Clinical trials of mental health interventions for Australian children: a rapid review

To understand the range and extent of clinical trials research on child mental health in Australia over the last 10 years to inform research prioritisation. PsycINFO, MEDLINE and CENTRAL databases were systematically searched to identify Australian clinical trials published from 2013–2022 that focused on mental health in children aged 0–12 years. A random sample of 33% of articles were selected and data were extracted on each study’s aims, design, participant characteristics, type of mental health problem, intervention details, and child outcome measures. A total of 121 studies from the sample met inclusion criteria. Most trials were randomised controlled trials of treatment interventions (77.7%) for children with a mental health disorder diagnosis (66.1%), followed by prevention programs (33.1%). Few trials focused on select population groups, such as rural/remote communities or Indigenous people. In comparison with prevalence and burden data, we found an under-representation of clinical trials on several mental health problems, including depression, eating disorders, trauma-and stressor-related disorders, intellectual disability and self-harm. Our findings offer a snapshot of the research effort of Australian clinical trials, guiding future trials and child mental health research to alleviate the growing burden of child mental health problems. What is already known about this topic:Childhood mental health problems are a common and increasing occurrence in Australia and globally.Investing in early intervention and prevention of mental health problems are fundamental for improving lifelong mental health outcomes, and preventing mental illness from developing later in adulthood.While clinical trials are essential for the development and improvement of interventions for child mental health, translation of evidence-based treatment is often faced with many barriers to implementation and uptake is slow. Childhood mental health problems are a common and increasing occurrence in Australia and globally. Investing in early intervention and prevention of mental health problems are fundamental for improving lifelong mental health outcomes, and preventing mental illness from developing later in adulthood. While clinical trials are essential for the development and improvement of interventions for child mental health, translation of evidence-based treatment is often faced with many barriers to implementation and uptake is slow. What this paper adds:Most Australian clinical trials focused on autism spectrum disorder (ASD), followed by anxiety, externalising problems (including conduct disorders), and ADHD.Mental health interventions were most commonly psychological or psychosocial in nature and delivered by health professionals in an individual rather than group format.Few clinical trials in Australia children focused on select population groups, children with chronic health conditions and interventions in the perinatal period. Most Australian clinical trials focused on autism spectrum disorder (ASD), followed by anxiety, externalising problems (including conduct disorders), and ADHD. Mental health interventions were most commonly psychological or psychosocial in nature and delivered by health professionals in an individual rather than group format. Few clinical trials in Australia children focused on select population groups, children with chronic health conditions and interventions in the perinatal period.

本研究旨在梳理近十年澳大利亚儿童心理健康领域临床试验研究的范畴与覆盖广度，为研究优先级制定提供科学参考。
系统检索PsycINFO、MEDLINE及CENTRAL数据库，以识别2013至2022年间发表的、针对0至12岁儿童心理健康的澳大利亚本土临床试验。研究选取33%的文献作为随机样本，提取每一项研究的研究目标、设计方案、受试者特征、心理健康问题类型、干预细节及儿童结局测量指标等数据。最终共有121项研究符合纳入标准。
多数试验为针对确诊心理健康障碍儿童（66.1%）的治疗类随机对照试验（randomised controlled trial，77.7%），其次为预防类项目（33.1%）。仅有少数试验聚焦于特定人群，如偏远/边远社区居民或原住民群体。结合患病率与疾病负担数据，本研究发现多项心理健康问题相关临床试验存在代表性不足的情况，包括抑郁症、进食障碍、创伤及应激相关障碍、智力障碍与自伤行为。
本研究结果勾勒出澳大利亚儿童心理健康临床试验的研究现状快照，可为未来临床试验及儿童心理健康研究提供指引，以缓解日益加重的儿童心理健康问题负担。

本领域已有的研究共识：
儿童心理健康问题在澳大利亚及全球范围内均普遍存在且发生率持续攀升。对心理健康问题开展早期干预与预防工作，是改善个体终身心理健康结局、预防成年期罹患精神疾病的核心举措。尽管临床试验是开发与优化儿童心理健康干预手段的必要环节，但循证治疗方案的转化落地往往面临诸多实施障碍，推广速度缓慢。儿童心理健康问题在澳大利亚及全球范围内均普遍存在且发生率持续攀升。对心理健康问题开展早期干预与预防工作，是改善个体终身心理健康结局、预防成年期罹患精神疾病的核心举措。尽管临床试验是开发与优化儿童心理健康干预手段的必要环节，但循证治疗方案的转化落地往往面临诸多实施障碍，推广速度缓慢。

本研究新增的核心发现：
澳大利亚多数儿童心理健康临床试验聚焦于孤独症谱系障碍（Autism Spectrum Disorder），其次为焦虑障碍、外化行为问题（含品行障碍）及注意缺陷多动障碍（Attention Deficit Hyperactivity Disorder）。心理健康干预手段以心理或社会心理干预最为常见，多由健康专业人员以个体而非团体形式开展。澳大利亚针对儿童的临床试验中，极少有聚焦于特定人群、慢性健康状况患儿或围产期干预的研究。澳大利亚多数儿童心理健康临床试验聚焦于孤独症谱系障碍（Autism Spectrum Disorder），其次为焦虑障碍、外化行为问题（含品行障碍）及注意缺陷多动障碍（Attention Deficit Hyperactivity Disorder）。心理健康干预手段以心理或社会心理干预最为常见，多由健康专业人员以个体而非团体形式开展。澳大利亚针对儿童的临床试验中，极少有聚焦于特定人群、慢性健康状况患儿或围产期干预的研究。