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Resch F, Parzer P. [Anxiety and depression in adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:374-382. [PMID: 38456934 PMCID: PMC10995088 DOI: 10.1007/s00103-024-03849-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] [Received: 08/07/2023] [Accepted: 02/15/2024] [Indexed: 03/09/2024]
Abstract
Anxiety and depression among young people had already increased in the years before the COVID-19 pandemic and then experienced a significant increase again during the pandemic. In this article the different clinical forms of expression of these emotional syndromes are presented in detail and the developmental paths of a combination of both disorders are also explained. Even subclinical forms of anxiety and depression already have clear clinical implications and impair the developmental tasks of adolescence. The "avolitional depression" (depression with severe drive disorders) is mentioned as a special form. Pathogenetic building blocks-from genetic vulnerability to psychosocial stressors-come up for discussion in light of the fact that anxiety and depression are about twice as common in adolescent females as in males. The embedding of the disorders in current events shows the special importance of the self-reflective emotion of shame in the adolescent development process. The scarcity and dysfunctionality of emotional dialogue between significant caregivers and children must be cautioned against. Its role in adolescents' self-regulation and affect regulation should not be underestimated. Finally, an overview of the most important therapeutic measures for anxiety and depression in adolescence is presented.
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Affiliation(s)
- Franz Resch
- Klinik für Kinder und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Blumenstraße 8, 69115, Heidelberg, Deutschland.
| | - Peter Parzer
- Klinik für Kinder und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Blumenstraße 8, 69115, Heidelberg, Deutschland
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Wang N, Kong JQ, Bai N, Zhang HY, Yin M. Psychological interventions for depression in children and adolescents: A bibliometric analysis. World J Psychiatry 2024; 14:467-483. [PMID: 38617982 PMCID: PMC11008384 DOI: 10.5498/wjp.v14.i3.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/20/2023] [Accepted: 02/02/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Depression has gradually become a common psychological disorder among children and adolescents. Depression in children and adolescents affects their physical and mental development. Psychotherapy is considered to be one of the main treatment options for depressed children and adolescents. However, our understanding of the global performance and progress of psychological interventions for depression in children and adolescents (PIDCA) research is limited. AIM To identify collaborative research networks in this field and explore the current research status and hotspots through bibliometrics. METHODS Articles and reviews related to PIDCA from January 2010 to April 2023 were identified from the Web of Science Core Collection database. The Charticulator website, CiteSpace and VOSviewer software were used to visualize the trends in publications and citations, the collaborative research networks (countries, institutions, and authors), and the current research status and hotspots. RESULTS Until April 16, 2023, 1482 publications were identified. The number of documents published each year and citations had increased rapidly in this field. The United States had the highest productivity in this field. The most prolific institution was the University of London. Pim Cuijpers was the most prolific author. In the context of research related to PIDCA, both reference co-citation analysis and keywords co-occurrence analysis identified 10 research hotspots, including third-wave cognitive behavior therapy, short-term psychoanalytic psychotherapy, cognitive behavioral analysis system of psychotherapy, family element in psychotherapy, modular treatment, mobile-health, emotion-regulation-based transdiagnostic intervention program, dementia risk in later life, predictors of the efficacy of psychological intervention, and risks of psychological intervention. CONCLUSION This bibliometric study provides a comprehensive overview of PIDCA from 2010 to present. Psychological intervention characterized as psychological-process-focused, short, family-involved, modular, internet-based, emotion-regulation-based, and personalized may benefit more young people.
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Affiliation(s)
- Nan Wang
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Jia-Qi Kong
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Nan Bai
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Hui-Yue Zhang
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Min Yin
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu Province, China
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Urbańska-Grosz J, Sitek EJ, Pakalska A, Pietraszczyk-Kędziora B, Skwarska K, Walkiewicz M. Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:131. [PMID: 38275441 PMCID: PMC10814122 DOI: 10.3390/children11010131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/08/2024] [Accepted: 01/14/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents' cognitive flexibility, are examined. The research incorporates the perspectives of both adolescents and mothers. METHODS The sample includes 63 mother-teenager dyads in the clinical group and 43 in the control group. Instruments encompass the Family Adaptability and Cohesion Evaluation Scales (FACES IV), Children's Depression Inventory (CDI-2), Beck Depression Inventory (BDI-II), The Brixton Spatial Anticipation Test, and structured interviews. RESULTS Families of adolescents with MDD exhibit lower flexibility, cohesion, communication, and overall satisfaction. Depressed adolescents display reduced cognitive flexibility. Discrepancies were observed between adolescents' and mothers' perspectives as associated with adolescents' MDD. Teenagers emphasized the severity of maternal depressive symptoms, while mothers highlighted the importance of family cohesion and flexibility. CONCLUSIONS This study emphasizes a holistic strategy in addressing adolescent depression, including family-based assessment and therapy. Screening for maternal depressive symptoms is identified as valuable. Cognitive flexibility also needs to be addressed during therapy for depression in adolescence.
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Affiliation(s)
- Justyna Urbańska-Grosz
- Rehabilitation Department of Child and Adolescent Psychiatry, Gdansk Health Center, 80-542 Gdansk, Poland; (J.U.-G.); (E.J.S.)
- Laboratory of Clinical Neuropsychology, Neurolinguistics and Neuropsychotherapy, Division of Neurological and Psychiatric Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-952 Gdansk, Poland
| | - Emilia J. Sitek
- Rehabilitation Department of Child and Adolescent Psychiatry, Gdansk Health Center, 80-542 Gdansk, Poland; (J.U.-G.); (E.J.S.)
- Laboratory of Clinical Neuropsychology, Neurolinguistics and Neuropsychotherapy, Division of Neurological and Psychiatric Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-952 Gdansk, Poland
- Department of Neurology, St. Adalbert Hospital, Copernicus PL, 80-462 Gdansk, Poland
| | - Anna Pakalska
- Rehabilitation Department of Child and Adolescent Psychiatry, Gdansk Health Center, 80-542 Gdansk, Poland; (J.U.-G.); (E.J.S.)
| | - Bożena Pietraszczyk-Kędziora
- Rehabilitation Department of Child and Adolescent Psychiatry, Gdansk Health Center, 80-542 Gdansk, Poland; (J.U.-G.); (E.J.S.)
| | - Kalina Skwarska
- Rehabilitation Department of Child and Adolescent Psychiatry, Gdansk Health Center, 80-542 Gdansk, Poland; (J.U.-G.); (E.J.S.)
| | - Maciej Walkiewicz
- Rehabilitation Department of Child and Adolescent Psychiatry, Gdansk Health Center, 80-542 Gdansk, Poland; (J.U.-G.); (E.J.S.)
- Division of Quality of Life Research, Department of Psychology, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdansk, Poland
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Weisz JR, Fitzpatrick OM, Venturo-Conerly KE, Sternberg A, Steinberg JS, Ng MY. Research Review: The internalizing paradox - youth anxiety and depression symptoms, psychotherapy outcomes, and implications for research and practice. J Child Psychol Psychiatry 2023; 64:1720-1734. [PMID: 37222162 PMCID: PMC10667566 DOI: 10.1111/jcpp.13820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Youth anxiety and depression have long been combined within the empirically derived internalizing syndrome. The two conditions show substantial comorbidity, symptom co-occurrence, and overlap in treatment procedures, but paradoxically diverge in psychotherapy outcomes: strong, positive effects for anxiety and weak effects for depression. METHODS Drawing on recent research, we examine candidate explanations for this paradox to help identify strategies for addressing it by improving outcomes for youth depression. RESULTS Candidate explanations include that youth depression, compared with youth anxiety, has more varied comorbidities and more heterogeneous symptom combinations, has greater uncertainty regarding mediators and mechanisms of change, is treated with more complex and potentially confusing protocols, and has characteristics that may impede client engagement. Candidate strategies for shrinking the psychotherapy effectiveness gap include personalizing through transdiagnostic modular treatment, simplifying therapy by focusing on empirically supported principles of change, developing effective strategies for engaging family members as intervention allies, using shared decision-making to inform clinical decisions and boost client engagement, capitalizing on youth-friendly technological advances, and shortening and digitizing treatments to enhance their accessibility and appeal. CONCLUSIONS Recent advances suggest explanations for the internalizing paradox, which in turn suggest strategies for shrinking the youth anxiety-depression psychotherapy outcome gap; these form an agenda for a promising new era of research.
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Affiliation(s)
- John R. Weisz
- Department of Psychology, Harvard University, Cambridge, MA 02138 USA
| | | | | | - Ariel Sternberg
- Department of Psychology, Harvard University, Cambridge, MA 02138 USA
| | | | - Mei Yi Ng
- Department of Psychology, Florida International University, Miami, FL 33199 USA
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Hong JS, Choi MJ, Wade RM, O'Donnell LA, Johns S. Racial/ethnic differences in parenting behaviors as protective factors in adolescent internalizing problems. THE JOURNAL OF GENERAL PSYCHOLOGY 2023; 150:467-484. [PMID: 36576224 DOI: 10.1080/00221309.2022.2152414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/17/2022] [Indexed: 12/29/2022]
Abstract
The current study explores variations among racially/ethnically diverse adolescents regarding parents' role in mitigating internalizing problems. Adolescents with a higher level of parental awareness, ease of talking to parents, and parental support were less likely to show internalizing problems. Parental awareness was negatively associated with internalizing problems among Whites and Hispanics. The ease of talking to parents was significant for all groups except for American Indians/Alaska Natives. These findings can inform culturally relevant treatments.
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Affiliation(s)
- Jun Sung Hong
- School of Social Work, Wayne State University, Detroit, MI, USA
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Mi Jin Choi
- School of Social Work, Texas State University, San Marcos, TX, USA
| | - Ryan M Wade
- School of Social Work, The University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Shantalea Johns
- School of Social Work, Wayne State University, Detroit, MI, USA
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Wang L, Li M, Guan B, Zeng L, Li X, Jiang X. Path Analysis of Self-Efficacy, Coping Style and Resilience on Depression in Patients with Recurrent Schizophrenia. Neuropsychiatr Dis Treat 2023; 19:1901-1910. [PMID: 37680590 PMCID: PMC10480561 DOI: 10.2147/ndt.s421731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/19/2023] [Indexed: 09/09/2023] Open
Abstract
Purpose Based on the two mediating variables of self-efficacy and coping style, a multiple mediating model was constructed to explore the mechanism by which psychological resilience affects depression in patients with recurrent schizophrenia. Methods A total of 210 patients with recurrent schizophrenia who were hospitalized in a tertiary hospital in Hunan Province, China, were enrolled. The Connor Davidson Resilience Scale (CD-RISC), Self-rating Depression Scale (SDS), General Self-Efficacy Energy Scale (GSES) and Simplified Coping Style Questionnaire (SCSQ) were used to evaluate resilience, self-efficacy, coping style and depression. Path analysis was performed by constructing a structural equation model, and the mediating effect between variables was verified by the bias-corrected nonparametric percentile bootstrap method. Results Resilience, self-efficacy and positive coping together explained 53.2% of the variance in depression. (1) The total scores of self-efficacy, coping style, resilience and depression in patients with recurrent schizophrenia were 2.54±0.61, 31.73±9.62, 58.06±17.26 and 50.48±12.55, respectively. (2) Pearson analysis showed that the scores of self-efficacy, positive coping, resilience and depression were significantly correlated with depression (r=-0.24-0.51, P<0.01). (3) The path analysis showed that resilience directly affects depression (β=-0.401); additionally, resilience indirectly affects depression through self-efficacy (β=-0.179) and through the chain mediating effect of self-efficacy and positive coping style (β=-0.024). Conclusion There is a high incidence of depression in patients with recurrent schizophrenia in China, and intervention is needed. This research revealed that resilience directly affects depression in patients with recurrent schizophrenia and that self-efficacy and positive coping play a part in mediating resilience and depression in patients with recurrent schizophrenia in China. Implementing targeted interventions based on action paths to improve the level of resilience and reduce the incidence of depression has guiding significance in the field of occupational rehabilitation of patients with recurrent schizophrenia.
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Affiliation(s)
- Liyi Wang
- Department of Oncology, Chengdu Fifth People’s Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People’s Republic of China
- College of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, People’s Republic of China
| | - Meizhi Li
- Hunan Provincial Brain Hospital (Hunan Second People’s Hospital), Changsha, Hunan, People’s Republic of China
| | - Bi Guan
- Department of Nursing, Fifth People’s Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People’s Republic of China
| | - Liangnan Zeng
- Department of Nursing, Fifth People’s Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People’s Republic of China
| | - Xinchun Li
- Hunan Provincial Brain Hospital (Hunan Second People’s Hospital), Changsha, Hunan, People’s Republic of China
| | - Xiaojian Jiang
- College of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, People’s Republic of China
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Szota K, Schulte KL, Christiansen H. Interventions Involving Caregivers for Children and Adolescents Following Traumatic Events: A Systematic Review and Meta-Analysis. Clin Child Fam Psychol Rev 2023; 26:17-32. [PMID: 36161385 PMCID: PMC9879828 DOI: 10.1007/s10567-022-00415-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 02/01/2023]
Abstract
Although treatment guidelines recommend interventions entailing caregiver involvement for children and adolescents following traumatic experiences, evidence on their effectiveness is inconsistent. The present systematic review and meta-analysis considered possible moderators of their effectiveness. METHOD Eligible studies were (quasi-)randomized controlled trials and efficacy trials published in English or German with participants up to the age of 21 years presenting symptoms of mental disorders due to traumatic experiences. The effectiveness of interventions entailing any kind and extent of caregiver involvement had to be investigated by applying evaluated instruments. PubMed, PsycINFO, ERIC, COCHRANE and PSYNDEX were searched. RESULTS A total of 33 studies with 36 independent samples were retrieved. Child- and parent-reports on PTSD, depression, anxiety, ADHD, internalizing, externalizing symptoms and behavior problems were analyzed where available. The pooled effect size is significant and robust at post-treatment for child-reported PTSD, g = - 0.34 (95% CI = - 0.53; - 0.14), parent-reported PTSD, g = - 0.41 (95% CI = - 0.71; - 0.11), child-reported depression, g = - 0.29 (95% CI = - 0.46; - 0.11), child-reported anxiety, g = - 0.25 (95% CI = - 0.42; - 0.08), and parent-reported internalizing symptoms, g = - 0.27 (95% CI = - 0.47; - 0.07). Female sex and fulfilling diagnostic criteria appeared as potential moderators. The only significant effect size at follow-up is found for child-reported PTSD symptoms 12 months post-treatment, g = - 0.37 (95% CI = - 0.67; - 0.07). CONCLUSIONS Interventions entailing caregiver involvement revealed greater symptom reductions than control conditions. Determinants of their effectiveness should be examined further.
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Affiliation(s)
- Katharina Szota
- grid.10253.350000 0004 1936 9756Department of Psychology, Philipps-University of Marburg, Gutenbergstr. 18, 35032 Marburg, Hesse Germany
| | - Katharina Louisa Schulte
- grid.10253.350000 0004 1936 9756Department of Psychology, Philipps-University of Marburg, Gutenbergstr. 18, 35032 Marburg, Hesse Germany
| | - Hanna Christiansen
- grid.10253.350000 0004 1936 9756Department of Psychology, Philipps-University of Marburg, Gutenbergstr. 18, 35032 Marburg, Hesse Germany
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Berry KR, Gliske K, Schmidt C, Ballard J, Killian M, Fenkel C. The Impact of Family Therapy Participation on Youth and Young Adult Engagement and Retention in a Telehealth Intensive Outpatient Program: Quality Improvement Analysis (Preprint). JMIR Form Res 2022; 7:e45305. [PMID: 37079372 PMCID: PMC10160927 DOI: 10.2196/45305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/17/2023] [Accepted: 03/27/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Early treatment dropout among youths and young adults (28%-75%) puts them at risk for poorer outcomes. Family engagement in treatment is linked to lower dropout and better attendance in outpatient, in-person treatment. However, this has not been studied in intensive or telehealth settings. OBJECTIVE We aimed to examine whether family members' participation in telehealth intensive outpatient (IOP) therapy for mental health disorders in youths and young adults is associated with patient's treatment engagement. A secondary aim was to assess demographic factors associated with family engagement in treatment. METHODS Data were collected from intake surveys, discharge outcome surveys, and administrative data for patients who attended a remote IOP for youths and young adults, nationwide. Data included 1487 patients who completed both intake and discharge surveys and either completed or disengaged from treatment between December 2020 and September 2022. Descriptive statistics were used to characterize the sample's baseline differences in demographics, engagement, and participation in family therapy. Mann-Whitney U and chi-square tests were used to explore differences in engagement and treatment completion between patients with and those without family therapy. Binomial regression was used to explore significant demographic predictors of family therapy participation and treatment completion. RESULTS Patients with family therapy had significantly better engagement and treatment completion outcomes than clients with no family therapy. Youths and young adults with ≥1 family therapy session were significantly more likely to stay in treatment an average of 2 weeks longer (median 11 weeks vs 9 weeks) and to attend a higher percentage of IOP sessions (median 84.38% vs 75.00%). Patients with family therapy were more likely to complete treatment than clients with no family therapy (608/731, 83.2% vs 445/752, 59.2%; P<.001). Different demographic variables were associated with an increased likelihood of participating in family therapy, including younger age (odds ratio 1.3) and identifying as heterosexual (odds ratio 1.4). After controlling for demographic factors, family therapy remained a significant predictor of treatment completion, such that each family therapy session attended was associated with a 1.4-fold increase in the odds of completing treatment (95% CI 1.3-1.4). CONCLUSIONS Youths and young adults whose families participate in any family therapy have lower dropout, greater length of stay, and higher treatment completion than those whose families do not participate in services in a remote IOP program. The findings of this quality improvement analysis are the first to establish a relationship between participation in family therapy and an increased engagement and retention in remote treatment for youths and young patients in IOP programing. Given the established importance of obtaining an adequate dosage of treatment, bolstering family therapy offerings is another tool that could contribute to the provision of care that better meets the needs of youths, young adults, and their families.
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Affiliation(s)
| | - Kate Gliske
- Charlie Health, Inc, Bozeman, MT, United States
| | | | - Jaime Ballard
- University of Minnesota, St. Paul, MN, United States
| | - Michael Killian
- College of Social Work, Florida State University, Tallahassee, FL, United States
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Dippel N, In-Albon T, Schneider S, Christiansen H, Brakemeier EL. Investigating the feasibility and effectiveness of a modular treatment program for children and adolescents with depression and interpersonal problems: study protocol of a quasi-experimental pilot feasibility trial (CBASP@YoungAge). Pilot Feasibility Stud 2022; 8:145. [PMID: 35821072 PMCID: PMC9275387 DOI: 10.1186/s40814-022-01091-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 06/07/2022] [Indexed: 12/12/2022] Open
Abstract
Background Depression is a serious disorder in childhood and adolescence. Affected children and adolescents show significant impairments in various aspects of life. Studies on the effectiveness or efficacy of psychotherapy in depressed children and adolescents are qualitatively very heterogeneous and reveal small effect sizes. There is thus a need to better tailor psychotherapy approaches to these age groups to improve outcomes like parent-child relationship, symptomatology, or quality of life. To address this gap, we designed a modular, individualized treatment program for children and adolescents based on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) including caregiver involvement. Method This quasi-experimental pilot feasibility trial is a phase 1 to phase 2 study investigating the feasibility and effectiveness of CBASP@YoungAge by including an intervention group (CBASP@YoungAge) and a treatment-as-usual control group. The treatment of depressive symptoms as well as interpersonal problems with primary caregivers are the main targets of CBASP@YoungAge. Personalization is ensured concerning the treatment course, caregivers’ involvement, and the patient’s age. The primary outcome relates to two areas: the feasibility of the CBASP@YoungAge treatment program in an outpatient context and a change in patients' depressive symptomatology from before to after treatment. We conduct a brief process evaluation after each session in the intervention group to closely monitor the treatment process and examine feasibility from the therapists' and patients' perspectives and mechanisms of symptom change. In addition, we consider interpersonal behavior between children and caregivers, parenting behavior, and monitor the global-health-index in children and parents as secondary outcomes. Pre-, post-, and follow-up data are evaluated. Discussion This is the first study of a modular-based intervention program for children and adolescents with depression and a clear focus on the interpersonal problems between the depressed young patient and her/his caregiver. It will provide important knowledge on the feasibility and effectiveness of the program and potential benefits of including caregivers in psychotherapy. Based on this study’s results, we plan a multicenter, randomized, controlled trial whose long-term aim is to improve the psychotherapeutic care of young patients with depression while preventing persistent courses of depressive disorders. Trial registration German Clinical Trials Register, DRKS (identifier DRKS00023281). Registered 17 November 2020–Retrospectively registered Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01091-3.
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Affiliation(s)
- N Dippel
- Philipps-University Marburg, Marburg, Germany.
| | - T In-Albon
- University of Koblenz-Landau, Landau, Germany
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