Psychotherapy for depression among children and adolescents: a systematic review.
OBJECTIVE
To examine the clinical benefit, the harm and the cost-effectiveness of psychotherapies in comparison with no treatment, waiting-list controls, attention-placebos, and treatment as usual in depressed youths.


METHODS
Meta-analyses were undertaken by using data from all relevant randomized-controlled trials identified by a comprehensive literature search. The primary outcome was relative risk (RR) of response.


RESULTS
We identified 27 studies containing 35 comparisons and 1,744 participants. At post-treatment, psychotherapy was significantly superior (RR = 1.39, 95% CI 1.18-1.65, P = 0.0001, number-needed to treat 4.3). There was an evidence of the existence of small study effects, including a publication bias (P < 0.001). The superiority of psychotherapy was no longer statistically significant (1.18 [0.94-1.47], P = 0.15) at 6-month follow-up. None of the studies reported adverse effects or cost-effectiveness outcomes.


CONCLUSIONS
Although the findings were biased by some small positive trials, psychotherapies appear to help depressed youths for the short term, but are no longer significantly favourable at 6-month follow-up.
Watanabe
N
N
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. noriow@med.nagoya-cu.ac.jp
Hunot
V
V
Omori
I M
IM
Churchill
R
R
Furukawa
T A
TA
D000293:Adolescent; D002648:Child; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D011613:Psychotherapy; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome