OBJECTIVE Youth depression is a debilitating condition that constitutes a major public health concern. A 2006 meta-analysis found modest benefits for psychotherapy versus control. Has 13 more years of research improved that picture? We sought to find out. METHOD We searched PubMed, PsychINFO, and Dissertation Abstracts International for 1960 to 2017, identifying 655 randomized, English-language psychotherapy trials for individuals aged 4 to 18 years. Of these, 55 assessed psychotherapy versus control for youth depression with outcome measures administered to both treatment and control conditions at post (κ = 53) and/or follow-up (κ = 32). Twelve study and outcome characteristics were extracted, and effect sizes were calculated for all psychotherapy versus control comparisons. Using a three-level random-effects model, we obtained an overall estimate of the psychotherapy versus control difference while accounting for the dependency among effect sizes. We then fitted a three-level mixed-effects model to identify moderators that might explain variation in effect size within and between studies. RESULTS The overall effect size (g) was 0.36 at posttreatment and 0.21 at follow-up (averaging 42 weeks after posttreatment). Three moderator effects were identified: effects were significantly larger for interpersonal therapy than for cognitive behavioral therapy, for youth self-reported outcomes than parent-reports, and for comparisons with inactive control conditions (eg, waitlist) than active controls (eg, usual care). Effects showed specificity, with significantly smaller effects for anxiety and externalizing behavior outcomes than for depression measures. CONCLUSION Youth depression psychotherapy effects are modest, with no significant change over the past 13 years. The findings highlight the need for treatment development and research to improve both immediate and longer-term benefits.

中文翻译：

---

荟萃分析：心理治疗对青年抑郁症影响的13年随访。

目的青年抑郁症是一种使人衰弱的疾病，构成了主要的公共卫生问题。2006年的一项荟萃​​分析发现，心理治疗与对照相比获益不大。13年的研究是否改善了这一状况？我们试图找出答案。方法我们搜索了1960年至2017年的PubMed，PsychINFO和Dissertation Abstracts International，确定了655项针对4至18岁个体的英语心理治疗试验。其中，有55种评估了青少年抑郁症的心理治疗与对照之间的关系，并在治疗后（κ= 53）和/或随访（κ= 32）对治疗和对照情况进行了结果评估。提取了十二项研究和结局特征，并计算了所有心理治疗与对照比较的效果大小。使用三级随机效应模型，我们获得了心理治疗与对照差异的总体估计，同时考虑了效应量之间的依赖性。然后，我们拟合了三级混合效应模型，以识别可解释研究内部和研究之间效应大小变化的主持人。结果治疗后的总体效果大小（g）为0.36，随访时为0.21（平均治疗后42周）。确定了三种调节作用：与人际关系治疗相比，对认知行为疗法的影响要大得多；对于青年自我报告的结局，其效果要比对父母的报告要大；与不活动的对照条件（例如，候补名单）进行比较的效果要比活动的对照（例如，常规护理）大。 ）。效果显示出特异性，对焦虑和外在行为结局的影响要比对抑郁症的影响要小得多。结论青年抑郁症的心理治疗效果不明显，在过去的13年中没有显着变化。这些发现强调了治疗开发和研究的必要性，以改善近期和长期的益处。