Cognitive behavior therapy for internalizing disorders in children and adolescents in routine clinical care: A systematic review and meta-analysis

IF 12.2 1区心理学 Q1 PSYCHOLOGY, CLINICAL Clinical Psychology Review Pub Date : 2021-02-01 DOI:10.1016/j.cpr.2020.101918

Gro Janne H. Wergeland , Eili N. Riise , Lars-Göran Öst

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引用次数: 33

Abstract

Cognitive behavioral therapy (CBT) has received considerable empirical support for internalizing disorders including anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder in children and adolescents. However, there is less knowledge regarding how CBT performs when delivered in routine clinical care. A systematic review and meta-analysis was conducted of CBT for internalizing disorders in children and adolescents in routine clinical care. Ovid MEDLINE, Embase OVID, and PsycINFO were systematically searched for articles published until October 2019. The effectiveness of CBT, methodological quality, and moderators of treatment outcome were examined. The effects of CBT in routine clinical care were benchmarked by comparing with efficacy studies for the same disorders. Fifty-eight studies were included, comprising 4618 participants. Large effect sizes for outcome were detected at post-treatment (g = 1.28–2.54), and follow-up (g = 1.72–3.36). Remission rates across diagnoses ranged from 50.7% - 77.4% post-treatment, to 53.5% -83.3% at follow-up. Attrition rate across the disorders was 12.2%. Quality of the included studies was fair, and heterogeneity was high. Similarities between the effectiveness and efficacy studies were greater than the differences in outcome. CBT delivered in routine clinical care is efficacious in reducing internalizing disorders and symptoms. The outcomes are comparable with results obtained in efficacy studies.

PROSPERO registration: ID CRD42019128709.

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认知行为疗法在儿童和青少年的内化障碍的常规临床护理:系统回顾和荟萃分析

认知行为疗法(CBT)在儿童和青少年的焦虑、抑郁、强迫症和创伤后应激障碍等内化障碍方面得到了相当多的经验支持。然而，关于CBT如何在常规临床护理中发挥作用的知识较少。对常规临床护理中儿童和青少年内化障碍的CBT进行了系统回顾和荟萃分析。Ovid MEDLINE, Embase Ovid和PsycINFO系统地检索了截至2019年10月发表的文章。研究了CBT的有效性、方法质量和治疗结果的调节因子。CBT在常规临床护理中的效果与对相同疾病的疗效研究进行比较。纳入了58项研究，包括4618名参与者。在治疗后(g = 1.28-2.54)和随访期间(g = 1.72-3.36)检测到结果的大效应量。治疗后诊断的缓解率为50.7% - 77.4%，随访时为53.5% -83.3%。这些疾病的流失率为12.2%。纳入的研究质量尚可，异质性较高。有效性和疗效研究之间的相似性大于结果的差异。CBT在常规临床护理中可有效减少内化障碍和症状。结果与疗效研究的结果相当。普洛斯彼罗注册:ID CRD42019128709。

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来源期刊

Clinical Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

23.10

自引率

1.60%

发文量

期刊介绍： Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.