Seven randomised controlled trials (RCTs) and 2 controlled studies investigated CBT in children with depressive symptoms (minimum n=233), while 6 RCTs looked at CBT in children diagnosed with depressive disorder (minimum n=247). Four RCTs examined family therapy in childhood depression (minimum n=120). There were no RCTs of interpersonal psychotherapy.
Four RCTs investigated the prevention of relapse and 5 RCTs looked at interventions to prevent depression in children (n=1,814).
Therapy.
Five RCTs and one non-randomised study reported that CBT in children with depressive symptoms was superior to no treatment (no statistical results presented). Two RCTs found no difference between CBT and no treatment, while one non-randomised study did not report whether CBT was more effective than the control intervention. Four RCTs found no difference between CBT and other therapies, e.g. relaxation therapy (no statistical results presented). When looking at children diagnosed with depressive disorder, the pooled data showed a significant improvement in the CBT group over the comparison interventions (odds ratio 2.2, number-needed-to-treat 4). No published RCTs of interpersonal psychotherapy were found. Randomised comparative studies of family interventions in children diagnosed with depressive disorder, did not find a significant difference from the comparison interventions.
Prevention of relapse.
Only one of the 4 RCTs found a significant long-term effect of treatment.
Primary prevention of childhood depression.
Two RCTs did not find any significant benefit of universal interventions designed to reduce depressive symptoms in the general population of children. However, 5 studies that included interventions targeted at high-risk children showed a significant reduction in depressive symptoms.