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Goldbeck L, Muche R, Sachser C, Tutus D, Rosner R. Effectiveness of Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents: A Randomized Controlled Trial in Eight German Mental Health Clinics. PSYCHOTHERAPY AND PSYCHOSOMATICS 2017; 85:159-70. [PMID: 27043952 DOI: 10.1159/000442824] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 11/26/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Trauma-focused cognitive behavioral therapy (Tf-CBT) is efficacious for children and adolescents with posttraumatic stress symptoms (PTSS). Its effectiveness in clinical practice has still to be investigated. AIMS To determine whether Tf-CBT is superior to waiting list (WL), and to investigate the predictors of treatment response. METHOD We conducted a single-blind parallel-group randomized controlled trial in eight German outpatient clinics with the main inclusion criteria of age 7-17 years, symptom score ≥35 on the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA), and caregiver participation. Patients were randomly assigned to 12 sessions of Tf-CBT (n = 76) or a WL (n = 83). The primary outcome was the CAPS-CA symptom score assessed at 4 months by blinded evaluators. The secondary measures were diagnostic status, the Children's Global Assessment Scale (CGAS), self-reported and caregiver-reported PTSS (UCLA-PTSD Reaction Index), the Child Posttraumatic Cognitions Inventory (CPTCI), the Children's Depression Inventory (CDI), the Screen for Child Anxiety- Related Emotional Disorders (SCARED), the Child Behavior Checklist (CBCL/4-18), and the Quality of Life Inventory for Children. RESULTS Intention-to-treat analyses showed that Tf-CBT was significantly superior to WL on the CAPS-CA (Tf-CBT: baseline = 58.51 ± 17.41; 4 months = 32.16 ± 26.02; WL: baseline = 57.39 ± 16.05; 4 months = 43.29 ± 25.2; F1, 157 = 12.3; p = 0.001; d = 0.50), in terms of secondary measures of the CGAS, UCLA-PTSD-RI, CPTCI, CDI, SCARED, and CBCL/4-18, but not in terms of quality of life. Age and comorbidity significantly predicted treatment response. CONCLUSIONS Tf-CBT is effective for children and adolescents with heterogeneous trauma types in German service settings. Younger patients with fewer comorbid disorders show most improvement.
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Affiliation(s)
- Lutz Goldbeck
- Clinic for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
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Kommunikation in der Familie. Monatsschr Kinderheilkd 2016. [DOI: 10.1007/s00112-016-0102-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Herr L, Mingebach T, Becker K, Christiansen H, Kamp-Becker I. Wirksamkeit elternzentrierter Interventionen bei Kindern im Alter von zwei bis zwölf Jahren. KINDHEIT UND ENTWICKLUNG 2015. [DOI: 10.1026/0942-5403/a000154] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Mittels eines systematischen Reviews von 68 Meta-Analysen und Übersichtsartikeln wird überprüft, welche elternzentrierten Interventionen für Kinder im Alter von zwei bis zwölf Jahren wirksam sind und welche psychischen Störungen effektiv behandelt werden können. Insgesamt zeigte sich, dass ein enger Einbezug der Eltern in die Behandlung der Kinder mit internalisierenden Störungen (v. a. bei jüngeren Kindern) sinnvoll ist. Hierbei scheinen vor allem kognitiv-behaviorale Ansätze mit Elterneinbezug wirksam zu sein. Hinsichtlich externalisierender Verhaltensprobleme erreichen behaviorale Elterntrainings neben einer Reduktion der Verhaltensprobleme auch positive Effekte auf Erziehungsverhalten und das elterliche psychische Wohlbefinden. Besonders behaviorale elternzentrierte Interventionen, deren Wirksamkeit nachgewiesen ist, sollten künftig häufiger angewendet werden und eine Möglichkeit zur Abrechnung über die Krankenkassen geschaffen werden.
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Affiliation(s)
- Linda Herr
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Philipps-Universität Marburg
| | - Tanja Mingebach
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Philipps-Universität Marburg
| | - Katja Becker
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Philipps-Universität Marburg
| | - Hanna Christiansen
- AG Klinische Kinder- und Jugendpsychologie, Fachbereich Psychologie, Philipps-Universität Marburg
| | - Inge Kamp-Becker
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Philipps-Universität Marburg
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Internetbasierte Ansätze in der Prävention und Behandlung von depressiven Beschwerden bei Jugendlichen und jungen Erwachsenen. Prax Kinderpsychol Kinderpsychiatr 2014; 63:395-415. [DOI: 10.13109/prkk.2014.63.5.395] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Straub J, Sproeber N, Plener PL, Fegert JM, Bonenberger M, Koelch MG. A brief cognitive-behavioural group therapy programme for the treatment of depression in adolescent outpatients: a pilot study. Child Adolesc Psychiatry Ment Health 2014; 8:9. [PMID: 24655595 PMCID: PMC3994391 DOI: 10.1186/1753-2000-8-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 03/11/2014] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The goal of this pilot study was to examine the feasibility and clinical outcomes of a brief (6-session) group therapy programme in adolescent outpatients with depression. The programme had previously been assessed in in-patients, with positive results. METHODS A total of 15 outpatients aged 13 to 18 years took part in the programme between October 2010 and May 2011, in 3 separate groups of 4-6 participants each. The outcomes measured were feasibility of the programme, as assessed by attendance rate, user feedback, fidelity of implementation, and response to treatment, as assessed by pre- and post-intervention measurement of depressive symptoms, quality of life, and suicidal ideation. RESULTS The programme demonstrated good feasibility, with a mean attendance rate of 5.33 out of 6 sessions, a mean rating by participants on overall satisfaction with the programme of 7.21 out of 10 (SD = 1.89), and a 93% concurrence between the contents of the sessions and the contents of the treatment manual. Compared to baseline scores, depressive symptoms at follow-up test were significantly reduced, as assessed by the Children's Depression Rating Scale Revised (F(1, 12) = 11.76, p < .01) and the Beck Depression Inventory Revision (F(1, 32) = 11.19, p < .01); quality of life improved, as assessed by the Inventory of Quality of Life (F(1, 31) = 5.27, p < .05); and suicidal ideation was reduced. No significant changes were seen on the measures of the Parent Rating Scale for Depression and the Clinical Global Impression scale. CONCLUSIONS Based on the results of this pilot study, it is feasible to further assess this brief outpatient treatment programme in a randomized controlled trial without further modifications.
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Affiliation(s)
- Joana Straub
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Nina Sproeber
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Joerg M Fegert
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Martina Bonenberger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Michael G Koelch
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Vivantes Hospitals, Berlin, Germany
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Straub J, Koelch M, Fegert J, Plener P, Gonzalez-Aracil I, Voit A, Sproeber N. Innovations in Practice: MICHI, a brief cognitive-behavioural group therapy for adolescents with depression - a pilot study of feasibility in an inpatient setting. Child Adolesc Ment Health 2013; 18:247-250. [PMID: 32847305 DOI: 10.1111/j.1475-3588.2012.00678.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Group therapy is an economic intervention, allowing for fast access, for the treatment of several depressed adolescents simultaneously; evaluated manualised programs, however, are scarce. METHOD Nine depressive adolescent inpatients (M = 16.33 years; SD = 1.92) participated between October 2009 and March 2010 in a brief manualised group therapy programme (MICHI), which was evaluated with respect to feasibility and trends of efficacy. RESULTS MICHI demonstrated good feasibility, was positively evaluated by the participants by means of an evaluation questionnaire ranging from 1 (very bad) to 10 (very good) (M = 7.22; SD = 1.79), and showed significant reduction of depressive symptoms (z = -2.66, p = .008) assessed by means of a clinical interview. CONCLUSIONS Feasibility of MICHI was demonstrated and larger trials for efficacy will follow.
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Affiliation(s)
- Joana Straub
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
| | - Michael Koelch
- Vivantes Klinikum im Friedrichshain, Landsberger Allee, Kinder- und Jugendpsychiatrie, Berlin, Germany
| | - Joerg Fegert
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
| | - Paul Plener
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
| | - Inma Gonzalez-Aracil
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
| | - Anja Voit
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
| | - Nina Sproeber
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
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Krischer MK, Trautmann-Voigt S, Kaspers S, Voigt B, Flechtner HH, Lehmkuhl G. [Effectiveness of psychodynamic psychotherapy in children and juveniles - results of a pilot study]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2013; 41:87-97. [PMID: 23425611 DOI: 10.1024/1422-4917/a000216] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
QUESTION The effectiveness of psychodynamic psychotherapy for children and adolescents has yet to be studied sufficiently in Germany. Because psychodynamic psychotherapy aims to reduce symptoms in both the short and long term - besides achieving other long-term goals - in this paper we present results focusing on whether symptoms and problem behavior can be improved within 25 h of outpatient psychodynamic psychotherapy taking place in a practice. Moreover, it addresses whether a positive change of life quality can be achieved in the same timeframe. METHOD Thirty children and juveniles with emotional, behavioral, and adjustment disorders who had received 25 h of psychodynamic psychotherapy were investigated. Parental reports on the Child Behavior Checklist and parental and expert opinions on the DISYPS-KJ were compared before and after therapy. RESULTS We found significant improvement on almost all measured CBCL scales, but not on the syndrome scales measured with the DISYPS. Predominantly medium-size effects were calculated. But parents did not report an improvement of general life quality of their children during the course of psychotherapy. CONCLUSIONS Our results indicate that there is an effective reduction of childhood emotional and behavioral symptoms following psychodynamic psychotherapy. The measured timeframe, however, seems to be too short to ensure significant improvements in specific childhood disorders from both parental and expert perspectives.
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Affiliation(s)
- Maya K Krischer
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters der Universität zu Köln.
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Weber P, Jenni O. Screening in child health: studies of the efficacy and relevance of preventive care practices. DEUTSCHES ARZTEBLATT INTERNATIONAL 2012; 109:431-5. [PMID: 22787505 DOI: 10.3238/arztebl.2012.0431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 04/17/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pediatric screening enables the prevention or early detection of diseases and developmental disturbances in infancy and childhood. Screening is a standard component of pediatric practice in many countries, but its scientific basis is not well known. METHODS The scientific justification for pediatric screening beyond the neonatal period is presented on the basis of a selective review of the literature on some aspects of pediatric screening. RESULTS The level of evidence varies highly among pediatric screening interventions and can be difficult to determine because of confounding variables. Parent counseling is associated with improvements in child-raising competence, accident prevention, and reading behavior. The early detection of abnormalities in a child's motor, linguistic, mental, or social development is possible and often leads to effective early interventions. Cyanotic congenital heart defects can be detected with 63% sensitivity and 99.8% specificity; cerebral palsy can be diagnosed with 33% to 100% sensitivity and 52.3% to 100% specificity (different figures from multiple studies). Physical therapy seems to improve some manifestations of cerebral palsy. Motor development at 90 days is correlated with motor development at 57 months (72% sensitivity, 91% specificity). A developmental quotient above 85 in a two-year-old child is correlated with an intelligence quotient above 85 when the child is 7 years old. CONCLUSION There is an increasing amount of scientific evidence in favor of pediatric screening. Nonetheless, further epidemiological studies are needed.
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Affiliation(s)
- Peter Weber
- Department of Neuropediatrics, University Children’s Hospital Basel.
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Pflug V, Seehagen S, Schneider S. [Nothing new since «Little Hans» and «Little Peter»? Psychotherapy for anxiety disorders in childhood and adolescence]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2011; 40:21-8. [PMID: 22161939 DOI: 10.1024/1422-4917/a000146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Anxiety disorders are among the most frequent psychological disorders in childhood and adolescence. They are characterized by early onset, tend to remain stable over time, and act as a significant risk factor for developing a psychological disorder in adulthood. Over the last few years, research has shown that anxiety disorders in children and adolescents can be treated effectively. However, to date only cognitive behavioral therapy (CBT) has received convincing empirical support as an effective psychotherapeutic treatment. Evidence for the effectiveness of other psychotherapeutic treatments such as nonbehavioral family therapy or psychodynamic interventions is rather scant. Recent randomized controlled trials (RCT) proved CBT to be effective from preschool age onwards. Contrary to long-held beliefs, however, the involvement of parents in a treatment program does not appear to be crucial to therapeutic outcome. Issues regarding the effectiveness of disorder-specific treatments and the combination of psychotherapeutic treatments with the application of selective serotonin reuptake inhibitors (SSRIs) are increasingly being taken up in recent studies. In addition to «classic» cognitive behavioural treatment programs there are some promising suggestions for the effectiveness of novel treatment methods such as attention bias modification or computer-assisted behavioral therapy.
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Affiliation(s)
- Verena Pflug
- Klinische Kinder- und Jugendpsychologie, Ruhr-Universität Bochum.
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[History of empirical psychotherapy research with special reference to the psychotherapy with children and adolescents]. Prax Kinderpsychol Kinderpsychiatr 2011; 60:608-25. [PMID: 22145419 DOI: 10.13109/prkk.2011.60.8.608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In the first fifty years of modern psychotherapy, most psychotherapists believed that it was not possible to investigate the efficacy of psychotherapy by means of empirical-statistical methods. Only in the second half of the 20th century, systematic psychotherapy research was initiated. Since this time a dynamic development of psychotherapy research can be observed, resulting in a rapidly growing knowledge base about processes and outcomes. In the first phase of research, the general question had to be answered, whether psychotherapy is able at all to cause the desired effects. After it had become evident that psychotherapy results are undoubtedly impressive, research emphasis was placed on the question "What works for whom" i. e. which therapy packages are effective for specific disorders. This disorder-specific research tasks are still prevailing; but now, after the first decade of the 21st century psychotherapy, research is confronted with additional and new challenges, which are outlined in the article.
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[How specific is the evidence base for child and adolescent psychotherapy?]. Prax Kinderpsychol Kinderpsychiatr 2011; 60:639-48. [PMID: 22145421 DOI: 10.13109/prkk.2011.60.8.639] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Evidence-based psychotherapy (EBP) proposes the fit between a specific treatment, therapist, patient and mental disorder. At the same time, the generalization of psychotherapy research findings is intended. In this conflict between individualized and standardized treatment the search for specific active components of psychotherapy is essential to improve intervention methods as well as training of therapists. Many manualized treatments for children and adolescents are considered evidence-based, proven by its outcome. However, their active ingredients often remain unclear. The following methods to identify necessary active components for successful treatments are described: classical comparative randomized controlled trials, dismantling studies, add-on studies, meta-analyses, and the multiphase optimization strategy. Consequences for the future agenda for child and adolescent psychotherapy research are discussed.
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Sprenger L, Gerhards F, Goldbeck L. Effects of psychological treatment on recurrent abdominal pain in children - a meta-analysis. Clin Psychol Rev 2011; 31:1192-7. [PMID: 21871242 DOI: 10.1016/j.cpr.2011.07.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Revised: 07/21/2011] [Accepted: 07/23/2011] [Indexed: 12/14/2022]
Abstract
Recurrent abdominal pain in children has a high prevalence, thought to be about 10%. Untreated, there is a high risk that the symptoms become chronic and may lead in some cases to co-morbid mental disorders. Evidence-based treatments are therefore urgently needed. The objective of this study was to examine the effectiveness of psychological therapies for pain reduction in children with recurrent abdominal pain (RAP) by a meta-analysis of intervention studies. Ten controlled studies fulfilling minimum methodical criteria were included. The results of the analysis showed that psychological therapies, mainly cognitive-behavioural, have a moderate effect on the reduction of pain in children with RAP. After analysing homogeneity and significance with the fixed effect model, the medium effect size, calculated with Hedges g, was 0.58 (σ=0.16), demonstrating highly significant (p<.01) effects. The study showed that psychological therapies are effective in treating children with chronic abdominal pain. The empirical basis in this field needs to be broadened.
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Affiliation(s)
- Linda Sprenger
- University Hospital Marburg and Gießen, Department for Child and Adolescent Psychiatry/Psychotherapy, Schützenstraße 49, D-35039 Marburg, Germany.
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Möller C, Petermann U. Kurz- und langfristige Effekte des Trainings mit sozial unsicheren Kindern. VERHALTENSTHERAPIE 2011. [DOI: 10.1159/000324299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Fischer† E, Vogt-Fischer M, Alterthum-Wajsberg K, Frank R. Depressive Erkrankungen. Monatsschr Kinderheilkd 2010. [DOI: 10.1007/s00112-010-2190-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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BACHMANN MAREILE, BACHMANN CHRISTIANJ, JOHN KATJA, HEINZEL-GUTENBRUNNER MONIKA, REMSCHMIDT HELMUT, MATTEJAT FRITZ. The effectiveness of child and adolescent psychiatric treatments in a naturalistic outpatient setting. World Psychiatry 2010; 9:111-7. [PMID: 20671900 PMCID: PMC2911091 DOI: 10.1002/j.2051-5545.2010.tb00288.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Data concerning the effectiveness of naturalistic treatments (treatment-as-usual) in child and adolescent psychiatric (CAP) services are scarce. The purpose of this prospective observational study was to examine the effectiveness of CAP treatments in a naturalistic outpatient setting. Three hundred six patients (attention-deficit/hyperactivity disorder, ADHD, n=94; conduct disorder, CD, n=57; anxiety disorder, AD, n=53; depressive disorder, DD, n=38; other diagnostic categories, n=64), from nine child and adolescent psychiatric practices in Germany, were evaluated. Treatment effects were compared between patients who received frequent treatment and patients who only participated in diagnostics and short interventions. Since randomization was not feasible, propensity score analysis methods were used. Regarding the total sample, no significant treatment effects were found. However, a subgroup analysis of the four most frequent disorders (ADHD, CD, AD, DD) showed small to moderate treatment effects in patients with ADHD and AD. In CD and DD subgroups, no significant treatment effects could be found. "Real-world" CAP outpatient treatment seems to produce significant effects for ADHD and AD, but not for CD and DD. Compared to efficacy studies, our results show that naturalistic treatment might be better than expected.
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Affiliation(s)
- MAREILE BACHMANN
- Department of Child and Adolescent Psychiatry,
University Hospital Gießen and Marburg, Campus Marburg, Hans-Sachs-Strasse
4-6, 35039 Marburg, Germany
| | - CHRISTIAN J. BACHMANN
- Department of Child and Adolescent Psychiatry,
University Hospital Gießen and Marburg, Campus Marburg, Hans-Sachs-Strasse
4-6, 35039 Marburg, Germany,Department of Child and Adolescent Psychiatry,
Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353
Berlin, Germany
| | - KATJA JOHN
- Department of Child and Adolescent Psychiatry,
University Hospital Gießen and Marburg, Campus Marburg, Hans-Sachs-Strasse
4-6, 35039 Marburg, Germany
| | - MONIKA HEINZEL-GUTENBRUNNER
- Department of Child and Adolescent Psychiatry,
University Hospital Gießen and Marburg, Campus Marburg, Hans-Sachs-Strasse
4-6, 35039 Marburg, Germany
| | - HELMUT REMSCHMIDT
- Department of Child and Adolescent Psychiatry,
University Hospital Gießen and Marburg, Campus Marburg, Hans-Sachs-Strasse
4-6, 35039 Marburg, Germany
| | - FRITZ MATTEJAT
- Department of Child and Adolescent Psychiatry,
University Hospital Gießen and Marburg, Campus Marburg, Hans-Sachs-Strasse
4-6, 35039 Marburg, Germany
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Warnke A, Gerlach M. [Psychopharmacological treatment and youth welfare]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2008; 37:5-6. [PMID: 19105159 DOI: 10.1024/1422-4917.37.1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Bachmann M, Bachmann C, Rief W, Mattejat F. [Efficacy of psychiatric and psychotherapeutic interventions in children and adolescents with psychiatric disorders--a systematic evaluation of meta-analyses and reviews. Part II: ADHD and conduct disorders]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2008; 36:321-33. [PMID: 18791982 DOI: 10.1024/1422-4917.36.5.321] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE In recent years, a large and growing body of research on the effectiveness of treatments for psychiatric disorders in childhood and adolescence has been published; however the large number makes it difficult to get an overview on the current status of research. The aim of this article is to systematically review the existing meta-analyses and reviews disorders on the four most frequent childhood and adolescent psychiatric disorders (anxiety disorder, depression, ADHD, conduct disorder) and to present an up-to-date summary on the effects of treatment for those disorders. METHODS This article is based on a systematic literature search, which produced 112 meta-analyses and reviews on the efficacy of psychological and psychiatric interventions in childhood and adolescence published between 2000 and 2007. The articles resulting from the literature search were evaluated according to clearly defined criteria. Presentation of the results follows a dichotomous classification (internalizing vs. externalizing disorders), with Part II of this article reporting the results on ADHD and conduct disorders. RESULTS The majority of reviews published between 2000 and 2007 focuses on the treatment of depressive disorders and ADHD. Only for ADHD is the use of medication (stimulants) considered to be the most efficacious treatment option available. For the remaining three disorders, psychotherapy is recommended as the most effective treatment of choice. A combination of psychological and pharmacological treatments is an important option in ADHD and depressive disorders. Considering the efficacy, treatments for ADHD and anxiety disorders produce higher effect-sizes than do interventions for depressive and conduct disorders. For all disorders, there are several desiderata (content and methodological aspects) to be incorporated into future research. CONCLUSIONS Empirically supported treatment recommendations can be derived for anxiety disorders, depressive disorders, ADHD and conduct disorders. Finally, important implications for research and practice are discussed.
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Affiliation(s)
- Mareile Bachmann
- 1 Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Giessen und Marburg, Standort Marburg, Hans-Sachs-Strasse 4-6, Marburg
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