OBJECTIVE: Practice parameters recommend systematic assessment of depression symptoms over the course of treatment to inform treatment planning; however, there are currently no guidelines regarding how to use symptom monitoring to guide treatment decisions for psychotherapy. The current study compared two time points (week 4 and week 8) for assessing symptoms during interpersonal psychotherapy for depressed adolescents (IPT-A) and explored four algorithms that use the symptom assessments to select the subsequent treatment. METHOD:Forty adolescents (aged 12-17 years) with a depression diagnosis began IPT-A with an initial treatment plan of 12 sessions delivered over 16 weeks. Adolescents were randomized to a week 4 or week 8 decision point for considering a change in treatment. Insufficient responders at either time point were randomized a second time to increased frequency of IPT-A (twice per week) or addition of fluoxetine. Measures were administered at baseline and weeks 4, 8, 12, and 16. RESULTS: The week 4 decision point for assessing response and implementing treatment augmentation for insufficient responders was more efficacious for reducing depression symptoms than the week 8 decision point. There were significant differences between algorithms in depression and psychosocial functioning outcomes. CONCLUSION: Therapists implementing IPT-A should routinely monitor depression symptoms and consider augmenting treatment for insufficient responders as early as week 4 of treatment. CLINICAL TRIAL REGISTRATION INFORMATION: An Adaptive Treatment Strategy for Adolescent Depression. https://clinicaltrials.gov; NCT02017535.
RCT Entities:
OBJECTIVE: Practice parameters recommend systematic assessment of depression symptoms over the course of treatment to inform treatment planning; however, there are currently no guidelines regarding how to use symptom monitoring to guide treatment decisions for psychotherapy. The current study compared two time points (week 4 and week 8) for assessing symptoms during interpersonal psychotherapy for depressed adolescents (IPT-A) and explored four algorithms that use the symptom assessments to select the subsequent treatment. METHOD: Forty adolescents (aged 12-17 years) with a depression diagnosis began IPT-A with an initial treatment plan of 12 sessions delivered over 16 weeks. Adolescents were randomized to a week 4 or week 8 decision point for considering a change in treatment. Insufficient responders at either time point were randomized a second time to increased frequency of IPT-A (twice per week) or addition of fluoxetine. Measures were administered at baseline and weeks 4, 8, 12, and 16. RESULTS: The week 4 decision point for assessing response and implementing treatment augmentation for insufficient responders was more efficacious for reducing depression symptoms than the week 8 decision point. There were significant differences between algorithms in depression and psychosocial functioning outcomes. CONCLUSION: Therapists implementing IPT-A should routinely monitor depression symptoms and consider augmenting treatment for insufficient responders as early as week 4 of treatment. CLINICAL TRIAL REGISTRATION INFORMATION: An Adaptive Treatment Strategy for Adolescent Depression. https://clinicaltrials.gov; NCT02017535.
Authors: Jeffrey R Strawn; Jeffrey A Mills; Vikram Suresh; Tara S Peris; John T Walkup; Paul E Croarkin Journal: J Affect Disord Date: 2021-10-31 Impact factor: 4.839
Authors: Darren B Courtney; Amy Cheung; Joanna Henderson; Kathryn Bennett; Marco Battaglia; John Strauss; Rachel Mitchell; Karen Wang; Peter Szatmari Journal: J Can Acad Child Adolesc Psychiatry Date: 2019-11-01
Authors: John F Curry; Yifrah Kaminer; David B Goldston; Grace Chan; Karen C Wells; Rebecca H Burke; Adrienne Banny Inscoe; Allison E Meyer; Shayna M Cheek Journal: J Am Acad Child Adolesc Psychiatry Date: 2021-08-06 Impact factor: 8.829
Authors: Darren B Courtney; Priya Watson; Karolin R Krause; Benjamin W C Chan; Kathryn Bennett; Meredith Gunlicks-Stoessel; Terri Rodak; Kirsten Neprily; Tabitha Zentner; Peter Szatmari Journal: JAMA Netw Open Date: 2022-02-01