Effekt av og sikkerhet ved medikamentelle og psykologiske intervensjoner for behandling av psykose og schizofreni hos barn, ungdom og unge voksne: Systematisk oversikt og metaanalyse

Efficacy and Safety of Pharmacological and Psychological Interventions for the Treatment of Psychosis and Schizophrenia in Children, Adolescents and Young Adults: A Systematic Review and Meta-Analysis

Forfattere
Stafford, M. R. Mayo-Wilson, E. Loucas, C. E. James, A. Hollis, C. Birchwood, M. Kendall, T.
Årstall
2015
Tidsskrift
Plos One
Volum
10
Sider
17
Background Studies report contrasting results regarding the efficacy and safety of pharmacological, psychological, and combined interventions in psychosis and schizophrenia in children, adolescents and young adults. Methods Systematic review and meta-analysis. Embase, Medline, PreMedline, PsycINFO, and CENTRAL were searched to July 2013 without restriction to publication status. Randomised trials comparing any pharmacological, psychological, or combined intervention for psychosis and schizophrenia in children, adolescents and young adults were included. Studies were assessed for bias, and GRADE criteria were used to describe the quality of the results. Results Twenty-seven trials including 3067 participants were identified. Meta-analyses were performed for 12 comparisons: symptoms, relapse, global state, psychosocial functioning, depression, weight and discontinuation. Low quality evidence demonstrated that antipsychotics have small beneficial effects on psychotic symptoms (SMD = -0.42, 95% CI -0.58 to -0.26), and a medium adverse effect on weight gain (WMD = 1.61, 95% CI 0.61 to 2.60) and discontinuation due to side effects (RR = 2.44, 95% CI, 1.12 to 5.31). There were no trials of psychological treatments in under-18 year olds. There was no evidence of an effect of psychological interventions on psychotic symptoms in an acute episode, or relapse rate, but low quality evidence of a large effect for family plus individual CBT on the number of days to relapse (WMD = 32.25, 95% CI -36.52 to -27.98). Conclusions For children, adolescents and young adults, the balance of risk and benefit of antipsychotics appears less favourable than in adults. Research is needed to establish the potential for psychological treatments, alone and in combination with antipsychotics, in this population.

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Andre problemer

Psykose

Tiltak

Psykologiske behandlingsmetoder

Familieterapi

Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi

Medikamentell behandling

Antipsykotisk medisin

Alternativ behandling

Musikk/kunst- og uttrykksterapi

Aldersgruppe

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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