Comparative efficacy and acceptability of treatment options for depressive disorders in children and adolescents: protocol of a network meta-analysis

AI Summary

Study will use network meta-analysis to compare efficacy and acceptability of pharmacological, psychological and physical treatments for depressive disorders in children and adolescents.
Pairwise and Bayesian network meta-analyses will assess primary outcome change in depressive symptoms, plus acceptability, response, remission and overall functioning.
No ethical approval required for secondary analysis; findings to be published; PROSPERO registration CRD42024557384.

BMJ Open. 2026 Jun 10;16(6):e108754. doi: 10.1136/bmjopen-2025-108754.

ABSTRACT

INTRODUCTION: The incidence of depression among children and adolescents has been increasing in recent years, posing significant challenges to public health and clinical care. A variety of treatments, including pharmacotherapy, psychotherapy and physical interventions, are widely used in clinical practice. However, a comprehensive synthesis of the evidence on the efficacy and acceptability of all these treatment modalities is currently lacking. This study aims to use network meta-analysis (NMA) to compare the efficacy and acceptability of all available treatments for depression in children and adolescents, offering valuable insights to inform clinical decision-making and guide future research in this critical area.

METHODS AND ANALYSIS: We will include randomised controlled trials evaluating active interventions for depressive disorders in children and adolescents. Seven electronic databases (PubMed, Embase, the Cochrane Library, Web of Science, PsycINFO, Scopus and ClinicalTrials.gov) were searched from inception to 2 July 2024 and updated on 2 November 2025. Two of four investigators will independently screen studies, extract data from eligible articles and assess the risk of bias using the Cochrane Risk of Bias 2.0 tool. The primary outcome will be the change in depressive symptoms. Secondary outcomes will include acceptability (all-cause discontinuation), response rate, remission rate and overall functioning. Pairwise and Bayesian NMA will be conducted. Small-study effects and publication bias will be assessed. The certainty of the evidence will be evaluated according to the Confidence in Network Meta-Analysis approach.

ETHICS AND DISSEMINATION: As this review involves secondary analysis of previously published studies, ethical approval is not required. The findings will be disseminated through publication in peer-reviewed journals.

PROSPERO REGISTRATION NUMBER: PROSPERO-ID CRD42024557384.

PMID:42270110 | DOI:10.1136/bmjopen-2025-108754

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