Manejo de las fobias infanto juveniles
Palabras clave:
fobias infantiles; adolescencia; terapia cognitivo-conductual; revisión sistemática; América LatinaResumen
Introducción: Las fobias en la infancia y la adolescencia constituyen un problema de salud mental de alta relevancia clínica y social, con prevalencia global estimada entre 5 % y 15 %. Suelen infradiagnosticarse y tienden a la persistencia; en América Latina la evidencia es escasa.
Objetivo: Analizar la evidencia actual sobre el manejo de las fobias infanto-juveniles, identificando brechas, estrategias de intervención y oportunidades de mejora.
Material y Métodos: Revisión sistemática según PRISMA 2020. Se incluyeron estudios en niños y adolescentes de 4 a 18 años con diagnóstico de fobia, publicados entre 2014 y 2024 y buscados en PubMed/MEDLINE, Scopus, Web of Science, PsycINFO y Cochrane Library. El cribado fue realizado por dos revisores independientes.
Resultados: Se incluyeron 47 estudios. Predominaron los de Europa (43 %) y Norteamérica (31 %); Latinoamérica aportó el 8 %. La terapia cognitivo-conductual con exposición graduada se confirma como intervención de primera línea, con remisión del 60 % al 85 % a los 6-12 meses; los fármacos se recomiendan solo como coadyuvantes. La realidad virtual mostró aceptabilidad superior al 70 %. Solo el 42 % de los estudios empleó instrumentos validados y escasean los seguimientos a largo plazo.
Conclusiones: La terapia cognitivo-conductual con exposición graduada es el tratamiento de elección. Se requieren detección precoz, guías clínicas contextualizadas, instrumentos culturalmente sensibles y expansión de intervenciones basadas en evidencia, con participación de la familia, la escuela y la comunidad, para reducir la carga de enfermedad y promover el bienestar emocional.
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