet (inkl. både vansker og lidelse)

Tiltak

Psykologiske behandlingsmetoder

Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi

Aldersgruppe

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

Mer informasjon
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