Tiltak for å forebygge depresjon blant barn og unge: Metaanalyse

Indicated preventive interventions for depression in children and adolescents: A meta-analysis and meta-regression

Forfattere
Ssegonja, R. Nystrand, C. Feldman, I. Sarkadi, A. Langenskiold, S. Jonsson, U.
Årstall
2019
Tidsskrift
Preventive Medicine
Volum
118
Sider
7-15
Depression contributes about 2% to the global burden of disease. A first onset of depressive disorder or subsyndromal depressive symptoms is common in adolescence, indicating that early prevention is a priority. However, trials of preventive interventions for depression in youths show conflicting results. This systematic review and meta-analysis investigated the effectiveness of group-based cognitive behavioral therapy (GB-CBT) as a preventive intervention targeting subsyndromal depression in children and adolescents. In addition, the impact of different covariates (type of comparator and use of booster sessions) was assessed. Relevant articles were identified from previous systematic reviews, and supplemented with an electronic search spanning from 01/09/2014 to 28/02/2018. The retrieved articles were assessed for eligibility and risk of bias. Relevant data were extracted. Intervention effectiveness was pooled using a random-effects model and the impact of covariates assessed using meta-regression. 38 eligible articles (34 trials) were obtained. The analysis showed GB-CBT to significantly reduce the incidence (relative risk 0.43, 95% CI 0.21-0.87) and symptoms (Cohen's d -0.22, 95% CI -0.32 to -0.11) of depression at post-test compared to all controls. Comparisons with passive comparators suggested that the effect decayed over time. However, compared to active controls, a significant intervention effect was evident only after 12month or more. Our results suggest that the preventive effect of GB-CBT wears off, but still lasts longer than the effect of active comparators. Only a few studies included booster sessions, precluding firm conclusions. Future studies should clarify to what extent maintenance strategies can prolong the preventive effect of GB-CBT.

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Tiltaksnivå

Behandling og hjelpetiltak

Tidlig innsats

Tema

Psykiske vansker og lidelser

Følelsesmessige problemer

Depresjon og nedstemthet (inkl. både vansker og lidelse)

Tiltak

Psykologiske behandlingsmetoder

Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi

Organisering av tiltak

Gruppetiltak

Aldersgruppe

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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