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Totzeck C, van der Meer AS, Christiansen H, Durlach F, Li Sanchez K, Schneider S. Systematic Review: Patient and Public Involvement of Children and Young People in Mental Health Research. Clin Child Fam Psychol Rev 2024; 27:257-274. [PMID: 38402358 PMCID: PMC10920437 DOI: 10.1007/s10567-024-00470-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE Patient and public involvement (PPI) is an essential ethical component in mental health research, and represents a major opportunity to improve translational mental health research. The goals of this review were to (1) provide a comprehensive overview of empirical research focusing on PPI of children and young people (CYP) in mental health research studies; (2) evaluate the results with CYP and parents of those affected; and (3) derive recommendations for PPI of CYP in future mental health research studies. METHODS Based on an extensive literature review following the PRISMA guidelines, studies including CYP (age range: 0-21 years) in mental health research were identified and examined along a two-part analysis process considering their usability for mental health research. The conclusions drawn from the studies concerning CYP involvement were summarized and recommendations derived. RESULTS Overall, 19 articles reported PPI of CYP (age range: 10-26 years) in mental health research and were included for further analyses. The integrated studies differed in the type of PPI, and in the way the participation and involvement processes were presented. CONCLUSION Progress has been made in engaging CYP in mental health research, but there is a need for international standards, operationalization, and evaluation measures. Future research should go beyond merely reporting the PPI process itself. It should clearly indicate how and to what extent feedback from these PPI members was incorporated throughout the research process.
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Affiliation(s)
- Christina Totzeck
- Mental Health Research and Treatment Center (FBZ), Ruhr University Bochum, Massenbergstrasse 9-13, 44787, Bochum, Germany.
- German Center for Mental Health (DZPG), Partner Site Bochum/Marburg, Bochum, Bochum, Germany.
| | - Anna Swantje van der Meer
- Department of Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
- German Center for Mental Health (DZPG), Partner Site Bochum/Marburg, Bochum, Bochum, Germany
| | - Hanna Christiansen
- Department of Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
- German Center for Mental Health (DZPG), Partner Site Bochum/Marburg, Bochum, Bochum, Germany
| | - Friederike Durlach
- Department of Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Kira Li Sanchez
- Department of Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Silvia Schneider
- Mental Health Research and Treatment Center (FBZ), Ruhr University Bochum, Massenbergstrasse 9-13, 44787, Bochum, Germany
- German Center for Mental Health (DZPG), Partner Site Bochum/Marburg, Bochum, Bochum, Germany
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Skarphedinsson G, Karlsson GK. The Feasibility and Efficacy of a Group-Based, Brief Transdiagnostic Cognitive-Behavioral Treatment for Adolescents with Internalizing Problems. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01552-7. [PMID: 37294420 DOI: 10.1007/s10578-023-01552-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 06/10/2023]
Abstract
The present study aimed to assess the efficacy of a group-based, brief transdiagnostic cognitive-behavioral therapy (CBT) program for adolescents with internalizing problems, such as anxiety and depressive disorders, seeking help in a primary health care clinic in Iceland. The group-based CBT program consisted of eight weekly 110-min sessions covering psychoeducation, cognitive restructuring, behavioral activation, exposure, problem-solving, social skills, and mindfulness. The study recruited 53 participants, who were randomly assigned to either receive the group treatment or be placed on a wait-list for monitoring purposes. Measures were taken at baseline, during treatment (week 4), at posttreatment (week 8), and at 2-, 4-month, and 1-year follow-ups. The primary outcome measures were the self-reported total scores of total anxiety and depression using the Revised Children's Anxiety and Depression Scale (RCADS). The study found a significant effect of time and time * treatment interaction on the depression and anxiety total scores. The secondary outcome measures, RCADS parent-rated depression and anxiety total scores, did not show significant effects of time * treatment interaction. However, during naturalistic follow-up, a significant reduction in parent-reported depression and anxiety total scores was observed. The study also observed good treatment adherence, as well as high satisfaction among parents and youth. The results suggest that this group-based, brief transdiagnostic CBT group treatment is feasible and effective in reducing depressive and anxiety symptoms in adolescents with internalizing problems and highlights the importance of addressing comorbidity in treatment.
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Wells A, Carter K, Hann M, Shields G, Wallis P, Cooper B, Capobianco L. Youth Metacognitive Therapy (YoMeta): protocol for a single-blind randomised feasibility trial of a transdiagnostic intervention versus treatment as usual in 11–16-year-olds with common mental health problems. Pilot Feasibility Stud 2022; 8:207. [PMID: 36096940 PMCID: PMC9465896 DOI: 10.1186/s40814-022-01162-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Mental health disorders in children and young people (CYP) are increasing but the provision of current evidence-based treatment for common mental health problems is limited. Treatment effects vary widely with no clear superiority of a single treatment approach. Further evaluation of contemporary and effective treatments in CYP is needed. Metacognitive therapy (MCT) has shown enhanced efficacy over ‘gold standard’ approaches in adult mental health, but so far has not been evaluated in a randomised trial of CYP. As such, we aim to assess the acceptability and feasibility of group-MCT for CYP with common mental health problems in comparison to usual treatment within Child and Adolescent Mental Health Services (CAMHS).
Method
YoMeta is a multicentre, two-arm, single-blind randomised feasibility trial comparing group-MCT to usual care in CYP with common mental health problems in CAMHS. CYP (target sample n = 100) with a common mental health problem will be recruited across at least three CAMHS services in the UK. Participants in the intervention arm will receive up to eight sessions of group-MCT delivered by a CAMHS mental health practitioner. The control arm will receive usual care in CAMHS which includes individual or group-based therapy. Feasibility will be assessed by the success of recruitment, retention, and data quality. Acceptability of the intervention will be assessed by the number of sessions attended and through qualitative interviews aimed at exploring CYP acceptability and understanding of the intervention. Symptoms of psychological distress will be assessed using the Revised Children Anxiety and Depression Scale (RCADS) at 20 weeks. We will also assess psychological well-being, symptoms of depression, metacognitive beliefs, quality of life, and measures to support economic evaluation (health status and health and social care use). Qualitative interviews will be conducted to understand practitioner’s views on training and delivery of group-MCT.
Discussion
The trial is designed to evaluate the acceptability and feasibility of group-MCT for CYP with common mental health problems. Group-MCT may aid in improving access to treatment, reduce waiting times, and improve outcomes for CYP with common mental health disorders. The study will provide important information and data to evaluate future research potential and confirm sample size estimation for a definitive large-scale RCT to test the effectiveness and cost-effectiveness of group-MCT in CYP.
Trial registration
NCT05260060; ISCTRN18335255
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McCashin D, Coyle D, O'Reilly G. Pesky gNATs for children experiencing low mood and anxiety - A pragmatic randomised controlled trial of technology-assisted CBT in primary care. Internet Interv 2021; 27:100489. [PMID: 35024346 PMCID: PMC8732748 DOI: 10.1016/j.invent.2021.100489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 12/01/2021] [Accepted: 12/10/2021] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Compared to the evidence base for adult populations, less is known about the effectiveness of technology-assisted CBT interventions for children aged 12 and under in real-world settings. AIMS This study aimed to evaluate the effectiveness of a technology-assisted CBT intervention called Pesky gNATs in primary care psychology services. METHODS A 2 × 3 (group by time) waitlist randomised controlled trial design was applied (n = 122), using the total internalising score from the Child Behaviour Checklist (CBCL) as the primary outcome measure; and a range of secondary outcomes. Participants were recruited from primary care services across Ireland and were assessed at baseline (Time 1), post-intervention (Time 2), and a follow-up at 3 months (Time 3). Repeated measures ANOVAs were used to analyse the data; in addition to Cohen's d for effect sizes, and the reliable change index (RCI) for clinically meaningful change. RESULTS Overall, no significant between-group differences were found on primary or secondary measures. Both intervention and waitlist control groups experienced significantly positive change across all timepoints. However, participant retention rate at Time 2 was 66%; and fell to 44% at Time 3. Intervention group feedback from children and parent at Time 2 indicated high levels of acceptability and satisfaction with Pesky gNATs. The RCI showed a statistically significant result at Time 2: more participants from the intervention group (n = 9) moved from clinical to non-clinical levels on the primary outcome than did waitlist control participants (n = 0); but no differences were found at Time 3. CONCLUSION This RCT did not demonstrate that Pesky gNATs is effective in providing clinically significant levels of change for low mood and anxiety. However, participant feedback showed high levels of acceptability and positive experiences However, given the high attrition rate and implementation challenges, further research is required to ascertain the effectiveness of technology-assisted CBT interventions such as Pesky gNATs.
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Affiliation(s)
- Darragh McCashin
- School of Psychology, Dublin City University, Ireland,Corresponding author.
| | - David Coyle
- School of Computer Science, University College Dublin, Ireland
| | - Gary O'Reilly
- School of Psychology, University College Dublin, Ireland
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Eklund K, Kilgus SP, Izumi J, DeMarchena SL, McCollom EM. The Resilience Education Program: Examining the efficacy of a Tier 2 internalizing intervention. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Katie Eklund
- Department of Educational Psychology University of Wisconsin‐Madison Madison Wisconsin USA
| | - Stephen P. Kilgus
- Department of Educational Psychology University of Wisconsin‐Madison Madison Wisconsin USA
| | - Jared Izumi
- Department of Educational School, and Counseling Psychology University of Missouri Columbia Missouri USA
| | - Sarah L. DeMarchena
- Department of Educational School, and Counseling Psychology University of Missouri Columbia Missouri USA
| | - Elizabeth M. McCollom
- Department of Educational School, and Counseling Psychology University of Missouri Columbia Missouri USA
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[Evaluation of Short-term Psychoanalytic Child Therapy (PaCT) for Young Children with Depressive Disorders: Results from a Pilot Study]. Prax Kinderpsychol Kinderpsychiatr 2021; 70:445-464. [PMID: 34187341 DOI: 10.13109/prkk.2021.70.5.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Depressive disorders in early childhood are associated with high psychosocial impairment and tend to remain stable over time without adequate treatment. Short-term psychoanalytic therapy is a common form of child psychotherapy, yet there is a lack of empirical evaluation of this approach for young children with depressive disorders. Therefore, this secondary evaluation of a study on the treatment of anxiety disorders used an uncontrolled pre-post design in a clinical setting to investigate whether children with depressive comorbidity would evidence significant diagnostic and symptomatic remission after treatment with manualized short-term Psychoanalytic Child Therapy (PaCT). Nineteen children who had an anxiety disorder and a (subclinical) depressive disorder (assessed with the Preschool Age Psychiatric Assessment using DSM-IV criteria) were treated with PaCT. After treatment, 15 of 19 children (78.94 %) were remitted and 15 of 17 children (88.24 %; 2 were lost to follow-up) were free of depressive disorders at the 6-month follow-up. Further analyses revealed significant effects for pre- to post and pre- to follow-up comparisons regarding internalizing symptoms and overall problems using parent- and (nursery-)teacher-ratings. These results suggest that short-term PaCT shows promise as a treatment for childhood depressive disorders.
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The Impact of Cognitive-Behavioral Group Psycho-Education Program on Psychological Resilience, Irrational Beliefs, and Well-Being. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021; 39:672-694. [PMID: 33824549 PMCID: PMC8016428 DOI: 10.1007/s10942-021-00392-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this study is to investigate the effect of cognitive-behavioral group psycho-education program on psychological resilience, irrational beliefs, and well-being. In the study, 29 high school students participated. As a data collection, The Resilience Scale, the Irrational Beliefs Scale-Adlescent Form, the Subjective Well-being Scale-High School Form and The Determination of Risk Factors were used. In the study, psycho-education program based on cognitive behavioral approach was applied to experimental group in 10 sessions, once a week. No study was performed with the control group. 2 × 3 experimental design was used in the research. The post-test was administered after the research was completed and follow-up measurements were performed five months later. As a result of the analyzes, it is concluded that there is an increase in psychological resilience levels and a decrease in irrational belief levels of students who participated in psycho-education program based on cognitive behavioral approach. It is concluded that there isn’t change in the subjective well-being of the students before and after the application.
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Wright I, Mughal F, Bowers G, Meiser-Stedman R. Dropout from randomised controlled trials of psychological treatments for depression in children and youth: a systematic review and meta-analyses. J Affect Disord 2021; 281:880-890. [PMID: 33248810 DOI: 10.1016/j.jad.2020.11.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 09/14/2020] [Accepted: 11/07/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Depression is a prevalent and disabling condition in youth. Treatment efficacy has been demonstrated for several therapeutic modalities. Acceptability of treatments is also important to explore and was addressed by investigating treatment dropout using meta-analyses. METHODS A systematic search was conducted using MEDLINE, CINAHL and PsycARTICLES databases. Peer-reviewed randomised controlled trials investigating psychotherapy treatment of depression in children and youth (aged up to and including 18 years) were included. Proportion meta-analyses were used to calculate estimated dropout rates; odds ratios assessed whether there was greater dropout from intervention or control arms and meta-regressions investigated for associations between dropout, study and treatment characteristics. RESULTS Thirty-seven studies were included (N=4343). Overall estimate of dropout from active interventions was 14.6% (95% CI 12.0-17.4%). Dropout was equally likely from intervention and control conditions, aside from family/dyadic interventions (where dropout was more likely from control arms). There was some suggestion that interventions offering more sessions and longer duration had less dropout and of less dropout from IPT than other interventions. There were no significant associations between dropout and study quality, CBT, family or individual versus other approaches. LIMITATIONS Lack of consistent reporting decreased the factors which could be analysed. CONCLUSIONS Dropout from depression treatment in children and youth was similar across different types of intervention and control conditions. Future treatment trials should specify minimum treatment dose, define dropout and provide information about participants who dropout. This may inform treatment choice and modification of treatments.
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Affiliation(s)
- Isobel Wright
- Department of Clinical Psychology, University of East Anglia, Norwich, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust
| | - Fahim Mughal
- Cambridgeshire and Peterborough NHS Foundation Trust
| | - Gemma Bowers
- Department of Clinical Psychology, University of East Anglia, Norwich, United Kingdom
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9
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Bekker MJ, Griffiths KM, Barrett PM. Improving accessibility of cognitive behavioural therapy for children and adolescents: Review of evidence and future directions. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12099] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Marthinus J. Bekker
- National Institute for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia,
| | - Kathleen M. Griffiths
- National Institute for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia,
| | - Paula M. Barrett
- National Institute for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia,
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Calub CA, Rapport MD, Alexander K. Reducing Aggression Using a Multimodal Cognitive Behavioral Treatment Approach: A Case Study of a Preschooler With Oppositional Defiant Disorder. Clin Case Stud 2020. [DOI: 10.1177/1534650120958069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Individual cognitive behavioral therapies (CBT) have been shown to be effective in decreasing disruptive behaviors in children and adolescents; however, less is known regarding their efficacy with preschoolers given the developmental limitations accompanying this age range. The current case study extends the use of individual CBT to a preschool aged girl with oppositional defiant disorder (ODD), and is the first to investigate its efficacy in combination with behaviorally-based parent training and classroom teacher consultation. A total of 18 CBT sessions with the child and her parents, in addition to school observations and on-site and phone consultations with teachers, were conducted over a 4-month period. Post-treatment and 2-month follow-up assessments demonstrated significant decreases in physical aggression and property destruction, as well as for parent and teacher reported internalizing and externalizing symptoms. Collectively, results of the case study provide preliminary evidence that a multimodal approach can be applied effectively to treat behavioral problems in preschool-age children.
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11
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McGovern C, Arcoleo K, Melnyk B. Sustained Effects From a School-Based Intervention Pilot Study for Children With Asthma and Anxiety. J Sch Nurs 2020; 38:347-357. [PMID: 32588717 DOI: 10.1177/1059840520934178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Children with chronic conditions (i.e., asthma) are more likely to have anxiety or depressive symptoms. Comorbid asthma and anxiety in children leads to increased morbidity, causing children to miss instructional time and parent/caregiver (CG) work absences. Asthma educational programs and mental health interventions have been developed, though no scalable programs integrate asthma education and mental health behavioral interventions for school-aged children. This study evaluated the sustained preliminary effects of an integrated asthma education and cognitive behavioral skills-building program, Creating Opportunities for Personal Empowerment for Asthma. Thirty-two children ages 8-12 years with asthma and symptoms of anxiety received the intervention. At 6-weeks postintervention, anxiety and CG-reported behavioral symptoms were significantly reduced, there were fewer missed doses of asthma controller medications, and asthma-related self-efficacy, personal beliefs, and the children's understanding of asthma significantly increased. Most children (n = 29, 91%) reported continued use of coping skills.
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Affiliation(s)
- Colleen McGovern
- School of Nursing, University of North Carolina at Chapel Hill, NC, USA
| | | | - Bernadette Melnyk
- College of Nursing, The Ohio State University, Columbus, OH, USA.,College of Medicine, The Ohio State University, Columbus, Ohio, USA
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Driot D, Nguyen-Soenen J, Costes M, Pomier M, Birebent J, Oustric S, Dupouy J. [Management of child and adolescent depression in primary care: A systematic meta-review]. Encephale 2019; 46:41-54. [PMID: 31561940 DOI: 10.1016/j.encep.2019.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 07/21/2019] [Accepted: 07/24/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To develop a practical guide for the management of child and adolescent depression for general practitioners (GPs), suited to their practice frame, that can be implemented on a website aimed to help GPs to manage the main mental disorders encountered in primary care. METHOD A systematic meta-review was performed as recommended by the PRISMA statement. Each step, articles' selection, inclusion, methodological assessment and data extraction for the narrative synthesis was independently performed by two researchers. A study protocol was registered on PROSPERO (number CRD42016042710). The databases Pubmed, Cochrane and Web of Science were explored. Each step was performed independently by two researchers following PRISMA. Meta-analyses and systematic reviews (including guidelines based on a systematic review), published between 2002 and 2015, in English or French, dealing with the therapeutic management, in primary care, of patients aged 6 to 18 years old with a major depressive disorder (MDD) were included. Grey literature was explored searching the websites of national and international health agencies, learned societies, and article references. The methodological and report qualities were assessed using the AGREE II, PRISMA checklist and R-AMSTAR grid. A narrative synthesis was performed to produce the practical guide, prioritizing data from the best evaluated articles. An expert group of GPs' and one child psychiatrist validated the guide in its final form. RESULTS Thirty-eight studies were included: 12 recommendations, 5 systematic reviews and 21 meta-analyses. The best evaluated guideline had an AGREE-II assessment of 81%, and the best evaluated meta-analysis had an assessment of 86% for R-AMSTAR and 96% for PRISMA. The average scores of the R-AMSTAR and PRISMA assessments were 65% and 72% respectively. The average score of the AGREE II grid assessment was 57%. The data were synthesized into a practical guide for the GPs' practice, corresponding to the different consultation times. MDD diagnosis should be done on the DSM or ICD basis. The Childrens' Depression Rating Scale-revised or the Revised Beck Depression Inventory are useful in primary care for MDD appraisal in children and adolescents. For mild MDD a supportive psychotherapy and surveillance for 4 to 6 weeks is preconized in primary care. In the absence of improvement, a specific and structured psychotherapy is recommended, and the patient should be addressed to a child psychiatrist. For moderate to severe MDD, the young patient should be addressed to a specialist in child psychiatry. A psychotherapy, which can be associated with fluoxetine, especially in adolescents, is indicated with a revaluation of the pharmacological treatment between 4 to 8 weeks. A weekly follow-up by the GP is recommended during the first month, especially after the initiation of an antidepressant to assess the suicidal risk. Beyond the first month, a consultation should be scheduled every two weeks. CONCLUSION A clinical guide was created from the best evidence-based data to help GPs in the management of child and adolescent MDD. A French-language website, aimed to assist GPs in mental disease management and available during their consultation, will be created based on the compilation of this meta-review with other similar meta-reviews.
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Affiliation(s)
- D Driot
- Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31062 Toulouse cedex, France; UMR 1027 Inserm, université Paul-Sabatier, 37, allées Jules Guesde, 31000 Toulouse, France.
| | - J Nguyen-Soenen
- Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31062 Toulouse cedex, France
| | - M Costes
- Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31062 Toulouse cedex, France
| | - M Pomier
- Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31062 Toulouse cedex, France
| | - J Birebent
- Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31062 Toulouse cedex, France
| | - S Oustric
- Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31062 Toulouse cedex, France; UMR 1027 Inserm, université Paul-Sabatier, 37, allées Jules Guesde, 31000 Toulouse, France
| | - J Dupouy
- Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31062 Toulouse cedex, France; UMR 1027 Inserm, université Paul-Sabatier, 37, allées Jules Guesde, 31000 Toulouse, France
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13
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Dahlenburg SC, Gleaves DH, Hutchinson AD. Treatment outcome research of enhanced cognitive behaviour therapy for eating disorders: a systematic review with narrative and meta-analytic synthesis. Eat Disord 2019; 27:482-502. [PMID: 30632926 DOI: 10.1080/10640266.2018.1560240] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Enhanced cognitive behaviour therapy (CBT-E) has recently generated interest as a potentially useful treatment for eating disorders (ED). In the current study, we conducted a systematic review of the outcome literature on CBT-E, with both narrative and meta-analytic synthesis. We included single-group uncontrolled pre-post design studies and randomised control trials (RCTs) of CBT-E, which allowed us to include a larger number of studies, and also compare the two methodologies in terms of effect size. The primary analysis included 15 CBT-E studies with a total of 948 participants. Narrative synthesis examined bingeing and purging episodes, BMI change, and follow-up results. A large, statistically significant effect supported CBT-E as a treatment for all EDs (g = 1.06). When comparing methodologies, both pre-post design studies (g = 1.26) and RCTs (g = 0.82) yielded large effects. Narrative synthesis outlined reductions in ED behaviours and increases in BMI which were maintained at follow-up. Limitations include that further RCTs of CBT-E are needed to establish clinical effectiveness of this treatment approach for all EDs; however, results from narrative exploration indicate this endeavour would be worthwhile. Despite the limitations, this study provides additional support for CBT-E as a successful treatment across the range of EDs.
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Affiliation(s)
- Sophie C Dahlenburg
- School of Psychology, Social Work and Social Policy, University of South Australia , Adelaide , South Australia , Australia
| | - David H Gleaves
- School of Psychology, Social Work and Social Policy, University of South Australia , Adelaide , South Australia , Australia
| | - Amanda D Hutchinson
- School of Psychology, Social Work and Social Policy, University of South Australia , Adelaide , South Australia , Australia
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Davaasambuu S, Phillip H, Ravindran A, Szatmari P. A Scoping Review of Evidence-Based Interventions for Adolescents with Depression and Suicide Related Behaviors in Low and Middle Income Countries. Community Ment Health J 2019; 55:954-972. [PMID: 31161577 DOI: 10.1007/s10597-019-00420-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 05/30/2019] [Indexed: 10/26/2022]
Abstract
Depression is the number one cause of disability for adolescents. Moreover, depression is the strongest predictor for suicide, which is the second cause for death among adolescents worldwide. A total of 22 RCTs conducted in 14 different LMICs have been reviewed. This is a significant effort to provide mental health services for adolescents in LMICs. However, considering that 2/3 of the world's countries meet criteria for LMIC status and 75% of suicides occur in LMICs, more research addressing both understanding and intervention/prevention of depression and suicide must be conducted in these countries.
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Affiliation(s)
| | - Hamid Phillip
- The Global Mental Health Postdoctoral Research Program, Columbia University, New York, NY, USA
| | - Arun Ravindran
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Peter Szatmari
- Child and Youth Mental Health Collaborative, Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Lieneman CC, Quetsch LB, Theodorou LL, Newton KA, McNeil CB. Reconceptualizing attrition in Parent-Child Interaction Therapy: "dropouts" demonstrate impressive improvements. Psychol Res Behav Manag 2019; 12:543-555. [PMID: 31413647 PMCID: PMC6660625 DOI: 10.2147/prbm.s207370] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/07/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: Behavior disorders in early childhood are linked to a variety of negative outcomes for both children and families. Parent-Child Interaction Therapy (PCIT), an evidence-based parent-training program, demonstrates large effect sizes in reducing child problem behavior for dyads who complete treatment; however, a high number of families seeking treatment in community-based settings terminate from PCIT prior to meeting the protocol's strict graduation criteria. The purpose of this study was to examine the impact of PCIT on child behavior problems for families who received at least a small dose of PCIT but not enough to meet the strict mastery criteria required for graduation. Patients and methods: This study employed one of the largest community research samples conducted with PCIT (2,787 children and their families across the state of Oregon, 1,318 with usable data) to determine how PCIT impacts both graduates and early terminators. Results: While families who graduated from PCIT (17.7% of the sample) demonstrated a very large effect size in problem behavior intensity improvements (d=1.65), families who terminated treatment early, but after attending at least four treatment sessions (51.7% of the sample), still showed significant improvements in behavior problems with a medium-to-large effect size (d=0.70). In contrast, very early terminators (those attending fewer than four treatment sessions, 0.3% of the sample), demonstrated little improvement at the time of dropout from services (d=0.12). Conclusion: Though early terminators in PCIT have previously been identified as treatment failures, the present study discusses the reconceptualization of "dropouts" in relation to some positive evidence of treatment outcomes, the implications for community-based service delivery, and possible future directions.
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Affiliation(s)
- Corey C Lieneman
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Lauren B Quetsch
- Department of Psychology, West Virginia University, Morgantown, WV, USA.,Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | | | - Cheryl B McNeil
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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Grist R, Croker A, Denne M, Stallard P. Technology Delivered Interventions for Depression and Anxiety in Children and Adolescents: A Systematic Review and Meta-analysis. Clin Child Fam Psychol Rev 2019; 22:147-171. [PMID: 30229343 PMCID: PMC6479049 DOI: 10.1007/s10567-018-0271-8] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Depression and anxiety are common during adolescence. Whilst effective interventions are available treatment services are limited resulting in many adolescents being unable to access effective help. Delivering mental health interventions via technology, such as computers or the internet, offers one potential way to increase access to psychological treatment. The aim of this systematic review and meta-analysis was to update previous work and investigate the current evidence for the effect of technology delivered interventions for children and adolescents (aged up to 18 years) with depression and anxiety. A systematic search of eight electronic databases identified 34 randomized controlled trials involving 3113 children and young people aged 6-18. The trials evaluated computerized and internet cognitive behavior therapy programs (CBT: n = 17), computer-delivered attention bias modification programs (ABM: n = 8) cognitive bias modification programs (CBM: n = 3) and other interventions (n = 6). Our results demonstrated a small effect in favor of technology delivered interventions compared to a waiting list control group: g = 0.45 [95% CI 0.29, 0.60] p < 0.001. CBT interventions yielded a medium effect size (n = 17, g = 0.66 [95% CI 0.42-0.90] p < 0.001). ABM interventions yielded a small effect size (n = 8, g = 0.41 [95%CI 0.08-0.73] p < 0.01). CBM and 'other' interventions failed to demonstrate a significant benefit over control groups. Type of control condition, problem severity, therapeutic support, parental support, and continuation of other ongoing treatment significantly influenced effect sizes. Our findings suggest there is a benefit in using CBT based technology delivered interventions where access to traditional psychotherapies is limited or delayed.
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Affiliation(s)
- Rebecca Grist
- Department for Health, University of Bath, 6.19 Wessex House, Bath, BA2 7AY, UK.
- School of Applied Social Science, University of Brighton, Mayfield House, Falmer, Brighton, BN1 9PH, UK.
| | - Abigail Croker
- Oxford Health NHS Foundation Trust, Child, and Adolescent Mental Health Service, Temple House, Keynsham, UK
| | - Megan Denne
- Oxford Health NHS Foundation Trust, Child, and Adolescent Mental Health Service, Temple House, Keynsham, UK
| | - Paul Stallard
- Department for Health, University of Bath, 6.19 Wessex House, Bath, BA2 7AY, UK
- Oxford Health NHS Foundation Trust, Child, and Adolescent Mental Health Service, Temple House, Keynsham, UK
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Halder S, Mahato AK. Cognitive Behavior Therapy for Children and Adolescents: Challenges and Gaps in Practice. Indian J Psychol Med 2019; 41:279-283. [PMID: 31142932 PMCID: PMC6532387 DOI: 10.4103/ijpsym.ijpsym_470_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Susmita Halder
- Department of Clinical Psychology, Amity University, Kolkata, West Bengal, India
| | - Akash Kumar Mahato
- Department of Clinical Psychology, Amity University, Kolkata, West Bengal, India
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Oud M, de Winter L, Vermeulen-Smit E, Bodden D, Nauta M, Stone L, van den Heuvel M, Taher RA, de Graaf I, Kendall T, Engels R, Stikkelbroek Y. Effectiveness of CBT for children and adolescents with depression: A systematic review and meta-regression analysis. Eur Psychiatry 2019; 57:33-45. [DOI: 10.1016/j.eurpsy.2018.12.008] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/27/2018] [Accepted: 12/28/2018] [Indexed: 12/19/2022] Open
Abstract
AbstractBackground:Cognitive-behavioral therapy (CBT) is first choice of treatment for depressive symptoms and disorders in adolescents, however improvements are necessary because overall efficacy is low. Insights on CBT components and contextual and structural characteristics might increase the efficacy. The aim of our approach is to evaluate the efficacy of CBT for youth with depression and investigate the influence of specific components, contextual and structural factors that could improve effects.Methods:A systematic review of randomized controlled trials was conducted, searches were undertaken in CINAHL, CENTRAL, EMBASE, MEDLINE/PubMed and PsycINFO. Outcomes were meta-analyzed and confidence in results was assessed using the GRADE-method. Meta-regression was used to pinpoint components or other factors that were associated with an in- or decrease of effects of CBT.Results:We included 31 trials with 4335 participants. Moderate-quality evidence was found for CBT reducing depressive symptoms at the end of treatment and at follow-up, and CBT as indicated prevention resulted in 63% less risk of being depressed at follow-up. CBT containing a combination of behavioral activation and challenging thoughts component (as part of cognitive restructuring) or the involvement of caregiver(s) in intervention were associated with better outcomes for youth on the long term.Conclusions:There is evidence that CBT is effective for youth with a (subclinical) depression. Our analyses show that effects might improve when CBT contains the components behavioral activation and challenging thoughts and also when the caregiver(s) are involved. However, the influential effects of these three moderators should be further tested in RCTs.
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Bergman H, Kornør H, Nikolakopoulou A, Hanssen‐Bauer K, Soares‐Weiser K, Tollefsen TK, Bjørndal A. Client feedback in psychological therapy for children and adolescents with mental health problems. Cochrane Database Syst Rev 2018; 8:CD011729. [PMID: 30124233 PMCID: PMC6513116 DOI: 10.1002/14651858.cd011729.pub2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Childhood and adolescent mental health problems are a serious and growing concern worldwide. Research suggests that psychotherapy can have a significant and positive impact on children and adolescents with mental health problems, such as anxiety disorders, depression and conduct disorders. Client feedback tools serve as a method of monitoring clients' progress and providing feedback from clients to therapists during the therapeutic process. These tools may help to enhance clinicians' decision-making by allowing them to adapt their treatment plans as the therapy progresses, resulting in a reduction of treatment failures. Research has shown that client feedback tools have a positive effect on adults' psychotherapy. This review addresses whether feedback tools in child and adolescent therapy could help therapists to better treat their young clients. OBJECTIVES To assess the effects of client feedback in psychological therapy on child and adolescent mental health outcomes. SEARCH METHODS We searched the Cochrane Common Mental Disorders Controlled Trials Register (CCMDCTR, Studies and References), the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE (1946-), Embase (1974-) and PsycINFO (1967-) to 3 April 2018. We did not apply any restriction on date, language or publication status to the search. SELECTION CRITERIA We included randomised controlled trials (RCTs) that compared client feedback to no client feedback in psychological therapies for children and adolescents. DATA COLLECTION AND ANALYSIS Two review authors independently assessed references for inclusion eligibility and extracted outcome, risk of bias and study characteristics data into customised forms. We contacted study authors to obtain missing data. We analysed dichotomous data using risk ratios (RRs) and calculated their 95% confidence intervals (CIs). For continuous data, we calculated mean differences (MDs), or standardised mean differences (SMDs) if different scales were used to measure the same outcome. We used a random-effects model for all analyses. MAIN RESULTS We included six published RCTs, conducted in the USA (5 RCTs) and Israel (1 RCT), with 1097 children and adolescents (11 to 18 years old), in the review.We are very uncertain about the effect of client feedback on improvement of symptoms, as reported by youth in the short term because we considered evidence to be of very low-certainty due to high risk of bias and very serious inconsistency in the effect estimates from the different studies. Similarly, we are very uncertain about the effect of client feedback on treatment acceptability, due to high risk of bias, imprecision in the results, and indirectness of measuring the outcome (RR 1.08, 95% CI 0.73 to 1.61; 2 studies, 237 participants; very low-certainty).Overall, most studies reported and carried out randomisation and allocation concealment adequately. None of the studies were blinded or attempted to blind participants and personnel and were at high risk of performance bias, and only one study had blind outcome assessors. All of the studies were at high or unclear risk of attrition bias mainly due to poor, non-transparent reporting of participants' flow through the studies. AUTHORS' CONCLUSIONS Due to the paucity of high-quality data and considerable inconsistency in results from different studies, there is currently insufficient evidence to reach any firm conclusions regarding the role of client feedback in psychological therapies for children and adolescents with mental health problems, and further research on this important topic is needed.Future studies should avoid risks of performance, detection and attrition biases, as seen in the studies included in this review. Studies from countries other than the USA are needed, as well as studies including children younger than 10 years.
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Affiliation(s)
- Hanna Bergman
- CochraneCochrane ResponseSt Albans House57‐59 HaymarketLondonUKSW1Y 4QX
| | - Hege Kornør
- Norwegian Institute of Public HealthDivision of Health ServicesPO box 222 Skøyen0213 OsloNorway
| | | | - Ketil Hanssen‐Bauer
- Akershus University HospitalDivision of Mental Health ServicesLørenskogNorway
| | - Karla Soares‐Weiser
- CochraneEditorial & Methods DepartmentSt Albans House, 57 ‐ 59 HaymarketLondonUKSW1Y 4QX
| | - Thomas K Tollefsen
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP)RBUP, Postboks 4623NydalenOsloNorway0405
| | - Arild Bjørndal
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP)RBUP, Postboks 4623NydalenOsloNorway0405
- University of OsloFaculty of MedicineOsloNorway
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Keles S, Idsoe T. A meta-analysis of group Cognitive Behavioral Therapy (CBT) interventions for adolescents with depression. J Adolesc 2018; 67:129-139. [DOI: 10.1016/j.adolescence.2018.05.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 05/23/2018] [Accepted: 05/27/2018] [Indexed: 01/09/2023]
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21
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Temple J, Salmon P, Tudur-Smith C, Huntley CD, Fisher PL. A systematic review of the quality of randomized controlled trials of psychological treatments for emotional distress in breast cancer. J Psychosom Res 2018; 108:22-31. [PMID: 29602322 DOI: 10.1016/j.jpsychores.2018.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/31/2018] [Accepted: 02/23/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Meta-analyses of trials of psychological treatments for emotional distress in breast cancer (BCa) conclude that efficacious treatments exist. Subsequently, their implementation in routine care is widely promoted by health policy. However, the methodological quality of these trials has not been systematically evaluated. The present review investigates this issue. METHOD A systematic search identified randomized controlled trials of psychological treatments for emotional distress in BCa. The Psychotherapy Outcome Study Methodology Rating Form was used to assess the quality of trials. Generic design elements, including representativeness of sample, control of concomitant treatments, reporting clinical significance outcomes, and design elements specific to psychotherapy trials, including manualisation, therapist training, and therapist adherence and competence were evaluated. RESULTS 91 trials were eligible. Overall, methodological quality was low. Generic design elements were limited in most trials: 15% specified as an inclusion criterion that participants were distressed; 10% controlled for concomitant treatments; and 11% reported the clinical significance of findings. Design elements specific to psychotherapy trials were also implemented poorly: 51% used treatment manuals; 8% used certified trained therapists; and monitoring of adherence and competence occurred in 15% and 4%, respectively. CONCLUSION The methodological quality of psychological treatment trials for emotional distress in BCa is improving. However, if relevant health policies are to be adequately empirically informed, trials of greater methodological rigour are essential. Trials should include participants with clinical levels of distress, control for concomitant treatments and report the clinical significance of findings. Trialists must also consider the specific requirements of psychotherapy trials.
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Affiliation(s)
- James Temple
- Department of Psychological Sciences, University of Liverpool, Whelan Building, Liverpool, UK
| | - Peter Salmon
- Department of Psychological Sciences, University of Liverpool, Whelan Building, Liverpool, UK; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Catrin Tudur-Smith
- Department of Biostatistics, Waterhouse Building, University of Liverpool, Liverpool, UK
| | - Christopher D Huntley
- Department of Psychological Sciences, University of Liverpool, Whelan Building, Liverpool, UK
| | - Peter L Fisher
- Department of Psychological Sciences, University of Liverpool, Whelan Building, Liverpool, UK; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK; Nidaros DPS, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway.
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22
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Dickerson JF, Lynch FL, Leo MC, DeBar LL, Pearson J, Clarke GN. Cost-effectiveness of Cognitive Behavioral Therapy for Depressed Youth Declining Antidepressants. Pediatrics 2018; 141:peds.2017-1969. [PMID: 29351965 PMCID: PMC5810604 DOI: 10.1542/peds.2017-1969] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Adolescents with depression identified in primary care settings often have limited treatment options beyond antidepressant (AD) therapy. We assessed the cost-effectiveness of a brief cognitive behavioral therapy (CBT) program among depressed adolescents who declined or quickly stopped using ADs. METHODS A total of 212 youth with depression were randomly assigned to treatment as usual (TAU) or TAU plus brief individual CBT. Clinical outcomes included depression-free days (DFDs) and estimated quality-adjusted life-years (QALYs). Costs were adjusted to 2008 US dollars. Incremental cost-effectiveness ratios (ICERs) comparing CBT to TAU were calculated over 12- and 24-month follow-up periods. RESULTS Youth randomly assigned to CBT had 26.8 more DFDs (P = .044) and 0.067 more QALYs (P = .044) on average compared with TAU over 12 months. Total costs were $4976 less (P = .025) by the end of the 24-month follow-up among youth randomly assigned to CBT. Total costs per DFD were -$51 (ICER = -$51; 95% confidence interval [CI]: -$394 to $9) at 12 months and -$115 (ICER = -$115; 95% CI: -$1090 to -$6) at 24 months. Total costs per QALY were -$20 282 (ICER = -$20 282; 95% CI: -$156 741 to $3617) at 12 months and -$45 792 (ICER = -$45 792; 95% CI: -$440 991 to -$2731) at 24 months. CONCLUSIONS Brief primary care CBT among youth declining AD therapy is cost-effective by widely accepted standards in depression treatment. CBT becomes dominant over TAU over time, as revealed by a statistically significant cost offset at the end of the 2-year follow-up.
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Affiliation(s)
| | - Frances L. Lynch
- Kaiser Permanente Center for Health Research, Portland, Oregon; and
| | - Michael C. Leo
- Kaiser Permanente Center for Health Research, Portland, Oregon; and
| | - Lynn L. DeBar
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - John Pearson
- Kaiser Permanente Center for Health Research, Portland, Oregon; and
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Music-based interventions to reduce internalizing symptoms in children and adolescents: A meta-analysis. J Affect Disord 2018; 225:647-656. [PMID: 28889050 DOI: 10.1016/j.jad.2017.08.035] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 06/19/2017] [Accepted: 08/14/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Existing systematic reviews provide evidence that music therapy is an effective intervention in the treatment of children and adolescents with psychopathology. The objective of the present review was to systematically review and quantify the effects of music-based interventions in reducing internalizing symptoms (i.e., depression and anxiety) in children and adolescents using a meta-analytical approach. METHODS Databases and journals were systematically screened for studies eligible for inclusion in meta-analysis on the effects of music-based interventions in reducing internalizing symptoms. A random-effect meta-analysis using standardized mean differences (SMD) was conducted. RESULTS Five studies were included. Analysis of data from (randomized) controlled trials, yielded a significant main effect (Hedge's g = -0.73; 95%CI [-1.42;-0.04], Z = 2.08, p = 0.04, k = 5), indicating a greater reduction of internalizing symptoms in youth receiving music-based interventions (n = 100) compared to different control group interventions (n = 95). LIMITATIONS The existing evidence is limited to studies of low power and methodological quality. Included studies were highly heterogeneous with respect to the nature of the intervention, the measurements applied, the samples studied, and the study design. CONCLUSIONS Findings indicate that music-based interventions may be efficient in reducing the severity of internalizing symptoms in children and adolescents. While these results are encouraging with respect to the application of music-based intervention, rigorous research is necessary to replicate existing findings and provide a broader base of evidence. More research adopting well controlled study designs of high methodological quality is needed.
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Pu J, Zhou X, Liu L, Zhang Y, Yang L, Yuan S, Zhang H, Han Y, Zou D, Xie P. Efficacy and acceptability of interpersonal psychotherapy for depression in adolescents: A meta-analysis of randomized controlled trials. Psychiatry Res 2017; 253:226-232. [PMID: 28391140 DOI: 10.1016/j.psychres.2017.03.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 11/04/2016] [Accepted: 03/11/2017] [Indexed: 01/29/2023]
Abstract
In this study, we evaluate the efficacy and safety of interpersonal psychotherapy (IPT) for adolescents with depression. We searched our existing database and electronic databases, including PubMed, Cochrane, EMBASE, PsycINFO, Web of Science, and CINAHL databases (from inception to May 2016). We included randomized controlled trials comparing IPT with various control conditions, including waitlist, psychological placebo, treatment as usual, and no treatment, in adolescents with depression. Finally, we selected seven studies comprising 538 participants comparing IPT with three different control conditions. Pooled analyses suggested that IPT was significantly more effective than control conditions in reducing depressive symptoms at post-treatment and follow-up, and increasing the response/remission rate at post-treatment. IPT was also superior to control conditions for all-cause discontinuation and quality of life/functioning improvement outcomes. However, there was no evidence that IPT reduces the risk of suicide from these data. Meta-analysis demonstrated publication bias for primary efficacy, while the adjusted standardized mean difference using the trim-and-fill method indicated IPT was still significantly superior to the control conditions. Current evidence indicates IPT has a superior efficacy and acceptability compared with control conditions in treating adolescents with depression.
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Affiliation(s)
- Juncai Pu
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Xinyu Zhou
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Lanxiang Liu
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Yuqing Zhang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Lining Yang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Shuai Yuan
- Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Hanpin Zhang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Yu Han
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Dezhi Zou
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Peng Xie
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China.
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Cooney P, Tunney C, O'Reilly G. A systematic review of the evidence regarding cognitive therapy skills that assist cognitive behavioural therapy in adults who have an intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:23-42. [PMID: 28544303 DOI: 10.1111/jar.12365] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) is being increasingly adapted for use with people who have an intellectual disability. However, it remains unclear whether inherent cognitive deficits that are present in adults who have an intellectual disability preclude the use of cognitive-based therapies. This review aims to systematically examine "cognitive therapy skills" in adults who have an intellectual disability that assist engagement in CBT. METHOD Two authors independently reviewed titles and abstracts of articles located through electronic database searching. RESULTS Outcomes of the 18 studies selected for full-text review are mixed and limited by a moderately high risk of bias. CONCLUSIONS The authors suggest eleven findings from research areas of emotion recognition, cognitive mediation, discriminating between thoughts, feelings and behaviours, linking events and emotions that have implications for the design of CBT programmes and future research for this population.
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Affiliation(s)
- Patricia Cooney
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
| | - Conall Tunney
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
| | - Gary O'Reilly
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
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26
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Schmit EL, Schmit MK, Lenz AS. Meta-Analysis of Solution-Focused Brief Therapy for Treating Symptoms of Internalizing Disorders. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/2150137815623836] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Erika L. Schmit
- Department of Psychology, Counseling, and Special Education, Texas A#x00026;M University–Commerce, Commerce, TX, USA
| | | | - A. Stephen Lenz
- Texas A#x00026;M University–Corpus Christi, Corpus Christi, TX, USA
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27
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Smith JL, Gregory S, McBride N, Murphy TK, Storch EA. Outpatient Treatment of Tic Disorders Among Children and Adults. Mov Disord Clin Pract 2017; 4:559-567. [PMID: 30363490 DOI: 10.1002/mdc3.12472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/21/2016] [Accepted: 01/10/2017] [Indexed: 12/19/2022] Open
Abstract
Introduction Limited information is available regarding treatment practices in applied settings for children and adults with tic disorders (TDs). We describe, for the first time, the treatment of TDs in U.S. children and adults in the outpatient setting. Methods Data from the 2003-2010 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Care Survey were used. Descriptive statistics for modality of treatment and class of pharmacological medications were reported by patient and visit characteristics. Separate multivariable logistic regression models were used to examine associations between patient and visit characteristics and classes of medications prescribed. Results One third (n = 99) of the sample did not receive any psychiatric or psychological treatment. Nearly two-thirds received a psychotropic medication. The most common class of medication was alpha-2 agonists (25%), followed by stimulants (23%), serotonin-reuptake inhibitors (SRIs) (19%), atypical antipsychotics (18%), anxiolytics (14%), anticonvulsants (11%), and typical antipsychotics (8%). Comorbid disorders and chronicity of problems were significantly associated with the receipt of certain classes of medications. Relatively few patients (18%) received psychotherapy. Conclusions If the decision is made to treat tic disorders, the choice of medication is dependent on the primary complaints, severity, chronicity, and the presence of comorbid psychiatric disorders. In general, comorbid externalizing, anxiety and mood disorders appear to influence treatment decisions in addition to TDs.
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Affiliation(s)
- Joseph L Smith
- Department of Health Policy and Management College of Public Health University of South Florida Tampa Florida USA
| | - Sean Gregory
- Department of Health Policy and Management College of Public Health University of South Florida Tampa Florida USA
| | - Nicole McBride
- Department of Psychology University of South Florida Tampa Florida USA
| | - Tanya K Murphy
- Department of Pediatrics University of South Florida Tampa Florida USA.,All Children's Hospital-Johns Hopkins Medicine Baltimore Maryland USA.,Department of Psychiatry and Behavioral Neurosciences University of South Florida Tampa Florida USA
| | - Eric A Storch
- Department of Health Policy and Management College of Public Health University of South Florida Tampa Florida USA.,Department of Psychology University of South Florida Tampa Florida USA.,Department of Pediatrics University of South Florida Tampa Florida USA.,Rogers Behavioral Health-Tampa Bay Tampa Florida USA.,All Children's Hospital-Johns Hopkins Medicine Baltimore Maryland USA.,Department of Psychiatry and Behavioral Neurosciences University of South Florida Tampa Florida USA
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Yang L, Zhou X, Zhou C, Zhang Y, Pu J, Liu L, Gong X, Xie P. Efficacy and Acceptability of Cognitive Behavioral Therapy for Depression in Children: A Systematic Review and Meta-analysis. Acad Pediatr 2017; 17:9-16. [PMID: 27989281 DOI: 10.1016/j.acap.2016.08.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 08/10/2016] [Accepted: 08/13/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Few meta-analyses have focused on the effect of cognitive behavioral therapy (CBT) for depression in children. STUDY SELECTION Randomized controlled trials comparing CBT with control conditions for depression in children (≤13 years old) were included. DATA SOURCES Seven electronic databases (PubMed, Embase, CENTRAL, Web of Science, PsycINFO, CINAHL, and LiLACS) were searched from inception to September 2015. DATA EXTRACTION AND SYNTHESIS The primary efficacy was defined as mean change scores in depressive symptoms, and the second efficacy (remission) was a score below the threshold for a diagnosis of depression, both after treatment and at the end of follow-up. We also measured acceptability by the proportion of participants who discontinued treatment up to posttreatment. RESULTS Nine studies with 306 participants were selected for this analysis. At posttreatment, CBT was significantly more effective than control conditions in terms of primary efficacy (standardized mean difference, -0.41; 95% confidence interval [CI], -0.64 to -0.18) and secondary efficacy (odds ratio [OR], 2.16; 95% CI, 1.24 to 3.78). At follow-up, the results were consistent with those of efficacy outcomes at posttreatment, with a standardized mean difference of -0.34 and an OR of 2.04. CBT had no statistical more all-cause discontinuations than the control group (OR, 0.69; 95% CI, 0.26 to 1.82). However, subgroup analyses found that CBT was only significantly more effective than nontreatment, while it was not better than wait list or psychological placebo. CONCLUSIONS CBT seems to be more beneficial in the treatment of depression in children than nontreatment; however, this finding is limited by the small size of the trials and low literature quality.
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Affiliation(s)
- Lining Yang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinyu Zhou
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chanjuan Zhou
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuqing Zhang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juncai Pu
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lanxiang Liu
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xue Gong
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Xie
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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MacQueen GM, Frey BN, Ismail Z, Jaworska N, Steiner M, Lieshout RJV, Kennedy SH, Lam RW, Milev RV, Parikh SV, Ravindran AV. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 6. Special Populations: Youth, Women, and the Elderly. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:588-603. [PMID: 27486149 PMCID: PMC4994788 DOI: 10.1177/0706743716659276] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. METHODS Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. This section on "Special Populations" is the sixth of six guidelines articles. RESULTS Recent studies inform the treatment of MDD in children and adolescents, pregnant and breastfeeding women, women in perimenopause or menopause, and the elderly. Evidence for efficacy of treatments in these populations is more limited than for the general adult population, however, and risks of treatment in these groups are often poorly studied and reported. CONCLUSIONS Despite the limited evidence base, extant data and clinical experience suggest that each of these special populations can benefit from the systematic application of treatment guidelines for treatment of MDD.
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Affiliation(s)
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Zahinoor Ismail
- Department of Psychiatry, University of Calgary, Calgary, Alberta
| | | | - Meir Steiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Sidney H Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - Roumen V Milev
- Department of Psychiatry, Queen's University, Kingston, Ontario
| | - Sagar V Parikh
- Department of Psychiatry, University of Toronto, Toronto, Ontario Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Arun V Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Ontario
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Bella-Awusah T, Ani C, Ajuwon A, Omigbodun O. Effectiveness of brief school-based, group cognitive behavioural therapy for depressed adolescents in south west Nigeria. Child Adolesc Ment Health 2016; 21:44-50. [PMID: 32680363 DOI: 10.1111/camh.12104] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is paucity of evidence-based psychological interventions for depressive disorders in Africa, more so among depressed children and adolescents. This study aimed to determine the effects of a school-based cognitive behavioural therapy programme (CBT) on depressed adolescents in South West Nigeria. METHODS Forty students who scored 18 or above on the Beck Depression Inventory (BDI) were recruited from two schools (20 from each school). One school was designated intervention and the other a wait-list control school. Five weekly sessions of group CBT programme were conducted in the intervention school. Primary outcome measure was the Beck Depression Inventory, and secondary outcome measures were the Short Mood and Feelings Questionnaire and the Impact Supplement of the Strengths and Difficulties Questionnaire. RESULTS Controlling for baseline scores and other confounders, the intervention group had significantly lower depressive symptoms scores on the BDI and SMFQ 1 week post intervention with large effect sizes. The intervention group maintained the treatment effect with significantly lower depression scores 16 weeks post intervention compared with their baseline scores. The effect sizes remained large. The intervention and control groups did not differ in their SDQ impact supplement scores post intervention, but the intervention group improved significantly on this measure at 16 weeks. CONCLUSIONS To our knowledge, this is the first study of a school-based group CBT programme for depressed adolescents in Africa. The programme showed good feasibility and promising effectiveness.
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Affiliation(s)
- Tolulope Bella-Awusah
- Centre for Child and Adolescent Mental Health, University of Ibadan, College of Medicine, University College Hospital, Ibadan, Nigeria.,Department of Psychiatry, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Cornelius Ani
- Academic Unit of Child and Adolescent Psychiatry, Imperial College London, London, UK
| | - Ademola Ajuwon
- Department of Health Promotion and Education, University of Ibadan, Ibadan, Nigeria
| | - Olayinka Omigbodun
- Centre for Child and Adolescent Mental Health, University of Ibadan, College of Medicine, University College Hospital, Ibadan, Nigeria.,Department of Psychiatry, University of Ibadan and University College Hospital, Ibadan, Nigeria
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Pataki C, Carlson GA. Major Depressive Disorder Among Children and Adolescents. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2015; 14:10-14. [PMID: 31975788 DOI: 10.1176/appi.focus.20150037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Depression among youths remains a public health concern, particularly because only a fraction of affected youths receive treatment. To obtain treatment, youths with depression must first be identified so that early intervention can occur. Furthermore, investigation of both more effective pharmacological agents and more widespread accessibility of cognitive-behavioral interventions are necessary. To address unmet needs in the identification and treatment of depression among youths, clinical counseling programs are being developed in primary care clinics and in schools to identify and treat depressive symptoms or milder major depressive disorder and have shown promising outcomes thus far in reducing depression and increasing quality of life.
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Affiliation(s)
- Caroly Pataki
- Dr. Pataki is health science clinical professor of Psychiatry and Biobehavioral Science, David Geffen School of Medicine at University of California, Los Angeles. Dr. Carlson is professor of Psychiatry and Pediatrics and director emerita in the Division of Child and Adolescent Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York (e-mail: gabrielle. )
| | - Gabrielle A Carlson
- Dr. Pataki is health science clinical professor of Psychiatry and Biobehavioral Science, David Geffen School of Medicine at University of California, Los Angeles. Dr. Carlson is professor of Psychiatry and Pediatrics and director emerita in the Division of Child and Adolescent Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York (e-mail: gabrielle. )
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Kornør H, Bergman H, Hanssen-Bauer K, Soares-Weiser K, Tollefsen TK, Bjørndal A. Client feedback in psychological therapy for children and adolescents with mental health problems. Hippokratia 2015. [DOI: 10.1002/14651858.cd011729] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Hege Kornør
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway; Box 4623 Nydalen Oslo Norway 0405
| | - Hanna Bergman
- Enhance Reviews Ltd; Central Office, Cobweb buildings The Lane, Lyford Wantage UK OX12 0EE
| | - Ketil Hanssen-Bauer
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway; Box 4623 Nydalen Oslo Norway 0405
| | - Karla Soares-Weiser
- Enhance Reviews Ltd; Central Office, Cobweb buildings The Lane, Lyford Wantage UK OX12 0EE
| | - Thomas K Tollefsen
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway; Box 4623 Nydalen Oslo Norway 0405
| | - Arild Bjørndal
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway; Box 4623 Nydalen Oslo Norway 0405
- University of Oslo; Oslo Norway
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