{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T15:18:13Z","timestamp":1793200693309,"version":"4.5.0"},"reference-count":44,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002865","name":"Chongqing Science and Technology Commission","doi-asserted-by":"publisher","award":["cstc2020jcyj-jqX0024"],"award-info":[{"award-number":["cstc2020jcyj-jqX0024"]}],"id":[{"id":"10.13039\/501100002865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences","award":["2019PT320002"],"award-info":[{"award-number":["2019PT320002"]}]},{"name":"National Key Research and Development Program of China","award":["2017YFA0505700"],"award-info":[{"award-number":["2017YFA0505700"]}]},{"name":"High-level Talents Special Support Plan of Chongqing","award":["T04040016"],"award-info":[{"award-number":["T04040016"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81820108015"],"award-info":[{"award-number":["81820108015"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81873800"],"award-info":[{"award-number":["81873800"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Evid Based Mental Health"],"accepted":{"date-parts":[[2021,9,20]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Available evidence on the comparative efficacy and acceptability of psychotherapies for post-traumatic stress disorder (PTSD) in children and adolescents remains uncertain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We aimed to compare and rank the different types and formats of psychotherapies for PTSD in children and adolescents.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched eight databases and other international registers up to 31 December 2020. The pairwise meta-analyses and frequentist network meta-analyses estimated pooled standardised mean differences (SMDs) and ORs with random-effects model. Efficacy at post-treatment and follow-up, acceptability, depressive and anxiety symptoms were measured.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>We included 56 randomised controlled trials with 5327 patients comparing 14 different types of psychotherapies and 3 control conditions. For efficacy, cognitive processing therapy (CPT), behavioural therapy (BT), individual trauma-focused cognitive\u2013behavioural therapy (TF-CBT), eye movement desensitisation and reprocessing, and group TF-CBT were significantly superior to all control conditions at post-treatment and follow-up (SMDs between \u22122.42 and \u22120.25). Moreover, CPT, BT and individual TF-CBT were more effective than supportive therapy (SMDs between \u22121.92 and \u22120.49). Results for depressive and anxiety symptoms were similar to the findings for the primary outcome. Most of the results were rated as \u2018moderate\u2019 to \u2018very low\u2019 in terms of confidence of evidence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>CPT, BT and individual TF-CBT appear to be the best choices of psychotherapy for PTSD in young patients. Other types and different ways of delivering psychological treatment can be alternative options. Clinicians should consider the importance of each outcome and the patients\u2019 preferences in real clinical practice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/ebmental-2021-300346","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T14:38:12Z","timestamp":1633099092000},"page":"153-160","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Comparative efficacy and acceptability of psychotherapies for post-traumatic stress disorder in children and adolescents: a systematic review and network meta-analysis"],"prefix":"10.1136","volume":"24","author":[{"given":"Yajie","family":"Xiang","sequence":"first","affiliation":[{"name":"Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"Chongqing Key Laboratory of Neurobiology, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5179-8321","authenticated-orcid":false,"given":"Andrea","family":"Cipriani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Oxford, Oxford, UK"},{"name":"Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teng","family":"Teng","sequence":"additional","affiliation":[{"name":"NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"Chongqing Key Laboratory of Neurobiology, Chongqing, China"},{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Del Giovane","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Weisz","sequence":"additional","affiliation":[{"name":"Department of Psychology, Harvard University, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"Chongqing Key Laboratory of Neurobiology, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5497-2743","authenticated-orcid":false,"given":"Pim","family":"Cuijpers","sequence":"additional","affiliation":[{"name":"Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueer","family":"Liu","sequence":"additional","affiliation":[{"name":"NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"Chongqing Key Laboratory of Neurobiology, Chongqing, China"},{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Barth","sequence":"additional","affiliation":[{"name":"Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanliang","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"Chongqing Key Laboratory of Neurobiology, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, H\u00f4pital Piti\u00e9\u2013Salp\u00e9tri\u00e8re, Institut des Syst\u00e8mes Intelligents et Robotiques, Universit\u00e9 Pierre et Marie Curie, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Fan","sequence":"additional","affiliation":[{"name":"NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"Chongqing Key Laboratory of Neurobiology, Chongqing, China"},{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Gillies","sequence":"additional","affiliation":[{"name":"University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"Chongqing Key Laboratory of Neurobiology, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun V.","family":"Ravindran","sequence":"additional","affiliation":[{"name":"Campbell Family Mental Health Research Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of 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update on diagnosis, risk factors, and intervention","volume":"167","author":"Kassam-Adams","year":"2013","journal-title":"JAMA Pediatr"},{"key":"2025082623032257000_24.4.153.2","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2018-300065"},{"key":"2025082623032257000_24.4.153.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.5.643"},{"key":"2025082623032257000_24.4.153.4","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20057"},{"key":"2025082623032257000_24.4.153.5","doi-asserted-by":"crossref","DOI":"10.1038\/nrg3406","article-title":"Neurogenetics: trauma and stress, from child to adult","volume":"14","author":"Jones","year":"2013","journal-title":"Nat Rev Genet"},{"key":"2025082623032257000_24.4.153.6","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/S2215-0366(19)30037-9","article-title":"Trauma and post-traumatic stress disorder: children should be seen and heard","volume":"6","author":"Bloomfield","year":"2019","journal-title":"Lancet 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NCCfMH. post-traumatic stress disorder: the management of PTSD in adults and children in primary and secondary care. Leicester (UK), 2005. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK56494\/ [Accessed 7 Aug 2021]."},{"key":"2025082623032257000_24.4.153.9","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.cpr.2016.05.006","article-title":"Interventions for children and adolescents with posttraumatic stress disorder: a meta-analysis of comparative outcome studies","volume":"47","author":"Morina","year":"2016","journal-title":"Clin Psychol Rev"},{"key":"2025082623032257000_24.4.153.10","first-page":"Cd006726","article-title":"Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents","volume":"12","author":"Gillies","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082623032257000_24.4.153.11","doi-asserted-by":"publisher","DOI":"10.1002\/da.20744"},{"key":"2025082623032257000_24.4.153.12","doi-asserted-by":"publisher","DOI":"10.1080\/15374410802148194"},{"key":"2025082623032257000_24.4.153.13","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12983"},{"key":"2025082623032257000_24.4.153.14","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22421"},{"key":"2025082623032257000_24.4.153.15","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20313"},{"key":"2025082623032257000_24.4.153.16","unstructured":"Pynoos RS RN , Steinberg A , et al . The UCLA PTSD reaction index for DSM-IV (revision 1). Los Angeles: UCLA Trauma Psychiatry Program, 1998."},{"key":"2025082623032257000_24.4.153.17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020198"},{"key":"2025082623032257000_24.4.153.18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040061"},{"key":"2025082623032257000_24.4.153.19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"2025082623032257000_24.4.153.20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003082"},{"key":"2025082623032257000_24.4.153.21","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1037\/abn0000368","article-title":"Examination of posttraumatic stress disorder symptom networks using clinician-rated and patient-rated data","volume":"127","author":"Moshier","year":"2018","journal-title":"J Abnorm Psychol"},{"key":"2025082623032257000_24.4.153.22","unstructured":"Higgins JPT TJ , Chandler J , Cumpston M . Cochrane Handbook for systematic reviews of interventions version 6.2, 2021.. 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Clinical practice guideline for the treatment of posttraumatic stress disorder. Available: http:\/\/wwwapaorg\/ptsd-guideline\/treatments\/indexaspx [Accessed 7 Aug 2021]."},{"key":"2025082623032257000_24.4.153.32","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1001\/jamapsychiatry.2018.4349","article-title":"Effect of developmentally adapted cognitive processing therapy for youth with symptoms of posttraumatic stress disorder after childhood sexual and physical abuse: a randomized clinical trial","volume":"76","author":"Rosner","year":"2019","journal-title":"JAMA Psychiatry"},{"key":"2025082623032257000_24.4.153.33","doi-asserted-by":"publisher","DOI":"10.1300\/J146v06n01_10"},{"key":"2025082623032257000_24.4.153.34","doi-asserted-by":"crossref","unstructured":"Anna Voge RR . Lost in transition? evidence-based treatments for adolescents and young adults with posttraumatic stress disorder and results of an uncontrolled feasibility trial evaluating cognitive processing therapy. 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