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Question: How effective are antidepressants and psychological therapies and their combination, for depression in children and adolescents?
Outcomes: Primary outcomes: remission (freedom from mood symptoms or asymptomatic for 8 weeks) from depressive disorder as assessed by a mental health professional; treatment acceptability (dropouts); suicide-related serious adverse outcomes.
Design: Systematic review with meta-analysis.
Data sources: Cochrane Collaboration Depression, Anxiety and Neurosis Group (CCDAN) clinical trials registers were searched from inception to November 2011 for randomised controlled trials (RCTs). Additional searches in MEDLINE, EMBASE and PsycINFO to April 2011 were performed. Reference lists of identified studies were hand searched. Authors of included studies and experts were contacted.
Study selection and analysis: RCTs in children (aged 6–12 years) and adolescents (aged 13–18 years) with depression that compared any antidepressant versus psychological therapy were selected; interventions could be given alone or combined with the other therapy. Random effects meta-analyses were conducted using RevMan software. Heterogeneity was assessed using the I2 statistic.
Ten RCTs met inclusion criteria (n=1235). Psychological …
Sources of funding: Headspace, Australia. Australian Government funding for the National Youth Mental Health Foundation.
Competing interests None.