Evidence map›Paper›PMID 34611729›Full record

SynthesisEuropean child & adolescent psychiatry2023

The effects of psychological treatments of depression in children and adolescents on response, reliable change, and deterioration: a systematic review and meta-analysis.

Pim Cuijpers, Eirini Karyotaki, Marketa Ciharova, Clara Miguel, Hisashi Noma, Yvonne Stikkelbroek, John R Weisz, Toshi A Furukawa

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European child & adolescent psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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  14. Deterioration in mental health: towards a conceptualization based on patients' perspectives.International journal of qualitative studies on health and well-being · 2026
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  18. Innovations to improve outcomes and uptake of psychotherapies for mental disorders: a state-of-the-art review.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Pim CuijpersDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands. p.cuijpers@vu.nl.ORCID http://orcid.org/0000-0001-5497-2743
Eirini KaryotakiDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-0071-2599
Marketa CiharovaDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-7131-1549
Clara MiguelDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0001-5563-5896
Hisashi NomaDepartment of Data Science, Institute of Statistical Mathematics, Tokyo, Japan.ORCID http://orcid.org/0000-0002-2520-9949
Yvonne StikkelbroekDepartment of Clinical Child and Family Studies, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands.ORCID http://orcid.org/0000-0001-5062-9585
John R WeiszHarvard University, Cambridge, Massachusetts, USA.ORCID http://orcid.org/0000-0002-5560-6814
Toshi A FurukawaDepartment of Clinical Child and Family Studies, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands.ORCID http://orcid.org/0000-0003-2159-3776

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Meta-analyses show that psychotherapies are effective in the treatment of depression in children and adolescents. However, these effects are usually reported in terms of effect sizes. For patients and clinicians, it is important to know whether patients achieve a clinically significant improvement or deterioration. We conducted such a meta-analysis to examine response, clinically significant change, clinically significant deterioration and recovery as outcomes. We searched four bibliographic databases and included 40 randomised trials comparing psychotherapy for youth depression against control conditions. We used a validated method to estimate outcome rates, based on means, standard deviation and N at baseline and post-test. We also calculated numbers-need-to- treat (NNT). The overall response rate in psychotherapies at 2 (±1) months after baseline was 39% (95% CI: 34-45) and 24% (95% CI: 0.19-28) in control conditions (NNT: 6.2). The difference between therapy and control was still significant at 6-12 months after baseline (NNT=7.8). Clinically significant improvement was found in 54% of youth in therapy, compared with 32% in control groups (NNT=5.3); clinically significant deterioration was 6% in therapy, 13% in controls (NNT=5.1); recovery was 58% in therapy, 36% in controls (NNT=3.3). Smaller effects were found in studies with low risk of bias. Psychotherapies for depression in youth are effective compared to control conditions, but more than 60% of youth receiving therapy do not respond. More effective treatments and treatment strategies are clearly needed. Trial registration https://osf.io/84xka.

Indexed as

DepressionPsychotherapyAdolescentChildControl GroupsData CollectionHumansTreatment OutcomeCognitive behaviour therapyDepressionMajor depressive disorderMeta-analysisPsychotherapy

Identifiers

PMID34611729
PMCPMC9908674

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.