Evidence-based guidelines for anxiety, depression, obsessive-compulsive disorder and Tourette syndrome in children and youth: A rapid review.

Abstract

Background: In response to the increasing need for mental health services in Canadian children and youth, the Canadian Institutes of Health Research launched funding towards developing pan-Canadian standards for children and youth mental health services.

Objective: The objective of this rapid review is to synthesize current evidence-based recommendations on assessment and treatment for children and youth with anxiety, depression, obsessive-compulsive disorder (OCD) and Tourette syndrome (TS).

Methods: This rapid review was developed and conducted using the STARR decision tool and the Cochrane organization's minimum standards. We included evidence-based guidelines providing recommendations for and comparative studies evaluating the effectiveness of implementation of evidence-based guideline recommendations on assessment and/or treatment of anxiety, depression, OCD, or TS in children and youth compared to usual care.

Results: Twenty guidelines and one study of the effectiveness of treatment approximating guideline standards were included in this review. There was reasonable consistency in recommendations between guidelines, especially for the management of anxiety disorders and TS, where psychological therapies were recommended as first line. For depression, some minor differences were noted in recommendations for the management of moderate to severe depression, with psychological therapies or SSRIs recommended as first-line in the some guidelines, whereas other guidelines prioritized psychological therapies.

Conclusion: Current evidence-based guidelines prioritize psychological therapies for children and adolescents with anxiety, depression, OCD, or TS. If adequate and equitable service provision is a priority for decision makers, it is essential for the healthcare system to fund appropriately trained mental health therapists to deliver these interventions.