The Evidence Base for Psychosocial and Psychopharmacological Interventions for Children with
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The Evidence Base for Psychosocial and Psychopharmacological Interventions for Children with Attention-Deficit/Hyperactivity Disorder, Major Depressive Disorder, Disruptive Behavior Disorders, Anxiety Disorders,and Posttraumatic Stress DisorderBarbara J. Burns, Ph.D.Scott N. Compton, Ph.D.Helen L. Egger, M.D.Elizabeth M. Z. Farmer, Ph.D.Duke University Medical Center


Specific Aims of Project Psychopharmacological Interventions for Children with

I .To identify efficacious/effective interventions

for the treatment of childhood mental disorders

which could reduce the risk for substance use

problems in adolescence and later;

II. To identify mental health intervention studies

in which substance use outcomes could be

examined in adolescence and later.


Inclusion Criteria for Literature Search Psychopharmacological Interventions for Children with

  • Study on one of five childhood disorders or related symptom group

  • Utilized a controlled design

  • Targeted children in 6-12 age range

  • Published 1985-1999

    (except interventions studied earlier and not repeated later)

  • Focused on outpatient treatment


Search results
Search Results Psychopharmacological Interventions for Children with

Clinical References References Meeting

Condition Identified Inclusion Criteria

ADHD 132 31*

Depression 28 19

Disruptive

Behavior 314 30*

Disorders

Anxiety 75 37

Disorders

Posttraumatic 58 5

Stress Disorder

*Studies with N < 30 were excluded


Psychopharmacological Interventions for Children with

Descriptors in Matrices

Study design and description

Target population

Demographic characteristics

(Age, gender, race/ethnicity)

Outcomes

Comments


Types of interventions with positive findings by clinical condition
Types of Interventions Psychopharmacological Interventions for Children with with Positive Findings by Clinical Condition

  • PSYCHOSOCIAL

  • PSYCHOPHARMACOLOGICAL

  • ADJUNCTIVE

    (combined treatments)


Interventions with positive findings for attention deficit hyperactivity disorder
Interventions with Positive Findings for Psychopharmacological Interventions for Children with Attention-Deficit/Hyperactivity Disorder

Psychosocial Psychopharmacological Adjunctive

cognitive behavior methylphenidate; slight evidence

therapy; desipramine; for psychosocial pindolol; in 2 of 8 studies

social skills training; buproprion; for combined

amphetamine sulfate treatment;

biofeedback

drugs superior to

psychosocial

treatment in

6 of 8 studies


Interventions with positive findings for depression
Interventions with Positive Findings for Psychopharmacological Interventions for Children with Depression

Psychosocial Psychopharmacological Adjunctive

cognitive behavior fluoxetine none

therapy;

self-control training


Interventions with positive findings for disruptive behavior disorders
Interventions with Positive Findings for Psychopharmacological Interventions for Children with Disruptive Behavior Disorders

Psychosocial Psychopharmacological Adjunctive

parent training; lithium; none

multisystemic therapy; methylphenidate

case management;

anger-coping;

problem-solving skills

PATHS;

Project LIFT;

First Step;

Fast Track


Interventions with positive findings for anxiety disorders
Interventions with Positive Findings for Psychopharmacological Interventions for Children with Anxiety Disorders

Psychosocial Psychopharmacological Adjunctive

systematic sertraline none

desensitization; (for obsessive compulsive

modeling; disorder only)

reinforced practice;

cognitive behavior

therapy;

contingency

management;

cognitive self-control;

educational support


Interventions with positive findings for posttraumatic stress disorder
Interventions with Positive Findings for Psychopharmacological Interventions for Children with Posttraumatic Stress Disorder

Psychosocial Psychopharmacological Adjunctive

stress inoculation; none none

gradual exposure;

cognitive behavior therapy

(for parent and child)


Specific Aims of Project Psychopharmacological Interventions for Children with

I .to identify efficacious/effective interventions

for the treatment of childhood mental disorders

which could reduce the risk for substance use

problems in adolescence and later;

-- EFFICACY --


Response to Aim Psychopharmacological Interventions for Children with I. -- EFFICACY --

Efficacious interventions exist for all disorders examined

Strength of psychopharmacological evidence

varies by disorder

Availability of efficacious interventions in clinical practice

is unknown, but suspected to be low

Increasing efficacious interventions through training and

quality monitoring is warranted


Specific Aims of Project Psychopharmacological Interventions for Children with

II. to identify mental health intervention studies

in which substance use outcomes could be

examined in adolescence and later.

-- FOLLOW-UP STUDIES --


Response to Aim Psychopharmacological Interventions for Children with II.-- FOLLOW-UP STUDIES --

To select follow-up studies from existing studies,

decisions are needed relative to:

(1) the standard for evidence-based interventions

(2) current age of previously studied samples

(3) adequacy of the methods

(4) risk of samples (i.e., disorders, ethnic diversity)

for substance problems

Prospective studies needed with substance assessment

and follow-up incorporated to:

(1) replicate older efficacious treatments

(2) develop psychosocial treatments (especially for PTSD)

and medications (except ADHD)


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