Affect-Focused Psychodynamic Internet-Based Therapy for Adolescent Depression : Randomized Controlled Trial
(2020) In Journal of Medical Internet Research 22(3).- Abstract
BACKGROUND: Adolescent depression is one of the largest health issues in the world and there is a pressing need for effective and accessible treatments. OBJECTIVE: This trial examines whether affect-focused internet-based psychodynamic therapy (IPDT) with therapist support is more effective than an internet-based supportive control condition on reducing depression in adolescents. METHODS: The trial included 76 adolescents (61/76, 80% female; mean age 16.6 years), self-referred via an open access website and fulfilling criteria for major depressive disorder. Adolescents were randomized to 8 weeks of IPDT (38/76, 50%) or supportive control (38/76, 50%). The primary outcome was self-reported depressive symptoms, measured with the Quick... (More)
BACKGROUND: Adolescent depression is one of the largest health issues in the world and there is a pressing need for effective and accessible treatments. OBJECTIVE: This trial examines whether affect-focused internet-based psychodynamic therapy (IPDT) with therapist support is more effective than an internet-based supportive control condition on reducing depression in adolescents. METHODS: The trial included 76 adolescents (61/76, 80% female; mean age 16.6 years), self-referred via an open access website and fulfilling criteria for major depressive disorder. Adolescents were randomized to 8 weeks of IPDT (38/76, 50%) or supportive control (38/76, 50%). The primary outcome was self-reported depressive symptoms, measured with the Quick Inventory of Depressive Symptomatology for Adolescents (QIDS-A17-SR). Secondary outcomes were anxiety severity, emotion regulation, self-compassion, and an additional depression measure. Assessments were made at baseline, postassessment, and at 6 months follow-up, in addition to weekly assessments of the primary outcome measure as well as emotion regulation during treatment. RESULTS: IPDT was significantly more effective than the control condition in reducing depression (d=0.82, P=.01), the result of which was corroborated by the second depression measure (d=0.80, P<.001). IPDT was also significantly more effective in reducing anxiety (d=0.78, P<.001) and increasing emotion regulation (d=0.97, P<.001) and self-compassion (d=0.65, P=.003). Significantly more patients in the IPDT group compared to the control group met criteria for response (56% vs 21%, respectively) and remission (35% vs 8%, respectively). Results on depression and anxiety symptoms were stable at 6 months follow-up. On average, participants completed 5.8 (SD 2.4) of the 8 modules. CONCLUSIONS: IPDT may be an effective intervention to reduce adolescent depression. Further research is needed, including comparisons with other treatments.
(Less)
- author
- organization
- publishing date
- 2020-03-30
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- adolescents, depressive disorder, internet-based treatment, mobile phone, psychodynamic, treatment outcome
- in
- Journal of Medical Internet Research
- volume
- 22
- issue
- 3
- article number
- e18047
- publisher
- JMIR Publications Inc.
- external identifiers
-
- pmid:32224489
- scopus:85082597897
- ISSN
- 1438-8871
- DOI
- 10.2196/18047
- language
- English
- LU publication?
- yes
- id
- c0d69628-711a-4a03-97ee-b9a177d8ee63
- date added to LUP
- 2020-04-17 17:01:33
- date last changed
- 2024-02-16 13:18:06
@article{c0d69628-711a-4a03-97ee-b9a177d8ee63,
abstract = {{<p>BACKGROUND: Adolescent depression is one of the largest health issues in the world and there is a pressing need for effective and accessible treatments. OBJECTIVE: This trial examines whether affect-focused internet-based psychodynamic therapy (IPDT) with therapist support is more effective than an internet-based supportive control condition on reducing depression in adolescents. METHODS: The trial included 76 adolescents (61/76, 80% female; mean age 16.6 years), self-referred via an open access website and fulfilling criteria for major depressive disorder. Adolescents were randomized to 8 weeks of IPDT (38/76, 50%) or supportive control (38/76, 50%). The primary outcome was self-reported depressive symptoms, measured with the Quick Inventory of Depressive Symptomatology for Adolescents (QIDS-A17-SR). Secondary outcomes were anxiety severity, emotion regulation, self-compassion, and an additional depression measure. Assessments were made at baseline, postassessment, and at 6 months follow-up, in addition to weekly assessments of the primary outcome measure as well as emotion regulation during treatment. RESULTS: IPDT was significantly more effective than the control condition in reducing depression (d=0.82, P=.01), the result of which was corroborated by the second depression measure (d=0.80, P<.001). IPDT was also significantly more effective in reducing anxiety (d=0.78, P<.001) and increasing emotion regulation (d=0.97, P<.001) and self-compassion (d=0.65, P=.003). Significantly more patients in the IPDT group compared to the control group met criteria for response (56% vs 21%, respectively) and remission (35% vs 8%, respectively). Results on depression and anxiety symptoms were stable at 6 months follow-up. On average, participants completed 5.8 (SD 2.4) of the 8 modules. CONCLUSIONS: IPDT may be an effective intervention to reduce adolescent depression. Further research is needed, including comparisons with other treatments. </p>}},
author = {{Lindqvist, Karin and Mechler, Jakob and Carlbring, Per and Lilliengren, Peter and Falkenström, Fredrik and Andersson, Gerhard and Johansson, Robert and Edbrooke-Childs, Julian and Dahl, Hanne Sofie J. and Lindert Bergsten, Katja and Midgley, Nick and Sandell, Rolf and Thorén, Agneta and Topooco, Naira and Ulberg, Randi and Philips, Björn}},
issn = {{1438-8871}},
keywords = {{adolescents; depressive disorder; internet-based treatment; mobile phone; psychodynamic; treatment outcome}},
language = {{eng}},
month = {{03}},
number = {{3}},
publisher = {{JMIR Publications Inc.}},
series = {{Journal of Medical Internet Research}},
title = {{Affect-Focused Psychodynamic Internet-Based Therapy for Adolescent Depression : Randomized Controlled Trial}},
url = {{http://dx.doi.org/10.2196/18047}},
doi = {{10.2196/18047}},
volume = {{22}},
year = {{2020}},
}