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Critical Decision Points for Augmenting Interpersonal Psychotherapy for Depressed Adolescents: A Pilot Sequential Multiple Assignment Randomized Trial.
- Source :
-
Journal of the American Academy of Child & Adolescent Psychiatry . Jan2019, Vol. 58 Issue 1, p80-91. 12p. - Publication Year :
- 2019
-
Abstract
- <bold>Objective: </bold>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.<bold>Method: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>Therapists implementing IPT-A should routinely monitor depression symptoms and consider augmenting treatment for insufficient responders as early as week 4 of treatment.<bold>Clinical Trial Registration Information: </bold>An Adaptive Treatment Strategy for Adolescent Depression. https://clinicaltrials.gov; NCT02017535. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 08908567
- Volume :
- 58
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 133622481
- Full Text :
- https://doi.org/10.1016/j.jaac.2018.06.032