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首页> 外文期刊>Child and adolescent psychiatric clinics of North America >Child and Adolescent Depression Intervention Overview: What Works, for Whom and How Well?
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Child and Adolescent Depression Intervention Overview: What Works, for Whom and How Well?

机译：儿童和青少年抑郁症干预概述：什么有效，适用于谁以及效果如何？

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In this review, the authors provide a summary of the currently available research evidence on interventions in pediatric depression. The use of SSRIs as an effective intervention in the treatment of depression in childhood and adolescence is supported by numerous large clinical trials including TADS and TORDIA. There is also evidence that the combination of medication and CBT is superior to medication alone for accelerating the pace of treatment response and remission, despite some negative studies. For mild to moderate depression, CBT and IPT are reasonable options, although the rate of improvement is much slower with psychotherapy (CBT) alone. Response rates after acute treatment remain modest at best, with significant residual symptoms, and remission rates over long-term follow-ups are not more promising. In order to improve the risk-to-benefit ratio for patients treated for pediatric depression, future studies should examine how to accelerate initial treatment response; target residual symptoms, especially sleep and anhedonia; improve adherence; and target contextual environmental risk factors that may lead to an unfavorable response to treatment.
机译：在这篇综述中，作者总结了目前有关小儿抑郁症干预措施的研究证据。许多大型临床试验（包括TADS和TORDIA）都支持将SSRI用作治疗儿童和青少年抑郁症的有效干预措施。还有证据表明，尽管进行了一些阴性研究，但药物和CBT的结合在加速治疗反应和缓解的速度方面优于单独使用药物。对于轻度至中度抑郁症，CBT和IPT是合理的选择，尽管仅心理疗法（CBT）的改善速度要慢得多。急性治疗后的缓解率仍然保持在中等水平，并伴有明显的残留症状，长期随访的缓解率也没有太大希望。为了提高小儿抑郁症患者的风险收益比，未来的研究应研究如何加快初始治疗的反应。针对残留症状，尤其是睡眠和快感不足;提高依从性;并针对可能导致对治疗产生不利反应的背景环境风险因素。

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