It is now well understood that disorders of anxiety and depression in children and adolescents are common, debilitating, and largely undetected and untreated.¹ The mainstays of treatment include psychological therapy, predominantly cognitive behavioral therapy, and medication, usually antidepressants, which, despite their name, are also used for anxiety disorders and obsessive-compulsive disorder.² In this issue of JAMA Psychiatry, Locher et al³ examine the evidence for selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine inhibitors (SNRIs) for children and adolescents with anxiety disorders, depressive disorders, obsessive-compulsive disorder, and posttraumatic stress disorder. To date, most reviews and meta-analyses have been focused on one or other disorder. Having the information gathered together in one review is helpful, particularly as there is a high rate of comorbidity between these disorders. Based on 36 studies with 6778 participants, the authors found modest effects sizes (Hedges g) from medication, ranging from 0.56 (95% CI, 0.40-0.72) for anxiety disorders through 0.39 (95% CI, 0.25-0.54) for obsessive-compulsive disorder to 0.20 (95% CI, 0.13-0.27) for depressive disorders. There was only 1 study showing no effect in posttraumatic stress disorder. Overall, the effect size was small (g = 0.32; 95% CI, 0.25-0.40).

现在众所周知，儿童和青少年的焦虑和抑郁症很普遍，使人衰弱，并且在很大程度上未被发现和治疗。¹治疗的主要手段包括心理治疗，主要是认知行为治疗和药物，通常是抗抑郁药，尽管其名称如此，但它们也可用于焦虑症和强迫症。²在本期《JAMA精神病学》中，Locher等人³检查针对患有焦虑症，抑郁症，强迫症和创伤后应激障碍的儿童和青少年的选择性5-羟色胺再摄取抑制剂（SSRIs）和5-羟色胺去甲肾上腺素抑制剂（SNRIs）的证据。迄今为止，大多数评论和荟萃分析都集中在一种或其他疾病上。一次综述中收集信息是有帮助的，特别是因为这些疾病之间合并症的发生率很高。基于对6778名参与者的36项研究，作者发现适度的效应量（Hedges g），从焦虑症的0.56（95％CI，0.40-0.72）到强迫症的0.39（95％CI，0.25-0.54）到抑郁症的0.20（95％CI，0.13-0.27）不等。只有1项研究显示对创伤后应激障碍无影响。总体而言，效果大小较小（g  = 0.32； 95％CI，0.25-0.40）。