Systemic therapy in children and adolescents with mental disorders: a systematic review and meta-analysis

被引：3

作者：

Seidel, David Henry ^{[1
]}

Markes, Martina ^{[1
]}

Grouven, Ulrich ^{[1
]}

Messow, Claudia-Martina ^{[1
]}

Sieben, Wiebke ^{[1
]}

Knelangen, Marco ^{[1
]}

Oelkers-Ax, Rieke ^{[2
]}

Gruemer, Sebastian ^{[1
]}

Koelsch, Heike ^{[1
]}

Kromp, Mandy ^{[1
]}

von Pluto Prondzinski, Markus ^{[1
]}

机构：

[1] Inst Qual & Wirtschaftlichkeit Gesundheitswesen I, Inst Qual & Efficiency Hlth Care, Mediapark 8, D-50670 Cologne, Germany

[2] Familientherapeut Zentrum gGmbH, Family Therapy Ctr, FaTZ, Hermann Walker Str 16, D-69151 Neckargemund, Germany

来源：

BMC PSYCHIATRY | 2024年 / 24卷 / 01期

关键词：

Psychotherapy; Systemic therapy; Cognitive behavioural therapy; Mental disorders; Child; Adolescent; Benefit assessment; Systematic review; MULTIDIMENSIONAL FAMILY-THERAPY; COGNITIVE-BEHAVIORAL THERAPY; ABUSING RUNAWAY ADOLESCENTS; RANDOMIZED CONTROLLED-TRIAL; CANNABIS USE DISORDER; OUTPATIENT MARIJUANA TREATMENT; OBSESSIVE-COMPULSIVE DISORDER; CLINICAL PSYCHOTHERAPY TRIAL; YOUTH TREATMENT CYT; BULIMIA-NERVOSA;

D O I：

10.1186/s12888-024-05556-y

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

BackgroundSystemic therapy (ST) is a psychotherapeutic intervention in complex human systems (both psychological and interpersonal). Cognitive behavioural therapy (CBT) is an established treatment for children and adolescents with mental disorders. As methodologically rigorous systematic reviews on ST in this population are lacking, we conducted a systematic review and meta-analysis to compare the benefit and harm of ST (and ST as an add-on to CBT) with CBT in children and adolescents with mental disorders.MethodsWe searched MEDLINE, Embase, PsycINFO and other sources for randomised controlled trials in 14 mental disorder classes for the above comparisons in respect of effects on patient-relevant outcomes (search date: 7/2022). Where possible, meta-analyses were performed and results were graded into 3 different evidence categories: "proof", "indication", or "hint" (or none of these categories). PRISMA standards were followed.ResultsFifteen studies in 5 mental disorder classes with usable data were identified. 2079 patients (mean age: 10 to 19 years) were analysed. 12/15 studies and 29/30 outcomes showed a high risk of bias. In 2 classes, statistically significant and clinically relevant effects in favour of ST were found, supporting the conclusion of a hint of greater benefit of ST for mental and behavioural disorders due to psychoactive substance use and of ST as an add-on to CBT for obsessive-compulsive disorders. In 2 other classes (eating disorders; hyperkinetic disorders), there was no evidence of greater benefit or harm of ST. For affective disorders, a statistically significant effect to the disadvantage of ST was found for 1 outcome, supporting the conclusion of a hint of lesser benefit of ST.ConclusionsOur results show a hint of greater benefit of ST (or ST as an add-on to CBT) compared with CBT for 2 mental disorder classes in children and adolescents (mental and behavioural disorders due to psychoactive substance use, obsessive compulsive disorders). Given the importance of CBT as a control intervention, ST can therefore be considered a beneficial treatment option for children and adolescents with certain mental disorders. Limitations include an overall high risk of bias of studies and outcomes and a lack of data for several disorders.

引用

页数：15

共 129 条

[1]

[Anonymous], 1998, ICH Harmonised Tripartite Guideline

[2]

Anorexia Bulimia Unit Child Adolescent Psychiatry Centre, 2019, The Gothenburg anorexia nervosa treatment study-a randomized control trial comparing individual cognitive behavioral therapy (I-CBT) and family therapy (FT) for young adults with anorexia nervosa

[3] Biomarkers and surrogate endpoints: Preferred definitions and conceptual framework [J].