抑郁和自杀倾向儿童及青少年的危机干预：一项系统评价与Meta分析。
完整摘要 · 中文译文
综述目的：综述针对经历急性精神病理学危机（尤其是严重抑郁、自杀意念、自伤和自杀行为）的儿童和青少年的危机干预服务的证据，并考察其在减轻症状、改善家庭功能和预防住院方面的有效性。 最新发现：按照PRISMA指南进行了一项系统综述，并在PROSPERO注册。检索PubMed、Web of Science、PsycInfo和ClinicalTrials.gov，共纳入15项符合条件的评估15种危机干预的研究。四种干预通过简短、结构化的方法针对自杀意念和自伤，显示出减少自杀想法、自杀未遂和急诊就诊的效果。七种以家庭为重点的干预（在八项研究中评估）改善了沟通、家庭凝聚力并降低了住院率。三种干预旨在稳定危机并促进与社区服务的衔接，改善了照护的连续性并减少了急诊服务使用。一种寄宿式干预（在两项研究中评估）显示出混合结果，行为方面有一定改善，但对内化症状的效果有限。当前证据提示，对于经历急性心理健康危机的儿童和青少年，危机服务可能是住院治疗的一种有前景的替代方案。这些干预在青少年的自然环境内提供强化支持，促进家庭参与，并与自杀意念的减少相关，de 抑郁症状、急诊就诊和住院情况。尽管研究结果令人鼓舞，但证据基础仍然有限，多为观察性且异质性较大，无法得出因果结论。未来研究应直接比较不同的危机服务模式，并纳入长期随访，以确定最有效的方法及其长期的可持续性。
完整摘要 · 英文原文
PURPOSE OF REVIEW: To review the evidence on crisis services for children and adolescents experiencing acute psychopathological crises, particularly severe depression, suicidal ideation, self-harm, and suicidal behaviour, and to examine their effectiveness in reducing symptoms, improving family functioning, and preventing hospitalisation. RECENT FINDINGS: A systematic review was conducted following PRISMA guidelines and registered in PROSPERO. Searches of PubMed, Web of Science, PsycInfo, and ClinicalTrials.gov identified 15 eligible studies evaluating 15 crisis interventions. Four interventions targeted suicidal ideation and self-harm through brief, structured approaches, demonstrating reductions in suicidal thoughts, suicide attempts, and emergency department visits. Seven family-focused interventions (evaluated in eight studies) improved communication, family cohesion, and reduced hospitalisation rates. Three interventions aimed to stabilise crises and facilitate linkage with community services, improving continuity of care and decreasing emergency service utilisation. One residential intervention (evaluated in two studies) showed mixed findings, with some behavioural improvements but limited effects on internalising symptoms. Current evidence suggests that crisis services might be a promising alternative to hospitalisation for children and adolescents experiencing acute mental health crises. These interventions provide intensive support within the young person's natural environment, promote family involvement, and were associated with reductions in suicidal ideation, depressive symptoms, emergency visits, and hospital admissions. Despite promising findings, the evidence base remains limited, largely observational and heterogeneous, and causal conclusions cannot be drawn. Future research should directly compare different crisis service models and include long-term follow-up to determine the most effective approaches and their sustainability over time.