Skip to main content

Advertisement

SpringerLink
Log in

Psychological treatments for depression in pre-adolescent children (12 years and younger): systematic review and meta-analysis of randomised controlled trials

  • Review
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

The objective of this study was to evaluate the efficacy of psychological treatments for depression in pre-adolescent children, a disorder affecting 1–2 % of children in this age range. A systematic review of studies of psychological interventions to treat depressive disorder in pre-adolescent children (aged up to 12-years-old) was carried out. The primary outcome was level of depressive symptoms. Studies were found using Medline, PsycINFO, EMBASE and Web of Knowledge databases and selected on several criteria. Only randomised controlled trials were included. Where individual studies covered a broader age range (usually including adolescents up to age 18 years), authors of those studies were contacted and requested to provide individual patient level data for those aged 12 years and younger. 2822 abstracts were reviewed, and from these 124 full text articles were reviewed, yielding 7 studies for which we were able to access appropriate data for this review. 5 of these studies evaluated cognitive behaviour therapy (CBT). Combined results from these studies suggest that there is a lack of evidence that CBT is better than no treatment [standard mean difference −0.342 (95 % confidence interval −0.961, 0.278)], although the number of participants included in the trials was relatively small. The evidence for efficacy of family therapy and psychodynamic therapy is even more limited. The very limited number of participants in randomised controlled trials means that there is inconclusive evidence for the psychological treatment of depression in children aged 12 years and below. Given the prevalence and significant impact of this disorder, there is an urgent need to establish the effectiveness or otherwise of psychological intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Murray CJL, Lopez AD (1996) The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. World Health Organization, Geneva

    Google Scholar 

  2. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. JAMA Psychiatry 62(6):593–602

    Google Scholar 

  3. Copeland WE, Adair CE, Smetanin P, Stiff D, Briante C, Colman I et al (2013) Diagnostic transitions from childhood to adolescence to early adulthood. J Child Psychol Psychiatry 54(7):791–799

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kim-Cohen J, Caspi A, Moffitt TE, Harrington H, Milne BJ, Poulton R (2003) Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry 60(7):709–717

    Article  PubMed  Google Scholar 

  5. Patel V, Flisher AJ, Hetrick S, McGorry P (2007) Mental health of young people: a global public-health challenge. Lancet 369:1302–1313

    Article  PubMed  Google Scholar 

  6. Weissman MM, Wolk S, Wickramaratne P, Goldstein RB, Adams P, Greenwald S et al (1999) Children with prepubertal-onset major depressive disorder and anxiety grown up. Arch Gen Psychiatry 56(9):794–801

    Article  CAS  PubMed  Google Scholar 

  7. NICE (2015) Depression in children and young people: identification and management in primary, community and secondary care. Issued: March 2015. NICE clinical guideline 28

  8. Dubicka B, Elvins R, Roberts C, Chick G, Wilkinson P, Goodyer IM (2010) Combined treatment with cognitive-behavioural therapy in adolescent depression: meta-analysis. Br J Psychiatry 197(6):433–440

    Article  PubMed  Google Scholar 

  9. Cox GR, Callahan P, Churchill R, Hunot V, Merry SN, Parker AG, Hetrick SE (2012) Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents. Cochrane Lib 11:CD008324

    Google Scholar 

  10. Bennett K, Manassis K, Walter SD, Cheung A, Wilansky-Traynor P, Diaz-Granados N, Duda S, Rice M, Baer S, Barrett P, Bodden D, Cobham VE, Dadds MR, Flannery-Schroeder E, Ginsburg G, Heyne D, Hudson JL, Kendall PC, Liber J, Warner CM, Mendlowitz S, Nauta MH, Rapee RM, Silverman W, Siqueland L, Spence SH, Utens E, Wood JJ (2013) Cognitive behavioral therapy age effects in child and adolescent anxiety: an individual patient data metaanalysis. Depress Anxiety 30(9):829–841

    Article  PubMed  PubMed Central  Google Scholar 

  11. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17(1):1–12

    Article  CAS  PubMed  Google Scholar 

  12. Stark KD, Reynolds WM, Kaslow NJ (1987) A comparison of the relative efficacy of self-control therapy and a behavioral problem-solving therapy for depression in children. J Abnorm Child Psychol. 15(1):91–113

    Article  CAS  PubMed  Google Scholar 

  13. Luby J, Lenze S, Tillman R (2012) A novel early intervention for preschool depression: findings from a pilot randomized controlled trial. J Child Psychol Psychiatry 53(3):313–322

    Article  PubMed  Google Scholar 

  14. Liddle B, Spence SH (1990) Cognitive-behaviour therapy with depressed primary school children: a cautionary note. Behav Psychother. 18:85–102

    Article  Google Scholar 

  15. Brent D, Emslie G, Clarke G, Wagner KD, Asarnow JR, Keller M, Vitiello B, Ritz L, Iyengar S, Abebe K, Birmaher B, Ryan N, Kennard B, Hughes C, DeBar L, McCracken J, Strober M, Suddath R, Spirito A, Leonard H, Melhem N, Porta G, Onorato M, Zelazny J (2008) Switching to another SSRI or to venlafaxine with or without cognitive behavioral therapy for adolescents with SSRI-resistant depression: the TORDIA randomized controlled trial. JAMA 299(8):901–913

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. March J, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, Burns B, Domino M, McNulty S, Vitiello B, Severe J, Treatment for Adolescents With Depression Study (TADS) Team (2004) Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial. JAMA 292(7):807–820

    Article  CAS  PubMed  Google Scholar 

  17. Stallard P, Richardson T, Velleman S, Attwood M (2011) Computerized CBT (Think, Feel, Do) for depression and anxiety in children and adolescents: outcomes and feedback from a pilot randomized controlled trial. Behav Cogn Psychother. 39(3):273–284

    Article  PubMed  Google Scholar 

  18. Trowell J, Joffe I, Campbell J, Clemente C, Almqvist F, Soininen M, Koskenranta-Aalto U, Weintraub S, Kolaitis G, Tomaras V, Anastasopoulos D, Grayson K, Barnes J, Tsiantis J (2007) Childhood depression: a place for psychotherapy. An outcome study comparing individual psychodynamic psychotherapy and family therapy. Eur Child Adolesc Psychiatry. 16(3):157–167

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank the National Institutes of Mental Health (US) and the lead authors of two of the other studies (Judith Trowell and Paul Stallard) for allowing us access to the data from four of the trials in this review. We acknowledge the support of Nitesh Mehta with the search strategies.

Author information

Authors and Affiliations

  1. The Centre for Mental Health, Hammersmith Campus, Imperial College London, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK

    M. Azul Forti-Buratti, Rupalim Saikia, Esther L. Wilkinson & Paul G. Ramchandani

Authors
  1. M. Azul Forti-Buratti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rupalim Saikia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Esther L. Wilkinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paul G. Ramchandani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul G. Ramchandani.

Ethics declarations

Funding

We received funding from the Fundación Alicia Koplowitz (a fellowship to MAF) and were supported by the NIHR Biomedical Research Centre award to Imperial College, London.

Conflict of interest

On behalf of all the authors, the corresponding author states that there is no conflict of interest.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 15 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Forti-Buratti, M.A., Saikia, R., Wilkinson, E.L. et al. Psychological treatments for depression in pre-adolescent children (12 years and younger): systematic review and meta-analysis of randomised controlled trials. Eur Child Adolesc Psychiatry 25, 1045–1054 (2016). https://doi.org/10.1007/s00787-016-0834-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-016-0834-5

Keywords

Search

Navigation