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Seidel DH, Markes M, Grouven U, Messow CM, Sieben W, Knelangen M, Oelkers-Ax R, Grümer S, Kölsch H, Kromp M, von Pluto Prondzinski M. Systemic therapy in children and adolescents with mental disorders: a systematic review and meta-analysis. BMC Psychiatry 2024; 24:125. [PMID: 38355466 PMCID: PMC10868021 DOI: 10.1186/s12888-024-05556-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Systemic therapy (ST) is a psychotherapeutic intervention in complex human systems (both psychological and interpersonal). Cognitive behavioural therapy (CBT) is an established treatment for children and adolescents with mental disorders. As methodologically rigorous systematic reviews on ST in this population are lacking, we conducted a systematic review and meta-analysis to compare the benefit and harm of ST (and ST as an add-on to CBT) with CBT in children and adolescents with mental disorders. METHODS We searched MEDLINE, Embase, PsycINFO and other sources for randomised controlled trials in 14 mental disorder classes for the above comparisons in respect of effects on patient-relevant outcomes (search date: 7/2022). Where possible, meta-analyses were performed and results were graded into 3 different evidence categories: "proof", "indication", or "hint" (or none of these categories). PRISMA standards were followed. RESULTS Fifteen studies in 5 mental disorder classes with usable data were identified. 2079 patients (mean age: 10 to 19 years) were analysed. 12/15 studies and 29/30 outcomes showed a high risk of bias. In 2 classes, statistically significant and clinically relevant effects in favour of ST were found, supporting the conclusion of a hint of greater benefit of ST for mental and behavioural disorders due to psychoactive substance use and of ST as an add-on to CBT for obsessive-compulsive disorders. In 2 other classes (eating disorders; hyperkinetic disorders), there was no evidence of greater benefit or harm of ST. For affective disorders, a statistically significant effect to the disadvantage of ST was found for 1 outcome, supporting the conclusion of a hint of lesser benefit of ST. CONCLUSIONS Our results show a hint of greater benefit of ST (or ST as an add-on to CBT) compared with CBT for 2 mental disorder classes in children and adolescents (mental and behavioural disorders due to psychoactive substance use, obsessive compulsive disorders). Given the importance of CBT as a control intervention, ST can therefore be considered a beneficial treatment option for children and adolescents with certain mental disorders. Limitations include an overall high risk of bias of studies and outcomes and a lack of data for several disorders.
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Affiliation(s)
- David Henry Seidel
- Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG), Im Mediapark 8, Cologne, 50670, Germany.
| | - Martina Markes
- Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG), Im Mediapark 8, Cologne, 50670, Germany
| | - Ulrich Grouven
- Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG), Im Mediapark 8, Cologne, 50670, Germany
| | - Claudia-Martina Messow
- Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG), Im Mediapark 8, Cologne, 50670, Germany
| | - Wiebke Sieben
- Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG), Im Mediapark 8, Cologne, 50670, Germany
| | - Marco Knelangen
- Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG), Im Mediapark 8, Cologne, 50670, Germany
| | - Rieke Oelkers-Ax
- Family Therapy Centre (Familientherapeutisches Zentrum gGmbH, FaTZ), Hermann-Walker-Straße 16, 69151, Neckargemünd, Germany
| | - Sebastian Grümer
- Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG), Im Mediapark 8, Cologne, 50670, Germany
| | - Heike Kölsch
- Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG), Im Mediapark 8, Cologne, 50670, Germany
| | - Mandy Kromp
- Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG), Im Mediapark 8, Cologne, 50670, Germany
| | - Markus von Pluto Prondzinski
- Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG), Im Mediapark 8, Cologne, 50670, Germany
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Shek DTL, Leung KH, Dou D, Zhu X. Family Functioning and Adolescent Delinquency in Mainland China: Positive Youth Development Attributes as a Mediator. Front Psychiatry 2022; 13:883439. [PMID: 35573365 PMCID: PMC9096017 DOI: 10.3389/fpsyt.2022.883439] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
According to the positive youth development (PYD) approach, PYD attributes such as psychosocial competencies are developmental assets which can promote the holistic development of adolescents, such as increase in thriving and decrease in risk behavior. Although there are research findings supporting this theoretical proposition, there are several weaknesses in this literature. These include a lack of studies examining family antecedents of PYD attributes and the mediating role of PYD attributes in the relationship between family functioning and adolescent delinquency. There are also few longitudinal studies utilizing large samples and validated measures of family functioning and PYD attributes in the scientific literature. In this study, we examined the predictive effect of family functioning on adolescent delinquency and the mediating role of PYD attributes. Using a short-term longitudinal study in Sichuan, China, we collected two waves of data from 4,981 adolescents aged 11 and above, with 6 months between the two waves. Analyses using structural equation modeling showed that family functioning at Wave 1 negatively predicted the level of and change in delinquent behavior at Wave 2, with PYD attributes at Wave 2 as a mediating factor. The present study enriches the conceptual framework on the role of family functioning and PYD attributes in adolescent delinquent behavior. The findings also suggest that strengthening family functioning and PYD attributes would protect adolescents from engaging in delinquent acts.
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Affiliation(s)
- Daniel T L Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Kim H Leung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Diya Dou
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Xiaoqin Zhu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Zhong S, Yu R, Fazel S. Drug Use Disorders and Violence: Associations With Individual Drug Categories. Epidemiol Rev 2020; 42:103-116. [PMID: 33005950 PMCID: PMC7879597 DOI: 10.1093/epirev/mxaa006] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 01/19/2023] Open
Abstract
We conducted a systematic review that examined the link between individual drug categories and violent outcomes. We searched for primary case-control and cohort investigations that reported risk of violence against others among individuals diagnosed with drug use disorders using validated clinical criteria, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We identified 18 studies published during 1990–2019, reporting data from 591,411 individuals with drug use disorders. We reported odds ratios of the violence risk in different categories of drug use disorders compared with those without. We found odds ratios ranging from 0.8 to 25.0 for most individual drug categories, with generally higher odds ratios among individuals with polydrug use disorders. In addition, we explored sources of between-study heterogeneity by subgroup and meta-regression analyses. Cohort investigations reported a lower risk of violence than case-control reports (odds ratio = 2.7 (95% confidence interval (CI): 2.1, 3.5) vs. 6.6 (95% CI: 5.1, 8.6)), and associations were stronger when the outcome was any violence rather than intimate partner violence (odds ratio = 5.7 (95% CI: 3.8, 8.6) vs. 1.7 (95% CI: 1.4, 2.1)), which was consistent with results from the meta-regression. Overall, these findings highlight the potential impact of preventing and treating drug use disorders on reducing violence risk and associated morbidities.
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Affiliation(s)
| | | | - Seena Fazel
- Correspondence to Dr. Seena Fazel, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, Oxford, United Kingdom (e-mail: )
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Bjornestad J, Veseth M, Berg H, Davidson L, McKay JR, Moltu C, Skaalevik AW, Slyngstad TE, Svendsen TS, Nesvåg S. Reports of the benefits of drug use from individuals with substance use disorders. Psychother Res 2019; 30:718-727. [DOI: 10.1080/10503307.2019.1677965] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Jone Bjornestad
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - Marius Veseth
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | | | - Larry Davidson
- School of Medicine and Institution for Social and Policy Studies, Yale University, New Haven, CT, USA
| | - James R. McKay
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | | | | | | | - Sverre Nesvåg
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
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