ABSTRACT
Depression in childhood and adolescence is a public health problem due to its high prevalence and the impact it has in the individual development. There is clear evidence of the efficacy of Interpersonal Therapy (IPT) and Cognitive-Behavioural Therapy (CBT) in the treatment of depression in children and adolescents; however, recent reviews and meta-analyses provide new perspectives for treatment. The purpose of this workis to synthesize the bibliography available through a systematic review of systematic reviews and meta-analysis that summarizes in a comprehensive way the evidence of the last two decades on the effectiveness of psychological interventions for infant-juvenile depression. A systematicreview of systematic reviews and meta-analyses was performed. A search was conducted in the Web of Science and Scopus databases. Eightrecords met the inclusion criteria, 2 were analysed in their entirety and from the remaining 6 the information needed for independent analysis wasextracted. Seven different psychotherapies were studied: CBT and IPT were the most studied (n=7; 87.5%), followed by family therapy (n=5;62.5%), psychodynamic therapy (n=3; 37.5%), behavioural therapy (n=3; 37.5%), computerised CBT (n=2; 25%), problem-solving therapy (n=1;12.5%) and supportive therapy (n=1; 12.5%). IPT and CBT were shown to be effective in the treatment of adolescent depression. Half of thereviews (n=4; 50%) had a low methodological quality and the other half (n=4; 50%) were classified as critically low. In general, psychologicalinterventions for child and adolescent depression produce significant, but modest effects. Specifically, IPT and CBT can be considered the maintreatment alternatives for adolescent depression. There is insufficient data of specific psychological treatment for children diagnosed with a depressive disorder. ... (AU)
La depresión infanto-juvenil es un problema de salud pública por su elevada prevalencia y el impacto que tiene en el desarrollo del individuo. Aunque existe una sólidaevidencia sobre la eficacia de la psicoterapia interpersonal y la terapia cognitivo-conductual (TCC) en el tratamiento de la depresión en niños yadolescentes, recientes revisiones y meta-análisis aportan nuevas perspectivas de tratamiento. La finalidad de este trabajo es sintetizar la bibliografía disponible mediante una revisión sistemática de revisiones sistemáticas y meta-análisis que resuma de manera integral la evidencia de lasúltimas dos décadas sobre la eficacia de las intervenciones psicológicas para la depresión infanto-juvenil. Se realizó una revisión sistemática derevisiones sistemáticas y meta-análisis. Se llevó a cabo una búsqueda en las bases de datos Web of Science y Scopus. Ocho registros cumplieron los criterios de inclusión, 2 se analizaron en su totalidad y de los 6 restantes se extrajo la información necesaria para ser analizada independientemente. Se estudiaron siete psicoterapias distintas: la TCC y la terapia interpersonal fueron las más estudiadas (n=7; 87,5%), seguidas porla terapia familiar (n=5; 62,5%), la terapia psicodinámica (n=3; 37,5%), la terapia conductual (n=3; 37,5%), la TCC informatizada (n=2; 25%), laterapia de resolución de problemas (n=1; 12,5%) y la terapia de apoyo (n=1; 12,5%). La terapia interpersonal y la TCC demostraron ser efectivas en el tratamiento de la depresión adolescente. La mitad de las revisiones (n=4; 50%) presentaron una calidad metodológica baja y la otramitad (n=4; 50%) se clasificó como críticamente baja. Las intervenciones psicológicas para la depresión infanto-juvenil, en general, producenefectos significativos, pero modestos. De forma específica, la terapia interpersonal y la TCC pueden considerarse las principales alternativas detratamiento para la depresión adolescente. ...(AU)
Subject(s)
Humans , Child , Adolescent , Psychotherapy/methods , Psychotherapy/trends , Depression/psychology , Depression/therapy , Child Behavior Disorders/psychology , Adolescent , Review Literature as Topic , Treatment OutcomeABSTRACT
BACKGROUND: Surveys report low frequencies of sexual history (SH) obtained in primary care. Sexually transmitted infections incidence can be reduced with timely screening. It is important to determine whether providers obtain thorough SH and to identify needs for improvement. AIM: To evaluate the frequency and depth of SH taking in primary care. METHODS: In this cross-sectional cohort study, 1,017 primary care visits were reviewed (1,017 adult patients, female 55.26%). 417 patients were seen by male providers and 600 patients were seen by female providers. Multivariate ordered and logit models were deployed. MAIN OUTCOME MEASURES: The primary outcome measures included SH taking rates and completeness based on the 5 P model as described by the Centers for Disease Control and Prevention. RESULTS: All components of SH were explored in 1.08% of visits. Partial SH was obtained in 33.92% of visits. No SH was taken in the majority of visits (65%). SH was more likely to be taken from female patients than from male patients (P < .001), and was less likely to be obtained from older patients as compared to younger individuals (P < .001). There was no significant difference in SH taking between male and female providers (P = .753). The provider title and the level of training were found to be independent predictors of SH taking (P < .001). CLINICAL IMPLICATIONS: The results of this study highlight an unmet need for more comprehensive and consistent SH taking amongst providers, particularly in high-risk settings, so that SH can be used as a valuable tool in preventive care. STRENGTHS & LIMITATIONS: To the best of our knowledge, this is the largest study to date examining SH taking in the primary care setting. Limitations include the retrospective study design, lack of generalizability to other hospitals, and inconsistencies in available data. CONCLUSION: The SH taking rates in primary care clinics are globally low with a variation depending on the provider position or level of training, provider gender, and patient age. Palaiodimos L, Herman HS, Wood E, et al. Practices and Barriers in Sexual History Taking: A Cross-Sectional Study in a Public Adult Primary Care Clinic. J Sex Med 2020;17:1509-1519.
