期刊
CLINICAL PSYCHOLOGY REVIEW
卷 50, 期 -, 页码 80-94出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.cpr.2016.09.006
关键词
Anxiety; Child; Adolescent; Clinical decision making; Therapeutics; Review
资金
- Canadian Institutes of Health Research [KA1-119793]
We conducted an overview of systematic reviews about child and adolescent anxiety treatment options (psycho social; medication; combination; web/computer-based treatment) to support evidence informed decision-making. Three questions were addressed: (i) Is the treatment more effective than passive controls? (ii) Is there evidence that the treatment is superior to or non-inferior to (i.e., as good as) active controls? (iii) What is the quality of evidence for the treatment? Pre-specified inclusion criteria identified high quality systematic reviews (2000-2015) reporting treatment effects on anxiety diagnosis and symptom severity. Evidence quality (EQ) was rated using Oxford evidence levels [EQ1 (highest); EQ5 (lowest)]. Twenty-two of 39 eligible reviews were high quality (AMSTAR score >= 3/5). CBT (individual or group, with or without parents) was more effective than passive controls (EQ1). CBT effects compared to active controls were mixed (EQ1). SSRI/SNRI were more effective than placebo (EQ1) but comparative effectiveness remains uncertain. EQ for combination therapy could not be determined. RCTs of web/computer-based interventions showed mixed results (EQ1). CBM/ABM was not more efficacious than active controls (EQ1). No other interventions could be rated. High quality RCTs sup port treatment with CBT and medication. Findings for combination and web/computer-based treatment are encouraging but further RCTs are required. Head-to-head comparisons of active treatment options are needed. (C) 2016 Elsevier Ltd. All rights reserved.
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