Abstract

Introduction Children and adolescents, after natural and man-made disasters, often exhibit various psychological,
emotional, and behavioral issues, showing a range of clinical symptoms related to post-traumatic stress disorder
(PTSD) and depression. This review used a network meta-analysis (NMA) approach to compare and rank psychological
interventions for PTSD and depression in children and adolescents after exposure to natural and man-made disasters.
Methods Randomized studies of psychosocial interventions for PTSD and depression in children and adolescents
exposed to natural and man-made disasters were identified. PTSD and depression symptoms at postintervention and
1–12 month follow-up are the outcomes. The standardized mean differences (SMDs) between pairs of interventions
at postintervention and follow-up were pooled. Mean effect sizes with 95% credible intervals (CI) were calculated, and
the ranking probabilities for all interventions were estimated using the surface under the cumulative ranking curve.
Study quality was assessed with version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2).
Results In total, 26 studies with 4331 participants were included in this NMA. Eye movement desensitization and
reprocessing therapy (EMDR) (SMD = − 0.67; 95% CI − 1.17 to − 0.17), exposure therapy (ET) (SMD = − 0.66; 95% CI
− 1.11 to − 0.22), and cognitive behavioral therapy (CBT) (SMD = − 0.62; 95% CI − 0.90 to − 0.34) were significantly more
effective for PTSD at postintervention than inactive intervention. EMDR (SMD = − 0.72; 95% CI − 1.11 to − 0.33) and
ET (SMD = − 0.62; 95% CI − 0.97 to − 0.27) were associated with a higher reduction in PTSD symptoms at follow-up
than inactive intervention. EMDR (SMD = − 0.40; 95% CI − 0.78 to − 0.03) and play therapy (PT) (SMD = − 0.37; 95% CI
− 0.62 to − 0.12) were significantly more effective for depression at postintervention than inactive intervention. For all
psychological interventions in reducing depression symptoms at follow-up compared with inactive intervention, the
differences were not significant.
Conclusion EMDR appears to be most effective in reducing PTSD and depression in children and adolescents
exposed to natural and man-made disasters. In addition, ET and CBT are potentially effective in reducing PTSD
symptoms at postintervention, while PT is beneficial in managing depression symptoms at the treatment endpoint.
Keywords Network meta-analysis, Post-traumatic stress disorder, Depression, Intervention, Disaster

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Джерело:Xie et al. BMC Psychiatry (2024) 24:468
https://doi.org/10.1186/s12888-024-05924-8

*Correspondence:
Binbin Kan
moc.361%40ew_3202nib
1 - School of Educational Science, Anhui Normal University, Wuhu, China. 2 - School of Computer and Information, Anhui Normal University, Wuhu, China. 3 - Office of Scientific Research, XuanCheng Vocational & Technical College, Xuancheng, China. 4 - School of Educational Science, Jiangsu Second Normal University, Nanjing, China