Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis

作者：Xinyu Zhou, Teng Teng, Yuqing Zhang, Cinzia Del Giovane, Toshi A. Furukawa, John R. Weisz, Xuemei Li, Pim Cuijpers, David Coghill, Yajie Xiang, Sarah Hetrick, Stefan Leucht, Mengchang Qin, Jürgen Barth, Arun Ravindran, Lining Yang, John F. Curry, Li Fan, Susan G. Silva, Andrea Cipriani, Peng Xie · 发表于：The Lancet Psychiatry · 年份：2020 · DOI：10.1016/s2215-0366(20)30137-1 · 被引用次数：362 · 研究领域：Child and Adolescent Psychosocial and Emotional Development、Attention Deficit Hyperactivity Disorder、Meta-analysis and systematic reviews

BACKGROUND: Depressive disorders are common in children and adolescents. Antidepressants, psychotherapies, and their combination are often used in routine clinical practice; however, available evidence on the comparative efficacy and safety of these interventions is inconclusive. Therefore, we sought to compare and rank all available treatment interventions for the acute treatment of depressive disorders in children and adolescents. METHODS: We did a systematic review and network meta-analysis. We searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, PsycINFO, ProQuest, CINAHL, LiLACS, international trial registries, and the websites of regulatory agencies for published and unpublished randomised controlled trials from database inception until Jan 1, 2019. We included placebo-controlled and head-to-head trials of 16 antidepressants, seven psychotherapies, and five combinations of antidepressant and psychotherapy that are used for the acute treatment of children and adolescents (≤18 years old and of both sexes) with depressive disorder diagnosed according to standard operationalised criteria. Trials recruiting participants with treatment-resistant depression, bipolar disorder, psychotic depression, treatment duration of less than 4 weeks, or an overall sample size of fewer than ten patients were excluded. We extracted data following a predefined hierarchy of outcome measures, and assessed risk of bias and certainty of evidence using valid...