[Efficacy of psychiatric and psychotherapeutic interventions in children and adolescents with psychiatric disorders--a systematic evaluation of meta-analyses and reviews. Part I: Anxiety disorders and depressive disorders]

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 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 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 I of this article reporting the results on anxiety disorders and depressive 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.

Discussion: 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.