Psychological treatment of depression in children and adolescents

1998 ◽  
Vol 173 (4) ◽  
pp. 291-298 ◽  
Author(s):  
Richard Harrington ◽  
Jane Whittaker ◽  
Philp Shoebridge
Keyword(s):  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Preventive Intervention ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Psychological Interventions ◽  
Psychological Treatments ◽  
Literature Searches ◽  
Cognitive Behavioural ◽  
Treatment Of Depression

BackgroundThis paper reviews research on the psychological treatment of depression in children.MethodManual and computer literature searches were performed.ResultsThe most promising psychological interventions for depression in children are individual rather than family therapies. Cognitive – behavioural therapy seems to be an effective treatment for depressive symptoms and mild depressive disorders. It may also be a useful preventive intervention, though this remains to be conclusively demonstrated. There have been no systematic studies comparing psychological treatments with medication.ConclusionsStudies comparing psychological treatments and medication are now required.

scholarly journals Psychological interventions for mental health disorders in children with chronic physical illness: a systematic review

2015 ◽  
Vol 100 (4) ◽  
pp. 308-316 ◽  
Author(s):  
Sophie Bennett ◽  
Roz Shafran ◽  
Anna Coughtrey ◽  
Susan Walker ◽  
Isobel Heyman
Keyword(s):  
Psychiatric Symptoms ◽  
Behavioural Therapy ◽  
Physical Illness ◽  
Psychological Interventions ◽  
Chronic Physical Illness ◽  
Psychological Treatments ◽  
Symptoms Of Depression ◽  
Cognitive Behavioural ◽  
Health Disorders ◽  
Randomised Controlled

BackgroundChildren with chronic physical illness are significantly more likely to develop common psychiatric symptoms than otherwise healthy children. These children therefore warrant effective integrated healthcare yet it is not established whether the known, effective, psychological treatments for symptoms of common childhood mental health disorders work in children with chronic physical illness.MethodsEMBASE, MEDLINE, PsycINFO and CINAHL databases were searched with predefined terms relating to evidence-based psychological interventions for psychiatric symptoms in children with chronic physical illness. We included all studies (randomised and non-randomised designs) investigating interventions aimed primarily at treating common psychiatric symptoms in children with a chronic physical illness in the review. Two reviewers independently assessed the relevance of abstracts identified, extracted data and undertook quality analysis.ResultsTen studies (209 children, including 70 in control groups) met the criteria for inclusion in the review. All studies demonstrated some positive outcomes of cognitive behavioural therapy for the treatment of psychiatric symptoms in children with chronic physical illness. Only two randomised controlled trials, both investigating interventions for symptoms of depression, were found.ConclusionsThere is preliminary evidence that cognitive behavioural therapy has positive effects in the treatment of symptoms of depression and anxiety in children with chronic physical illness. However, the current evidence base is weak and fully powered randomised controlled trials are needed to establish the efficacy of psychological treatments in this vulnerable population.

scholarly journals Cognitive–behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial

2017 ◽  
Vol 21 (12) ◽  
pp. 1-94 ◽  
Author(s):  
Ian M Goodyer ◽  
Shirley Reynolds ◽  
Barbara Barrett ◽  
Sarah Byford ◽  
Bernadka Dubicka ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Major Depression ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Depression Symptoms ◽  
Psychological Treatments ◽  
Treatment Groups ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundAlthough there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years.ObjectiveTo determine whether or not either of two specialist psychological treatments, cognitive–behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment.DesignObserver-blind, parallel-group, pragmatic superiority randomised controlled trial.SettingA total of 15 outpatient NHS clinics in the UK from East Anglia, north-west England and North London.ParticipantsAdolescents aged 11–17 years withDiagnostic and Statistical Manual of Mental Disorders-Fourth Edition major depression including those with suicidality, depressive psychosis and conduct disorder. Patients were randomised using stochastic minimisation controlling for age, sex and self-reported depression sum score; 470 patients were randomised and 465 were included in the analyses.InterventionsIn total, 154 adolescents received CBT, 156 received STPP and 155 received BPI. The trial lasted 86 weeks and study treatments were delivered in the first 36 weeks, with 52 weeks of follow-up.Main outcome measuresMean sum score on self-reported depressive symptoms (primary outcome) at final study assessment (nominally 86 weeks, at least 52 weeks after end of treatment). Secondary measures were change in mean sum scores on self-reported anxiety symptoms and researcher-rated Health of the Nation scales for children and adolescents measuring psychosocial function. Following baseline assessment, there were a further five planned follow-up reassessments at nominal time points of 6, 12, 52 and 86 weeks post randomisation.ResultsThere were non-inferiority effects of CBT compared with STPP [treatment effect by final follow-up = –0.578, 95% confidence interval (CI) –2.948 to 4.104;p = 0.748]. There were no superiority effects for the two specialist treatments (CBT + STPP) compared with BPI (treatment effect by final follow-up = –1.898, 95% CI –4.922 to 1.126;p = 0.219). At final assessment there was no significant difference in the mean depressive symptom score between treatment groups. There was an average 49–52% reduction in depression symptoms by the end of the study. There were no differences in total costs or quality-of-life scores between treatment groups and prescribing a selective serotonin reuptake inhibitor (SSRI) during treatment or follow-up did not differ between the therapy arms and, therefore, did not mediate the outcome.ConclusionsThe three psychological treatments differed markedly in theoretical and clinical approach and are associated with a similar degree of clinical improvement, cost-effectiveness and subsequent maintenance of lowered depressive symptoms. Both STPP and BPI offer an additional patient treatment choice, alongside CBT, for depressed adolescents attending specialist Child and Adolescent Mental Health Services. Further research should focus on psychological mechanisms that are associated with treatment response, the maintenance of positive effects, determinants of non-response and whether or not brief psychotherapies are of use in primary care and community settings.LimitationsNeither reason for SSRI prescribing or monitoring of medication compliance was controlled for over the course of the study, and the economic results were limited by missing data.Trial registrationCurrent Controlled Trials ISRCTN83033550.FundingThis project was funded by the National Institute for Heath Research Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 12. See the National Institute for Heath Research Journals Library website for further project information. Funding was also provided by the Department of Health. The funders had no role in the study design, patient recruitment, data collection, analysis or writing of the study, any aspect pertinent to the study or the decision to submit toThe Lancet.

scholarly journals Electroacupuncture and Cognitive Behavioural Therapy for Sub-Syndromal Depression among Undergraduates: A Controlled Clinical Trial

2016 ◽  
Vol 34 (5) ◽  
pp. 356-363 ◽  
Author(s):  
Tianwei Guo ◽  
Zhuo Guo ◽  
Wenyue Zhang ◽  
Wenhao Ma ◽  
Xinjing Yang ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Behavioural Therapy ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Remission Rate ◽  
Behavioural Therapy ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Cognitive Behavioural ◽  
Increased Risk

Background Individuals with sub-syndromal depression (SSD) are at increased risk of incident depressive disorders; however, the ideal therapeutic approach to SSD remains unknown. Objective To evaluate the effects of electroacupuncture (EA) and cognitive behavioural therapy (CBT), alone or in combination, on depressive symptoms. Methods Undergraduate students with SSD were recruited and allocated to one of four groups based on their preferences: EA (n=6), CBT (n=10), EA+CBT (n=6), and untreated control (n=11) groups. Six weeks of treatment were provided in the first three groups. Clinical outcomes were measured using the 17-item Hamilton Depression (HAMD-17) rating scale, Center for Epidemiologic Depression (CES-D) scale, WHO Quality of Life-Brief version (WHOQOL-BREF) questionnaire, and clinical remission rate. Results All 33 subjects were included in an intent-to-treat analysis. Statistically significant improvements in HAMD-17, CES-D, and WHOQOL-BREF scores and a higher remission rate were found in the EA, CBT, and EA+CBT intervention groups compared with the control group (all p<0.05). No significant differences were found between the three intervention groups. HAMD-17 factor score analysis revealed that EA reduced sleep disturbance scores more than CBT or EA+CBT (p<0.05), and CBT reduced retardation scores more than EA (p<0.01). EA+CBT reduced anxiety/somatisation scores more than EA or CBT (p<0.05) and retardation scores more than EA (p<0.05). Conclusions Early intervention may alleviate depressive symptoms in SSD. EA and CBT may have differential effects on certain symptoms. Combination therapy targeting both physical and psychological symptoms may represent an ideal strategy for SSD intervention. However, randomised trials with larger sample sizes are needed. Trial Registration Number ChiCTR-TRC-10000889; Results.

Interventions for specific conditions

2019 ◽  
pp. 253-260
Author(s):  
Ian Barkataki ◽  
Louise Ross
Keyword(s):  
Psychotic Disorders ◽  
Psychological Treatment ◽  
Bipolar Affective Disorder ◽  
Psychological Theory ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Psychological Interventions ◽  
Supporting Evidence ◽  
Staff Support ◽  
Cognitive Behavioural

This chapter focuses on specific psychological interventions for disorders and conditions that commonly present within an inpatient environment. Three main psychological orientations (cognitive behavioural therapy, psychodynamic psychotherapy, and systemic therapy) are defined, along with their strengths and applicability for inpatient work. The importance of adapting psychological approaches in this setting is considered. Psychological theory, supporting evidence base, and specific techniques for mood disorders (including depression, bipolar affective disorder, and anxiety); psychotic disorders; and personality disorders are outlined in greater detail. The practical considerations of short-term and acute working, including the importance of staff support, in the delivery of effective psychological treatment on the ward are discussed.

scholarly journals The effects of psychological treatment of perinatal depression: an overview

2021 ◽  
Author(s):  
Pim Cuijpers ◽  
Eirini Karyotaki
Keyword(s):  
Parental Stress ◽  
Perinatal Depression ◽  
Psychological Treatment ◽  
Public Health Problem ◽  
Psychological Interventions ◽  
Important Public Health Problem ◽  
Psychological Treatments ◽  
Treatment Of Depression ◽  
Moderate Effect Size ◽  
Meta Analyses

Abstract Perinatal depression is an important public health problem. Psychological interventions play an essential role in the treatment of depression. In the current paper, we will present the results of a series of meta-analyses on psychological treatments of perinatal depression. We report the results of a series of meta-analyses on psychological treatments of depression, including perinatal depression. The meta-analyses are based on a database of randomized trials on psychotherapies for depression that has been systematically developed and updated every year. Psychological interventions are effective in the treatment of perinatal depression with a moderate effect size of g = 0.67, corresponding with a NNT of about 4. These effects were still significant at 12 months after the start of the treatment. These interventions also have significant effects on social support, anxiety, functional impairment, parental stress, and marital stress. Possibly the effects are overestimated because of the use of waiting list control groups, the low quality of the majority of trials and publication bias. Research on psychotherapies for depression in general has shown that there are no significant differences between the major types of therapy, except for non-directive counseling that may have somewhat smaller effects. CBT can also be delivered in individual, group, telephone, and guided self-help format. Interventions in subthreshold depression are also effective and may prevent the onset of a full-blown depressive disorder, while therapies may be less effective in chronic depression. Psychological interventions are effective and deserve their place as first-line treatment of perinatal depression.

scholarly journals Integrating non-drug treatments in early schizophrenia

2005 ◽  
Vol 187 (S48) ◽  
pp. s65-s71 ◽  
Author(s):  
Shôn W. Lewis ◽  
Nicolas Tarrier ◽  
Richard James Drake
Keyword(s):  
Cognitive Remediation ◽  
Behavioural Therapy ◽  
Treatment Modalities ◽  
First Episode ◽  
Psychological Interventions ◽  
Neurocognitive Deficits ◽  
Psychological Treatments ◽  
Adherence To Medication ◽  
Cognitive Behavioural ◽  
Drug Treatments

SummaryThere is a range of psychological interventions for established schizophrenia. These include family interventions, motivational interventions for substance misuse and for non-adherence to medication, cognitive remediation for neurocognitive deficits and cognitive–behavioural therapy for symptoms. Psychological interventions may explicitly target risk factors for poor outcome, such as substance use, or protective factors, such as adherence to medication, or be directed at specific symptoms or deficits. There is emerging evidence for efficacy of psychological treatments during, following and even prior to the first episode. Important areas for further study are how different treatment modalities can interact productively and patient and carer preferences for treatment. Many trials of psychological treatments have design flaws and this tends to overestimate the treatment effect.

scholarly journals Network meta-analysis: a useful tool for comparing different psychological treatments for panic disorder?

2018 ◽  
Vol 24 (1) ◽  
pp. 3-8
Author(s):  
Katharine Smith
Keyword(s):  
Panic Disorder ◽  
Statistical Method ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Behavioural Therapy ◽  
Psychological Treatments ◽  
Cognitive Behavioural ◽  
Different Types ◽  
Multiple Treatments

SUMMARYNetwork meta-analysis (NMA) is a statistical method that allows comparison of multiple treatments against each other. The use of NMA, and its advantages and potential limitations, is discussed here in the context of this issue's Cochrane review of psychological treatments for panic disorder. The review showed benefits for psychological treatment when compared to a waiting list, particularly for cognitive behavioural therapy in both the short and longer term. The findings were limited by the primary studies available, but despite these, this analysis using NMA presents the best evidence to date of the relative benefits of different types of psychological treatments in panic disorder.DECLARATION OF INTERESTNone.

scholarly journals Long-term outcomes of psychological treatment for posttraumatic stress disorder: a systematic review and meta-analysis

2021 ◽  
pp. 1-11
Author(s):  
Maxi Weber ◽  
Sarah Schumacher ◽  
Wiebke Hannig ◽  
Jürgen Barth ◽  
Annett Lotzin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Stress Disorder ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Long Term Outcomes ◽  
Psychological Treatments

Abstract Several types of psychological treatment for posttraumatic stress disorder (PTSD) are considered well established and effective, but evidence of their long-term efficacy is limited. This systematic review and meta-analysis aimed to investigate the long-term outcomes across psychological treatments for PTSD. MEDLINE, Cochrane Library, PTSDpubs, PsycINFO, PSYNDEX, and related articles were searched for randomized controlled trials with at least 12 months of follow-up. Twenty-two studies (N = 2638) met inclusion criteria, and 43 comparisons of cognitive behavioral therapy (CBT) were available at follow-up. Active treatments for PTSD yielded large effect sizes from pretest to follow-up and a small controlled effect size compared with non-directive control groups at follow-up. Trauma-focused treatment (TFT) and non-TFT showed large improvements from pretest to follow-up, and effect sizes did not significantly differ from each other. Active treatments for comorbid depressive symptoms revealed small to medium effect sizes at follow-up, and improved PTSD and depressive symptoms remained stable from treatment end to follow-up. Military personnel, low proportion of female patients, and self-rated PTSD measures were associated with decreased effect sizes for PTSD at follow-up. The findings suggest that CBT for PTSD is efficacious in the long term. Future studies are needed to determine the lasting efficacy of other psychological treatments and to confirm benefits beyond 12-month follow-up.

scholarly journals What we know, what we do not know, and where are we heading? Efficacy and acceptability of psychological interventions for depression

2015 ◽  
Vol 25 (4) ◽  
pp. 301-308 ◽  
Author(s):  
N. Solomonov ◽  
J. P. Barber
Keyword(s):  
Randomized Clinical Trials ◽  
Behavioural Therapy ◽  
Drop Out ◽  
Interpersonal Therapy ◽  
Problem Solving Therapy ◽  
Cognitive Behavioural ◽  
Treatment Of Depression ◽  
Personalised Treatment ◽  
Meta Analyses ◽  
And Control

In the past several decades, increasing evidence supports the efficacy of psychotherapies for depression. The vast majority of findings from meta-analyses, randomized clinical trials (RCTs) and naturalistic studies have demonstrated that well-established psychotherapies (behavioural activation, problem-solving therapy, psychodynamic therapy, cognitive-behavioural therapy, interpersonal therapy and emotion-focused therapy) are superior to no-treatment and control conditions, and are in most cases equally effective in treating depression. However, despite this abundant support for psychotherapies, studies have also consistently shown high drop-out rates, high percentages of non-respondent patients who experience treatment failures, and mixed findings regarding the enduring effects of psychotherapy. Thus, there is a need to develop more personalised treatment models tailored to patients’ needs. A new integrative sequential stepwise approach to the treatment of depression is suggested.

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