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Efficacy and acceptability of psychological interventions for social anxiety disorder in children and adolescents: a meta-analysis of randomized controlled trials

  • Lining Yang
  • Xinyu Zhou
  • Juncai Pu
  • Lanxiang Liu
  • Pim Cuijpers
  • Yuqing Zhang
  • Hanping Zhang
  • Shuai Yuan
  • Teng Teng
  • Lu Tian
  • Peng Xie
Original Contribution

Abstract

Social anxiety disorder (SAD) is highly prevalent and persistent in children and adolescents. However, evidence for the efficacy and acceptability of psychological interventions for SAD in children and adolescents remains unclear. Seven electronic databases (PubMed, CENTRAL, Embase, Web of Science, PsycINFO, CINAHL, and ProQuest) were searched. Randomized controlled trials (RCTs) that compared psychological interventions for SAD with control conditions in children and adolescents were included. Primary outcomes were the efficacy (mean change in anxiety symptom scores) and acceptability (dropouts for all reasons). Secondary outcomes were remission, quality of life/functional improvement, and depressive symptoms measures. Seventeen RCTs were included in this meta-analysis. Psychological interventions (including cognitive behavioral therapy and behavioral therapy) were significantly more effective than control conditions, with a standardized mean difference (SMD) of − 1.13, and remission with a risk ratio (RR) of 8.99, the number needed to treat was 3.3. There was no statistically significant difference between psychological interventions and control conditions for all-cause dropouts (RR = 1.00). Psychological interventions were superior to control conditions in improving quality of life/functioning (SMD = 0.79) and reducing depressive symptoms (SMD = − 0.39). Given considerable heterogeneity of primary efficacy outcome, a series of subgroup analyses of different variables were conducted. Psychological interventions are probably efficacious in the treatment of SAD among children and adolescents, and may markedly improve quality of life and functioning in this population. However, this finding should be interpreted with caution because of the high heterogeneity of trials and low literature quality.

Keywords

Child Adolescent Psychological intervention Meta-analysis Social anxiety disorder 

Notes

Author contributions

LY and JP conceived the study. LY and JP drafted the manuscript. XZ and YZ assisted in the design and revision. LL and HZ participated in the search strategy development. SY and XJ designed the statistical analysis; PX and PC are the guarantors. The first four authors contributed equally to this study. All authors read and approved the final version of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors have declared that they have no conflicts of interest regarding the content of this article.

Supplementary material

787_2018_1189_MOESM1_ESM.docx (3.3 mb)
Supplementary material 1 (DOCX 3422 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingPeople’s Republic of China
  2. 2.Department of PsychiatryThe First Affiliated Hospital of Chongqing Medical UniversityChongqingPeople’s Republic of China
  3. 3.Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands

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