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Effectiveness and Safety of Antidepressants for Children and AdolescentsImplications for Clinical Practice
JAMA Psychiatry ( IF 22.5 ) Pub Date : 2017-08-30 , DOI: 10.1001/jamapsychiatry.2017.2410
Sally Nicola Merry 1 , Sarah Elisabeth Hetrick 2 , Karolina Stasiak 1
Affiliation  

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).



中文翻译:

儿童和青少年抗抑郁药的有效性和安全性对临床实践的意义

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)。

更新日期:2017-08-30
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