A Systematic Review of Controlled-Trials for PTSD in Maltreated Children and Adolescents

2020 ◽  
pp. 107755952096117
Author(s):  
Rhiannon S. Bennett ◽  
Megan Denne ◽  
Rosie McGuire ◽  
Rachel M. Hiller
Keyword(s):  
Systematic Review ◽  
Young People ◽  
Child Maltreatment ◽  
Children And Adolescents ◽  
Treatment Decision ◽  
Evidence Base ◽  
Traumatic Experiences ◽  
Controlled Trials ◽  
Post Traumatic Stress ◽  
Randomized Controlled

Child maltreatment is associated with elevated risk of post-traumatic stress disorder (PTSD), which can often present alongside comorbidities. While evidence-based treatments for PTSD in young people already exist, there remains ongoing clinical and academic debate about the suitability of these approaches, particularly cognitive-behavioral approaches, for young people who have been exposed to more complex traumatic experiences, such as maltreatment. We conducted an updated systematic review of the evidence-base for psychological treatments for PTSD, specifically for maltreated young people. Fifteen randomized controlled trials and five non-randomized controlled clinical trials satisfied the inclusion criteria. Trials included treatments ranging from trauma-focused CBT to creative-based therapies. Trauma-focused CBT remained the best supported treatment for children and adolescents following child maltreatment, with new evidence that symptom improvements are maintained at longer-term follow up. The evidence for other therapies remained limited, and there were concerns regarding methodological quality. Implications for treatment decision-making are discussed.

RANDOMISED CONTROLLED TRIALS OF CHRONIC PAIN IN CHILDREN AND ADOLESCENTS: A SYSTEMATIC REVIEW

2015 ◽  
Vol 101 (1) ◽  
pp. e1.66-e1
Author(s):  
Rym Boulkedid ◽  
Armiya Yousouf Abdou ◽  
Emilie Desselas ◽  
Marlène Monegat ◽  
Corinne Alberti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Randomized Controlled Trials ◽  
Children And Adolescents ◽  
Methodological Quality ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Recurrent Pain ◽  
Pharmacological Agents ◽  
Randomized Controlled

BackgroundApproximately 15 to 30% of children and adolescents suffer from daily pain persistent over more than 3 months and there is evidence supporting that the prevalence of chronic pain is steadily increasing in this population. Chronic pain is known to have a negative impact on children's development and social behaviour, leading often to severe psychological distress and physical disability. We reviewed medical literature to assess the characteristics and quality of randomized controlled trials (RCTs) on pharmacological and non-pharmacological therapies in chronic and recurrent pain in the paediatric population.MethodsWe performed a systematic search of PubMed, Embase and the Cochrane Library up to March 2014. Bibliographies of relevant articles were also hand-searched. We included all RCTs that involved children and adolescents (age 0 to 18 years) and evaluated the use of a pharmacological agent or a non-pharmacological approach in the context of chronic or recurrent pain. The latter was defined as pain persisting for more than 3 months. Methodological quality was evaluated using the Cochrane Risk of Bias Tool. Two reviewers independently assessed studies for inclusion and evaluated methodological quality.ResultsA total of 52 randomized controlled trials were selected and included in the analysis. The majority were conducted in single hospital institutions, with no information on study funding. Median sample size was 45 (34–57) participants. Almost 50% of the RCTs included both adults and children with a median age at inclusion of 13 years. Non-pharmacological approaches were more commonly tested whereas evaluation of pharmacological agents concerned less than 30% of RCTs. Abdominal pain and headache were the most common types of chronic pain experienced among trial participants. Overall, the methodological quality was poor and did not parallel the number of RCTs that increased over the years. The risk of bias was high or unclear in 70% of the trials.ConclusionsThis is the first systematic review of RCTs conducted to evaluate pharmacological and non-pharmacological therapies in chronic and recurrent pain in children and adolescents. Although, management of pain in adults has significantly improved over the years due to the evaluation of numerous analgesic therapies, our results highlight the existing knowledge gap with regards to children and adolescents. Therapeutic strategies, in particular pharmacological agents, applied to relieve chronic or recurrent pain in children and adolescents are not evaluated through high quality RCTs. The need to improve analgesic therapy in children and adolescents with chronic pain is still unmet. We discuss possible research constraints and challenges related to this fact as well as adequate methodologies to circumvent them.

Current Evidence Base for the UP-C and UP-A

2021 ◽  
pp. 31-38
Author(s):  
Niza Tonarely ◽  
Dominique Phillips
Keyword(s):  
Randomized Controlled Trial ◽  
Children And Adolescents ◽  
Emotional Disorders ◽  
Controlled Trial ◽  
Evidence Base ◽  
Current Evidence ◽  
Controlled Trials ◽  
Transdiagnostic Treatment ◽  
Randomized Controlled ◽  
Current Evidence Base

This chapter summarizes current research support for Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C and UP-A), which have been found to be efficacious for children and adolescents with a range of emotional concerns. The UP-A has been investigated in randomized controlled trials and has demonstrated efficacy in treating anxiety and depressive symptoms, with significant decreases in symptoms during treatment and maintenance of gains following treatment. The UP-C has been investigated using open and randomized controlled trial designs and was found to be as efficacious as an established anxiety protocol. This chapter also presents research on patterns of change across symptoms and individuals in response to the UP-C and UP-A, including response trajectories, the timing of change, and comparisons of rates of change by symptom and reporter.

Sign in / Sign up

Export Citation Format

Share Document