Skip to main navigation menu Skip to main content Skip to site footer
Quaderni di Psicoterapia Cognitiva - Open Access

Sezione Generale - Linee guida per i disturbi sintomatici

No. 54 (2024)

International guidelines for the treatment of psychological disorders in developmental age

DOI
https://doi.org/10.3280/qpc54-2024oa18657
Submitted
ottobre 10, 2024
Published
2024-10-17

Abstract

This review includes the international guidelines available for the treatment of psychological disorders for Children and Adolescents, all the guidelines are drawn up by the British National Institute for Health and Care Excellence (NICE). The authors have chosen to analyze some of the currently most significant psychological disorders both in terms of frequency, intensity and impact on the functioning and development of children and adolescents. As is known, the post-Covid-19 pandemic has led to a progressive and constant increase in the request for clinical intervention aimed at subjects of developmental age, especially in cases of: mood disorders/depression, social anxiety, obsessive compulsive disorders; externalizing problems (ADHD and behavioral disorders including antisocial conduct) and more serious disorders relating to the area of psychotic onset. The authors of this article have decided to report, for each of these psychopathological areas, the indications regarding diagnosis and treatment present in the guidelines. Furthermore, for each disorder, the meta-analysis works published after the guidelines themselves were taken into consideration, in order to provide an updated overview of the available evidence.

References

  1. Alozkan-Sever C., Uppendahl J.R., Cuijpers P., de Vries R., Rahman A., Mittendorfer-Rutz E., Akhtar A., Zheng Z. & Sijbrandij M. (2023). Research Review: Psychological and psychosocial interventions for children and adolescents with depression, anxiety, and post-traumatic stress disorder in low- and middle-income countries. A systematic review and meta-analysis. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 64(12): 1776-1788. DOI: 10.1111/jcpp.13891.
  2. Battagliese G., Caccetta M., Luppino O.I., Baglioni C., Cardi V., Mancini F. & Buonanno C. (2015). Cognitive-behavioral therapy for externalizing disorders: A meta-analysis of treatment effectiveness. Behaviour Research and Therapy, 75: 60-71. DOI: 10.1016/j.brat.2015.10.008.
  3. Catalan A., Salazar de Pablo G., Vaquerizo Serrano J., Mosillo P., Baldwin H., Fernández-Rivas A., Moreno C., Arango C., Correll C.U., Bonoldi I. & Fusar-Poli P. (2021). Annual Research Review: Prevention of psychosis in adolescents. Systematic review and meta-analysis of advances in detection, prognosis and intervention. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 62(5): 657-673. DOI: 10.1111/jcpp.13322.
  4. Cervin M., McGuire J.F., D’Souza J.M., De Nadai A.S., Aspvall K., Goodman W.K., Andrén P., Schneider S.C., Geller D.A., Mataix-Cols D. & Storch E.A. (2024). Efficacy and acceptability of cognitive-behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive-compulsive disorder: a network meta-analysis. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 65(5): 594-609. DOI: 10.1111/jcpp.13934.
  5. Correll C.U., Galling B., Pawar A., Krivko A., Bonetto C., Ruggeri M., Craig T.J., Nordentoft M., Srihari V.H., Guloksuz S., Hui C.L.M., Chen E.Y.H., Valencia M., Juarez F., Robinson D.G., Schooler N.R., Brunette M.F., Mueser K.T., Rosenheck R.A., Marcy P., … Kane J.M. (2018). Comparison of Early Intervention Services vs Treatment as Usual for Early-Phase Psychosis: A Systematic Review, Meta-analysis, and Meta-regression. JAMA psychiatry, 75(6): 555-565. DOI: 10.1001/jamapsychiatry.2018.0623.
  6. Cuijpers P., Karyotaki E., Ciharova M., Miguel C., Noma H., Stikkelbroek Y., Weisz J.R. & Furukawa T.A. (2023). The effects of psychological treatments of depression in children and adolescents on response, reliable change, and deterioration: a systematic review and meta-analysis. European Child & Adolescent Psychiatry, 32(1): 177-192. DOI: 10.1007/s00787-021-01884-6.
  7. Cuijpers P., Pineda B.S., Ng M.Y., Weisz J.R., Muñoz R.F., Gentili C., Quero S. & Karyotaki E. (2021). A Meta-analytic Review: Psychological Treatment of Subthreshold Depression in Children and Adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 60(9): 1072-1084. DOI: 10.1016/j.jaac.2020.11.024.
  8. Devoe D.J., Farris M.S., Townes P. & Addington J. (2020). Interventions and Transition in Youth at Risk of Psychosis: A Systematic Review and Meta-Analyses. The Journal of Clinical Psychiatry, 81(3): 17r12053. DOI: 10.4088/JCP.17r12053.
  9. Eckshtain D., Kuppens S., Ugueto A., Ng M.Y., Vaughn-Coaxum R., Corteselli K. & Weisz J.R. (2020). Meta-Analysis: 13-Year Follow-up of Psychotherapy Effects on Youth Depression. Journal of the American Academy of Child and Adolescent Psychiatry, 59(1): 45-63. DOI: 10.1016/j.jaac.2019.04.002.
  10. Faraone S.V., Banaschewski T., Coghill D., Zheng Y., Biederman J., Bellgrove M.A., Newcorn J.H., Gignac M., Al Saud N.M., Manor I., Rohde L.A., Yang L., Cortese S., Almagor D., Stein M.A., Albatti T.H., Aljoudi H.F., Alqahtani M.M.J., Asherson P., Atwoli L., … Wang Y. (2021). The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Neuroscience and Biobehavioral Reviews, 128: 789-818. DOI: 10.1016/j.neubiorev.2021.01.022.
  11. Fulambarkar N., Seo B., Testerman A., Rees M., Bausback K. & Bunge E. (2023). Review: Meta-analysis on mindfulness-based interventions for adolescents’ stress, depression, and anxiety in school settings: a cautionary tale. Child and Adolescent Mental Health, 28(2): 307-317. DOI: 10.1111/camh.12572.
  12. Furlong M., McGilloway S., Bywater T., Hutchings J., Smith S.M. & Donnelly M. (2012). Behavioural and cognitive-behavioural group-based parenting programmes for early-onset conduct problems in children aged 3 to 12 years. The Cochrane Database of Systematic Reviews, (2), CD008225. DOI: 10.1002/14651858.CD008225.pub2.
  13. Guo C., Assumpcao L. & Hu Z. (2022). Efficacy of Non-pharmacological Treatments on Emotional Symptoms of Children and Adults with Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis. Journal of Attention Disorders, 26(4): 508-524. DOI: 10.1177/10870547211001953.
  14. Iniesta-Sepúlveda M., Rosa-Alcázar A.I., Sánchez-Meca J., Parada-Navas J.L. & Rosa-Alcázar, Á. (2017). Cognitive-behavioral high parental involvement treatments for pediatric obsessive-compulsive disorder: A meta-analysis. Journal of Anxiety Disorders, 49: 53-64. DOI: 10.1016/j.janxdis.2017.03.010.
  15. Ivarsson T., Skarphedinsson G., Kornør H., Axelsdottir B., Biedilæ S., Heyman I., Asbahr F., Thomsen P.H., Fineberg N., March J. & Accreditation Task Force of The Canadian Institute for Obsessive Compulsive Disorders (2015). The place of and evidence for serotonin reuptake inhibitors (SRIs) for obsessive compulsive disorder (OCD) in children and adolescents: Views based on a systematic review and meta-analysis. Psychiatry Research, 227(1): 93-103. DOI: 10.1016/j.psychres.2015.01.015.
  16. Kunas S.L., Lautenbacher L.M., Lueken P.U. & Hilbert K. (2021). Psychological Predictors of Cognitive-Behavioral Therapy Outcomes for Anxiety and Depressive Disorders in Children and Adolescents: A Systematic Review and Meta-Analysis. Journal of Affective Disorders, 278: 614-626. DOI: 10.1016/j.jad.2020.09.092.
  17. Lambez B., Harwood-Gross A., Golumbic E.Z. & Rassovsky Y. (2020). Non-pharmacological interventions for cognitive difficulties in ADHD: A systematic review and meta-analysis. Journal of Psychiatric Research, 120: 40-55. DOI: 10.1016/j.jpsychires.2019.10.007.
  18. Lee Y.C., Chen C.R. & Lin K.C. (2022). Effects of Mindfulness-Based Interventions in Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. International Journal of Environmental Research and Public Health, 19(22), 15198. DOI: 10.3390/ijerph192215198.
  19. Ma L., Zhang Y., Huang C. & Cui Z. (2020). Resilience-oriented cognitive behavioral interventions for depressive symptoms in children and adolescents: A meta-analytic review. Journal of Affective Disorders, 270: 150-164. DOI: 10.1016/j.jad.2020.03.051.
  20. McGuire J.F., Piacentini J., Lewin A.B., Brennan E.A., Murphy T.K. & Storch E.A. (2015). A meta-analysis of cognitive behavior therapy and medication for child obsessive-compulsive disorder: moderators of treatment efficacy, response, and remission. Depression and Anxiety, 32(8): 580-593. DOI: 10.1002/da.22389.
  21. Mendez E.M., Dahlsgaard K.K., Hjelmgren J.M., Mills J.A., Suresh V. & Strawn J.R. (2023). What Is the Added Benefit of Combining Cognitive Behavioral Therapy and Selective Serotonin Reuptake Inhibitors in Youth with Obsessive Compulsive Disorder? A Bayesian Hierarchical Modeling Meta-Analysis. Journal of Child and Adolescent Psychopharmacology, 33(6): 203-211. DOI: 10.1089/cap.2023.0018.
  22. Olatunji B.O., Davis M.L., Powers M.B. & Smits J.A. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: a meta-analysis of treatment outcome and moderators. Journal of Psychiatric Research, 47(1): 33-41. DOI: 10.1016/j.jpsychires.2012.08.020.
  23. Oliva F., Malandrone F., di Girolamo G., Mirabella S., Colombi N., Carletto S. & Ostacoli L. (2021). The efficacy of mindfulness-based interventions in attention-deficit/hyperactivity disorder beyond core symptoms: A systematic review, meta-analysis, and meta-regression. Journal of Affective Disorders, 292: 475-486. DOI: 10.1016/j.jad.2021.05.068.
  24. Öst L.G., Riise E.N., Wergeland G.J., Hansen B. & Kvale G. (2016). Cognitive behavioral and pharmacological treatments of OCD in children: A systematic review and meta-analysis. Journal of Anxiety Disorders, 43: 58-69. DOI: 10.1016/j.janxdis.2016.08.003.
  25. Reid J.E., Laws K.R., Drummond L., Vismara M., Grancini B., Mpavaenda D. & Fineberg N.A. (2021). Cognitive behavioural therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: A systematic review and meta-analysis of randomised controlled trials. Comprehensive Psychiatry, 106: 152223. DOI: 10.1016/j.comppsych.2021.152223.
  26. Riise E.N., Wergeland G.J.H., Njardvik U. & Öst L.G. (2021). Cognitive behavior therapy for externalizing disorders in children and adolescents in routine clinical care: A systematic review and meta-analysis. Clinical Psychology Review, 83: 101954. DOI: 10.1016/j.cpr.2020.101954.
  27. Rith-Najarian L.R., Mesri B., Park A.L., Sun M., Chavira D.A. & Chorpita B.F. (2019). Durability of Cognitive Behavioral Therapy Effects for Youth and Adolescents With Anxiety, Depression, or Traumatic Stress: A Meta-Analysis on Long-Term Follow-Ups. Behavior Therapy, 50(1): 225-240. DOI: 10.1016/j.beth.2018.05.006.
  28. Rosa-Alcázar A.I., Sánchez-Meca J., Rosa-Alcázar, Á., Iniesta-Sepúlveda M., Olivares-Rodríguez J. & Parada-Navas J.L. (2015). Psychological treatment of obsessive-compulsive disorder in children and adolescents: a meta-analysis. The Spanish Journal of Psychology, 18, E20. DOI: 10.1017/sjp.2015.22.
  29. Rosa-Alcázar, Á., Sánchez-Meca J., Rubio-Aparicio M., Bernal-Ruiz C. & Rosa-Alcázar A.I. (2022). Cognitive-Behavioral Therapy and Anxiety and Depression Level in Pediatric Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis. Psicothema, 34(3): 353-364. DOI: 10.7334/psicothema2021.478.
  30. Scaini S., Belotti R., Ogliari A. & Battaglia M. (2016). A comprehensive meta-analysis of cognitive-behavioral interventions for social anxiety disorder in children and adolescents. Journal of Anxiety Disorders, 42: 105-112. DOI: 10.1016/j.janxdis.2016.05.008.
  31. Skapinakis P., Caldwell D., Hollingworth W., Bryden P., Fineberg N., Salkovskis P., Welton N., Baxter H., Kessler D., Churchill R. & Lewis G. (2016). A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder in children/adolescents and adults. Health Technology Assessment, 20(43): 1-392. DOI: 10.3310/hta20430.
  32. Skarphedinsson G., Hanssen-Bauer K., Kornør H., Heiervang E.R., Landrø N.I., Axelsdottir B., Biedilæ S. & Ivarsson T. (2015). Standard individual cognitive behaviour therapy for paediatric obsessive-compulsive disorder: a systematic review of effect estimates across comparisons. Nordic Journal of Psychiatry, 69(2): 81-92. DOI: 10.3109/08039488.2014.941395.
  33. Stafford M.R., Jackson H., Mayo-Wilson E., Morrison A.P. & Kendall T. (2013). Early interventions to prevent psychosis: systematic review and meta-analysis. BMJ, 346, f185. DOI: 10.1136/bmj.f185.
  34. Sun M., Rith-Najarian L.R., Williamson T.J. & Chorpita B.F. (2019). Treatment Features Associated with Youth Cognitive Behavioral Therapy Follow-Up Effects for Internalizing Disorders: A Meta-Analysis. Journal of clinical child and adolescent psychology: the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 48(sup1): S269-S283. DOI: 10.1080/15374416.2018.1443459.
  35. Tao Y., Li H., Li L., Zhang H., Xu H., Zhang H., Zou S., Deng F., Huang L., Wang Y., Wang X., Tang X., Fu X. & Yin L. (2022). Comparing the efficacy of pharmacological and psychological treatment, alone and in combination, in children and adolescents with obsessive-compulsive disorder: A network meta-analysis. Journal of Psychiatric Research, 148: 95-102. DOI: 10.1016/j.jpsychires.2022.01.057.
  36. Uhre C.F., Uhre V.F., Lønfeldt N.N., Pretzmann L., Vangkilde S., Plessen K.J., Gluud C., Jakobsen J.C. & Pagsberg A.K. (2020). Systematic Review and Meta-Analysis: Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in Children and Adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 59(1): 64-77. DOI: 10.1016/j.jaac.2019.08.480.
  37. Watson H.J. & Rees C.S. (2008). Meta-analysis of randomized, controlled treatment trials for pediatric obsessive-compulsive disorder. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 49(5): 489-498. DOI: 10.1111/j.1469-7610.2007.01875.x.
  38. Wergeland G.J.H., Riise E.N. & Öst L.G. (2021). Cognitive behavior therapy for internalizing disorders in children and adolescents in routine clinical care: A systematic review and meta-analysis. Clinical Psychology Review, 83, 101918. DOI: 10.1016/j.cpr.2020.101918.
  39. Wergeland G.J.H., Riise E.N. & Öst L.G. (2021). Cognitive behavior therapy for internalizing disorders in children and adolescents in routine clinical care: A systematic review and meta-analysis. Clinical Psychology Review, 83, 101918. DOI: 10.1016/j.cpr.2020.101918.
  40. Wright I., Mughal F., Bowers G. & Meiser-Stedman R. (2021). Dropout from randomised controlled trials of psychological treatments for depression in children and youth: a systematic review and meta-analyses. Journal of Affective Disorders, 281: 880-890. DOI: 10.1016/j.jad.2020.11.039.
  41. Wu Y., Lang Z. & Zhang H. (2016). Efficacy of Cognitive-Behavioral Therapy in Pediatric Obsessive-Compulsive Disorder: A Meta-Analysis. Medical Science Monitor, 22: 1646-1653. DOI: 10.12659/msm.895481.
  42. Wuthrich V.M., Zagic D., Dickson S.J., McLellan L.F., Chen J.T., Jones M.P. & Rapee R.M. (2023). Effectiveness of Psychotherapy for Internalising Symptoms in Children and Adolescents When Delivered in Routine Settings: A Systematic Review and Metaanalysis. Clinical Child and Family Psychology Review, 26(3): 824-848. DOI: 10.1007/s10567-023-00433-8.
  43. Xiang Y., Cuijpers P., Teng T., Li X., Fan L., Liu X., Jiang Y., Du K., Lin J., Zhou X. & Xie P. (2022). Comparative short-term efficacy and acceptability of a combination of pharmacotherapy and psychotherapy for depressive disorder in children and adolescents: a systematic review and meta-analysis. BMC Psychiatry, 22(1): 139. DOI: 10.1186/s12888-022-03760-2.
  44. Xue J., Zhang Y. & Huang Y. (2019). A meta-analytic investigation of the impact of mindfulness-based interventions on ADHD symptoms. Medicine, 98(23): e15957. DOI: 10.1097/MD.0000000000015957.
  45. Yang L., Zhou X., Pu J., Liu L., Cuijpers P., Zhang Y., Zhang H., Yuan S., Teng T., Tian L. & Xie P. (2019). Efficacy and acceptability of psychological interventions for social anxiety disorder in children and adolescents: a meta-analysis of randomized controlled trials. European Child & Adolescent Psychiatry, 28(1): 79-89. DOI: 10.1007/s00787-018-1189-x.
  46. Zhang Q., Wang J. & Neitzel A. (2023). School-based Mental Health Interventions Targeting Depression or Anxiety: A Meta-analysis of Rigorous Randomized Controlled Trials for School-aged Children and Adolescents. Journal of Youth and Adolescence, 52(1): 195-217. DOI: 10.1007/s10964-022-01684-4.
  47. Zhou X., Teng T., Zhang Y., Del Giovane C., Furukawa T.A., Weisz J.R., Li X., Cuijpers P., Coghill D., Xiang Y., Hetrick S.E., Leucht S., Qin M., Barth J., Ravindran A.V., Yang L., Curry J., Fan L., Silva S.G., Cipriani A., … Xie P. (2020). 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. The Lancet. Psychiatry, 7(7): 581-601. DOI: 10.1016/S2215-0366(20)30137-1.
  48. www.nice.org.UK/guidance/ng134.
  49. www.nice.org.uk/Guidance/CG155.
  50. www.nice.org.uk/guidance/ng87.
  51. www.nice.org.uk/Guidance/CG158.
  52. www.nice.org.uk/guidance/CG159.
  53. www.nice.org.uk/Guidance/CG31.

Metrics

Metrics Loading ...