Meta-analysis: 13-year follow-up of psychotherapy effects on youth depression

Eckshtain, Dikla; Kuppens, Sofie; Ugueto, Ana; Ng, Mei Yi; Vaughn-Coaxum, Rachel; Corteselli, Katherine; Weisz, John R.

doi:10.1016/j.jaac.2019.04.002

Cited by 224Psychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

Meta-analysis: 13-year follow-up of psychotherapy effects on youth depression

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Eckshtain, Dikla, Kuppens, Sofie, Ugueto, Ana, Ng, Mei Yi, Vaughn-Coaxum, Rachel, Corteselli, Katherine, Weisz, John R.·2020·Journal of the American Academy of Child & Adolescent Psychiatry

DOI 10.1016/j.jaac.2019.04.002

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Abstract

Objective Youth depression is a debilitating condition that constitutes a major public health concern. A 2006 meta-analysis found modest benefits for psychotherapy versus control. Has 13 more years of research improved that picture? We sought to find out.Method We searched PubMed, PsychINFO, and Dissertation Abstracts International for 1960 to 2017, identifying 655 randomized, English-language psychotherapy trials for individuals aged 4 to 18 years. Of these, 55 assessed psychotherapy versus control for youth depression with outcome measures administered to both treatment and control conditions at post (κ = 53) and/or follow-up (κ = 32). Twelve study and outcome characteristics were extracted, and effect sizes were calculated for all psychotherapy versus control comparisons. Using a three-level random-effects model, we obtained an overall estimate of the psychotherapy versus control difference while accounting for the dependency among effect sizes. We then fitted a three-level mixed-effects model to identify moderators that might explain variation in effect size within and between studies.Results The overall effect size (g) was 0.36 at posttreatment and 0.21 at follow-up (averaging 42 weeks after posttreatment). Three moderator effects were identified: effects were significantly larger for interpersonal therapy than for cognitive behavioral therapy, for youth self-reported outcomes than parent-reports, and for comparisons with inactive control conditions (eg, waitlist) than active controls (eg, usual care). Effects showed specificity, with significantly smaller effects for anxiety and externalizing behavior outcomes than for depression measures.Conclusion Youth depression psychotherapy effects are modest, with no significant change over the past 13 years. The findings highlight the need for treatment development and research to improve both immediate and longer-term benefits.

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Earlier meta-analyses indicated that psychotherapies, particularly CBT and interpersonal psychotherapy, were more effective than psychological control conditions for child and adolescent depression.
“especially cognitivebehavioural therapy (CBT) and interpersonal psychotherapy, appeared to be more effective compared with psychological controls in previous metaanalyses.7,8”
From 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 (2020) · cites this paper as [8]

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Authors: Eckshtain, D., Kuppens, S., Ugueto, A., Ng, M. Y., Vaughn-Coaxum, R., Corteselli, K., & Weisz, J. R.
Affiliations: Harvard University (US)
Karel de Grote Hogeschool (BE)
The University of Texas Health Science Center at Houston (US)
Florida International University (US)
Corresponding author: Eckshtain, Dikla
ORCID: Eckshtain, Dikla
Kuppens, Sofie
Ugueto, Ana
Ng, Mei Yi
Corteselli, Katherine
Weisz, John R.
Venue: Journal of the American Academy of Child & Adolescent Psychiatry
Publisher: Elsevier BV
Published: 2020-01
Volume: 59
Issue: 1
Pages: 45-63
ISSN: 0890-8567 (ISSN-L)
DOI: 10.1016/j.jaac.2019.04.002
OpenAlex: W2935979699
Cited by: 224
References: 128
Citations by year: 2026: 20 · 2025: 22 · 2024: 56 · 2023: 36 · 2022: 34 · 2021: 33 · 2020: 19 · 2019: 4
FWCI: 3.54
Type: journal article
Language: en
Open access: green
lirias.kuleuven.be
Licence: other-oa
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
PubMed (publishedVersion)
Lirias (KU Leuven) (submittedVersion, other-oa)
Funders: National Institute of Mental Health
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords: adolescent depression, psychotherapy, long-term follow-up, interpersonal psychotherapy, cognitive behavioral therapy, treatment effect size, treatment moderators, anxiety, externalizing problems
MeSH terms: Adolescent, Anxiety, Child, Child, Preschool, Depression, Follow-Up Studies, Humans, Psychotherapy, Cognitive Behavioral Therapy

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Meta-analysis: 13-year follow-up of psychotherapy effects on youth depression

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