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Übersichtsarbeit

Effekte pharmakologischer und psychotherapeutischer Interventionen auf Depressionen bei Kindern und Jugendlichen

Published Online:October 03, 2006https://doi.org/10.1024/1422-4917.34.4.243

Abstract

Zusammenfassung: Entgegen früheren Überzeugungen besteht heute Konsens und Evidenz dahingehend, dass Depressionen eine bedeutsame Problematik bei Jugendlichen darstellen. Aus diesem Grund stellt sich die Frage nach effektiven Therapieangeboten für depressive Kinder und Jugendliche. Deshalb werden in der vorliegenden Übersichtsarbeit 24 Originalstudien (Kriterium: kontrollierte, randomisierte Interventionsstudien) zu pharmakologischen, 11 Studien zu psychotherapeutischen Interventionen und zwei Studien zur Kombinationsbehandlung dargestellt. Für etwa die Hälfte der Behandlungmethoden (pharmakologische Methoden 3/8; psychotherapeutische Methoden: 2/5) liegen keine randomisierten Kontrollgruppenstudien vor. Weiterhin liegen nur für einige SSRIs (Fluoxetin, Citalopram, Sertralin) ausschließlich positive Daten bezüglich der Besserung depressiver Symptomatik vor. Weiterhin zeigen sich nur für Fluoxetin keine Hinweise, dass Suizidalität im Vergleich zu einer Placebokontrollgruppe steigt (Hammad et al., 2006; Whittington et al., 2004). Auch für KVT, IPT und Familientherapie liegen überwiegend positive Daten zur Effektivität vor. Weiterhin zeigen erste Ergebnisse, dass eine Kombinationsbehandlung (SSRI & KVT) Monotherapien gegenüber überlegen ist. Nach der Darstellung der bisherigen empirischen Daten werden Stärken und Kritikpunkte der bisherigen Therapieforschung zur Behandlung von Depression bei Kindern und Jugendlichen diskutiert.


Effects of pharmaco- and psychotherapeutic interventions in depression among children and adolescents

Summary: Contrary to earlier assumptions, the current consensus is that depression constitutes an important issue in the mental health of children and adolescents. Thus, effective therapy options for depressive children and adolescents are needed. Randomized, controlled intervention studies are reviewed: 24 studies on pharmacological interventions, 11 studies on psychological interventions, and two on combination therapy. For approximately half of the intervention methods (pharmacotherapy: 3/8; psychotherapy: 2/5) no randomized, controlled studies carried out. Furthermore, only some SSRI (fluoxetin, citalopram and sertralin) yielded positive results with regard to depressive symptoms. Beyond these results, fluoxetin is the sole pharmacological treatment during which suicidality does not increase as compared to results for a placebo control group (Hammad et al., 2006; Whittington et al., 2004). Earlier studies of CBT, IPT, and family therapy reported predominantly positive effects. Nevertheless, initial results for combination therapies (SSRI & CBT) indicate an advantage of this therapy approach over mono-therapies. Empirical data are described, followed by a discussion of the strengths and limitations of the earlier studies.

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