OBJECTIVE This evidence-based update (EBU) builds on three previous reviews (1998, 2008, 2017) sponsored by the Society of Clinical Child and Adolescent Psychology with the aim of evaluating the empirical support for psychosocial interventions for depression in youth. METHOD In the current review period (2014-2022), 25 randomized controlled trials (RCT) were identified: four in children and 21 in adolescents. Descriptive effect sizes and number-needed-to-treat (NNT) ratios were calculated for primary outcomes. Results were integrated with prior reviews, and cumulative evidence used to classify treatments as well-established, probably efficacious, possibly efficacious, or experimental. Published secondary analyses of predictors, moderators, and mediators were examined. RESULTS For adolescents, cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT-A), CBT in combination with antidepressant medication, and collaborative care programs were all classified as well-established. The evidence was considerably weaker for children, with no treatments achieving well-established or probably efficacious status. New developments include greater exploration of parent- and family-mediated treatment models and increasing evidence on technology-assisted interventions. Data on predictors, moderators, and mediators continued to be focused on adolescent depression samples and drawn from a limited number of RCT datasets. CONCLUSION Since the prior EBU, there has been incremental progress in youth depression treatment research. There is an urgent need to: (a) develop innovative approaches to substantially improve on the modest effects seen in most RCTs, (b) expand the evidence base for children and other underserved groups, (c) craft evidence-based guidelines for choosing between interventions when multiple efficacious treatments do exist, and (d) address issues of treatment effectiveness and scalability to ameliorate the wide prevalence and high impact of depression in youth.

中文翻译：

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儿童和青少年抑郁症的社会心理和联合治疗的循证更新。


目的 本循证更新 （EBU） 建立在临床儿童和青少年心理学会赞助的先前三篇综述 （1998、2008、2017） 的基础上，旨在评估对青少年抑郁症社会心理干预的实证支持。方法 在本综述期间 （2014-2022），确定了 25 项随机对照试验 （RCT）： 4 项儿童试验和 21 项青少年试验。计算主要结局的描述性效应大小和需要治疗的数量 （NNT） 比率。将结果与先前的综述相结合，并将累积证据用于将治疗分类为公认的、可能有效的、可能有效的或实验性的。检查了已发表的预测因子、调节因子和中介因子的二次分析。结果 对于青少年，认知行为疗法 （CBT） 、人际心理疗法 （IPT-A）、CBT 联合抗抑郁药物和协作护理计划均被归类为成熟。儿童的证据要弱得多，没有治疗方法达到公认的或可能有效的状态。新的发展包括对父母和家庭介导的治疗模型的更多探索，以及关于技术辅助干预的更多证据。关于预测因子、调节因子和中介因子的数据继续集中在青少年抑郁症样本上，并从有限数量的 RCT 数据集中提取。结论 自之前的 EBU 以来，青年抑郁症治疗研究取得了渐进式进展。 迫切需要：（a） 开发创新方法以大幅改善大多数 RCT 中观察到的适度效果，（b） 扩大儿童和其他服务不足群体的证据基础，（c） 制定循证指南，以便在确实存在多种有效治疗方法时在干预措施之间进行选择，以及 （d） 解决治疗效果和可扩展性问题，以改善青少年抑郁症的广泛患病率和高影响。