Different Types and Acceptability of Psychotherapies for Acute Anxiety Disorders in Children and Adolescents: A Network Meta-analysis.

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dc.contributor.author Zhou, Xinyu en
dc.contributor.author Zhang, Yuqing en
dc.contributor.author Furukawa, Toshiaki A en
dc.contributor.author Cuijpers, Pim en
dc.contributor.author Pu, Juncai en
dc.contributor.author Weisz, John R en
dc.contributor.author Yang, Lining en
dc.contributor.author Hetrick, Sarah en
dc.contributor.author Del Giovane, Cinzia en
dc.contributor.author Cohen, David en
dc.contributor.author James, Anthony C en
dc.contributor.author Yuan, Shuai en
dc.contributor.author Whittington, Craig en
dc.contributor.author Jiang, Xiaofeng en
dc.contributor.author Teng, Teng en
dc.contributor.author Cipriani, Andrea en
dc.contributor.author Xie, Peng en
dc.date.accessioned 2019-05-28T04:01:02Z en
dc.date.issued 2019-01 en
dc.identifier.citation JAMA psychiatry 76(1):41-50 Jan 2019 en
dc.identifier.issn 2168-622X en
dc.identifier.uri http://hdl.handle.net/2292/46700 en
dc.description.abstract Importance:Anxiety disorders are common in children and adolescents, and uncertainty remains regarding the optimal strategy of psychotherapies in this population. Objective:To compare and rank the different types of psychotherapies and the different ways of delivering psychological treatments for anxiety disorders in children and adolescents. Data Sources:PubMed, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, Web of Science, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ProQuest Dissertations, LILACS (Literatura Latino Americana em Ciências da Saúde), international trial registers, and US Food and Drug Administration reports were searched from inception to November 30, 2017. Study Selection:Randomized clinical trials that compared any structured psychotherapy with another psychotherapy or a control condition for anxiety disorders in children and adolescents were selected. Data Extraction and Synthesis:Four researchers independently performed data extraction and quality assessment. Pairwise meta-analyses and Bayesian network meta-analysis within the random-effects model were used to synthesize data. Main Outcomes and Measures:Efficacy (change in anxiety symptoms) posttreatment and at follow-up, acceptability (all-cause discontinuation), and quality of life and functional improvement were measured. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. Results:A total of 101 unique trials including 6625 unique participants compared 11 different psychotherapies with 4 specific control conditions. The certainty of evidence was rated as low or very low for most comparisons. For efficacy, most psychotherapies were significantly more effective than the wait list condition posttreatment (standardized mean difference [SMD], -1.43 to -0.61) and at the longest follow-up (SMD, -1.84 to -1.64). However, only group cognitive behavioral therapy (CBT) was significantly more effective than the other psychotherapies and all control conditions posttreatment. For acceptability, bibliotherapy CBT had significantly more all-cause discontinuations than some psychotherapies and control conditions (range of odds ratios, 2.48-9.32). In terms of quality of life and functional improvement, CBT (delivered in different ways) was significantly beneficial compared with psychological placebo and the wait list condition (SMDs, 0.73 to 1.99). Conclusions and Relevance:Group CBT would be the more appropriate choice of psychotherapy for anxiety disorders in children and adolescents, based on these findings. Other types of psychotherapies and different ways of delivering psychological treatment can be alternative options. Further research is needed to explore specific anxiety disorders, disorder-specific psychotherapy, and moderators of treatment effect. Trial Registration:PROSPERO Identifier: CRD42015016283. en
dc.format.medium Print en
dc.language eng en
dc.relation.ispartofseries JAMA psychiatry en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Humans en
dc.subject Anxiety Disorders en
dc.subject Psychotherapy en
dc.subject Adolescent en
dc.subject Child en
dc.subject Female en
dc.subject Male en
dc.subject Randomized Controlled Trials as Topic en
dc.subject Network Meta-Analysis en
dc.title Different Types and Acceptability of Psychotherapies for Acute Anxiety Disorders in Children and Adolescents: A Network Meta-analysis. en
dc.type Journal Article en
dc.identifier.doi 10.1001/jamapsychiatry.2018.3070 en
pubs.issue 1 en
pubs.begin-page 41 en
pubs.volume 76 en
dc.rights.holder Copyright: The authors en
pubs.end-page 50 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype Meta-Analysis en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype research-article en
pubs.subtype Journal Article en
pubs.elements-id 756496 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Psychological Medicine Dept en
dc.identifier.eissn 2168-6238 en
pubs.record-created-at-source-date 2018-11-02 en
pubs.dimensions-id 30383099 en

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