David A Brent1, Giovanna Porta2, Michelle S Rozenman3, Araceli Gonzalez4, Karen T G Schwartz5, Frances L Lynch6, John F Dickerson6, Satish Iyengar7, V Robin Weersing5. 1. UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania; University of Pittsburgh School of Medicine, Pennsylvania. Electronic address: brentda@upmc.edu. 2. UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania. 3. University of Denver, Colorado. 4. California State University, Long Beach. 5. San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego. 6. Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon. 7. University of Pittsburgh, Pennsylvania.
Abstract
OBJECTIVE: To report on the 32-week outcome of the Brief Behavioral Therapy (BBT) for Pediatric Anxiety and Depression in Primary Care clinical trial. METHOD: A total of 185 youths aged 8 to 17 years with anxiety and/or depression identified through 9 pediatric primary care (PPC) settings in San Diego and Pittsburgh were randomized to receive Assisted Referral to Care (ARC) or up to 12 sessions of BBT over 16 weeks. The primary outcome was clinical response across anxiety and depression, defined as a Clinical Global Impressions-Improvement Score of ≤2. Secondary outcomes included interview-rated functioning, depression, and anxiety. Here, we report on outcomes at 32 weeks after randomization. All analyses with primary outcomes are corrected for multiple comparisons using the false discovery rate procedure. RESULTS: At 32 weeks, BBT was superior to ARC with respect to response (67.5% versus 43.1%, q = 0.03, number needed to treat [NNT] = 5) and functioning (d = 0.49, q = 0.04). BBT was superior to ARC with respect to its impact on anxiety (f = 0.21) but not depressive symptoms (f = 0.05). These findings persisted after controlling for the number of sessions received. Ethnicity moderated the impact of BBT on outcome (NNT for Hispanic youths = 2), because of a much lower response rate to ARC in Hispanic than in non-Hispanic youths (16.7% versus 49.2%, p = 0.04). CONCLUSION: BBT is a promising intervention that can be effectively delivered in PPC and may be particularly effective for Hispanic patients. Further work is indicated to improve its impact on depressive symptoms and to test BBT against other treatments delivered in pediatric primary care. CLINICAL TRIAL REGISTRATION INFORMATION: Brief Cognitive Behavioral Therapy (CBT) for Pediatric Anxiety and Depression in Primary Care; http://clinicaltrials.gov; NCT01147614.
OBJECTIVE: To report on the 32-week outcome of the Brief Behavioral Therapy (BBT) for Pediatric Anxiety and Depression in Primary Care clinical trial. METHOD: A total of 185 youths aged 8 to 17 years with anxiety and/or depression identified through 9 pediatric primary care (PPC) settings in San Diego and Pittsburgh were randomized to receive Assisted Referral to Care (ARC) or up to 12 sessions of BBT over 16 weeks. The primary outcome was clinical response across anxiety and depression, defined as a Clinical Global Impressions-Improvement Score of ≤2. Secondary outcomes included interview-rated functioning, depression, and anxiety. Here, we report on outcomes at 32 weeks after randomization. All analyses with primary outcomes are corrected for multiple comparisons using the false discovery rate procedure. RESULTS: At 32 weeks, BBT was superior to ARC with respect to response (67.5% versus 43.1%, q = 0.03, number needed to treat [NNT] = 5) and functioning (d = 0.49, q = 0.04). BBT was superior to ARC with respect to its impact on anxiety (f = 0.21) but not depressive symptoms (f = 0.05). These findings persisted after controlling for the number of sessions received. Ethnicity moderated the impact of BBT on outcome (NNT for Hispanic youths = 2), because of a much lower response rate to ARC in Hispanic than in non-Hispanic youths (16.7% versus 49.2%, p = 0.04). CONCLUSION: BBT is a promising intervention that can be effectively delivered in PPC and may be particularly effective for Hispanic patients. Further work is indicated to improve its impact on depressive symptoms and to test BBT against other treatments delivered in pediatric primary care. CLINICAL TRIAL REGISTRATION INFORMATION: Brief Cognitive Behavioral Therapy (CBT) for Pediatric Anxiety and Depression in Primary Care; http://clinicaltrials.gov; NCT01147614.
Authors: Tara S Peris; Nicole E Caporino; Sarah O'Rourke; Philip C Kendall; John T Walkup; Anne Marie Albano; R Lindsey Bergman; James T McCracken; Boris Birmaher; Golda S Ginsburg; Dara Sakolsky; John Piacentini; Scott N Compton Journal: J Am Acad Child Adolesc Psychiatry Date: 2017-10-09 Impact factor: 8.829
Authors: Sona Dimidjian; Steven D Hollon; Keith S Dobson; Karen B Schmaling; Robert J Kohlenberg; Michael E Addis; Robert Gallop; Joseph B McGlinchey; David K Markley; Jackie K Gollan; David C Atkins; David L Dunner; Neil S Jacobson Journal: J Consult Clin Psychol Date: 2006-08
Authors: Frances L Lynch; John F Dickerson; Michelle S Rozenman; Araceli Gonzalez; Karen T G Schwartz; Giovanna Porta; Maureen O'Keeffe-Rosetti; David Brent; V Robin Weersing Journal: JAMA Netw Open Date: 2021-03-01