A Randomized Clinical Trial Comparing Family-Focused Treatment and Individual Supportive Therapy for Depression in Childhood and Early Adolescence - 06/10/17
, Catherine A. Sugar, PhD b, David A. Langer, PhD a, Joan R. Asarnow, PhD bAbstract |
Objective |
Despite the morbidity and negative outcomes associated with early-onset depression, few studies have examined the efficacy of psychosocial treatment for depressive disorders during childhood. Integrating family in treatment could have particularly salutary effects during this developmental period. This trial compared immediate posttreatment effects of family-focused treatment for childhood depression (FFT-CD) with those of individual supportive psychotherapy (IP) for children 7 to 14 years old with depressive disorders.
Method |
Children were randomized to 15 sessions of FFT-CD (n = 67) or IP (n = 67) over 4 months. The primary treatment outcome was adequate clinical depression response, defined as at least a 50% decrease in score on the Children’s Depression Rating Scale–Revised (CDRS-R). Additional outcomes included patient-centered outcomes (parent- and child-reported treatment satisfaction), remission (defined as CDRS-R score ≤28), change in continuous CDRS-R score, and change in child and parent reports of depressive and non-depressive symptoms and social adjustment.
Results |
Significant improvement was evident across groups for depressive and non-depressive symptoms, global response, and functioning and social adjustment. Compared with children randomized to IP, children randomized to FFT-CD showed higher rates of adequate clinical depression response (77.7% versus 59.9%; number needed to treat = 5.72; odds ratio 2.29; 95% CI 1.001–5.247; t = 1.97, p = .0498). Across treatments, families reported high satisfaction; compared with IP families, FFT-CD families reported greater knowledge and skills for managing depression. There were no significant differences between treatment arms on secondary outcomes.
Conclusion |
Results support the value of psychosocial intervention, emphasize the important role that families play, and highlight the potential for FFT-CD for supporting recovery in children with depression.
Clinical trial registration information—Systems of Support Study for Childhood Depression; clinicaltrials.gov; NCT01159041.
Le texte complet de cet article est disponible en PDF.Key words : childhood depression treatment, family-focused therapy, intervention, psychoeducation
Plan
| This article is discussed in an editorial by Dr. Laura J. Dietz on page 464. |
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| This work was supported by grants from the National Institute of Mental Health (NIMH; MH082861, principal investigator Martha C. Tompson, PhD; MH082856, principal investigator Joan R Asarnow, PhD). |
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| Dr. Sugar served as the statistical expert for this research. |
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| Disclosure: Dr. Tompson has received research support from the NIMH, the Patient Centered Outcomes Research Institute, and the Smith Family Foundation; book royalties from Guilford Press and BVT Publishing; and honoraria from the American Psychological Association (APA). Dr. Sugar has received research support from the National Institutes of Health (NIH) through multiple divisions including the NIMH, the National Institute of General Medical Sciences, the National Institute of Child Health and Human Development, the National Institute of Allergy and Infectious Diseases, and the National Institute of Diabetes and Digestive and Kidney Diseases; the Health Resources and Services Administration; the U.S. Department of Veterans Affairs; and the John Templeton Foundation. She has served on technical experts panels for the Centers for Medicare and Medicaid Services and Data Safety and Monitoring Boards for academic institutions and Kaiser Permanente. Dr. Langer has received research support from the NIMH and honoraria from the Society for Clinical Child and Adolescent Psychology (Division 53 of the APA). Dr. Asarnow has received grant or research support from the NIMH, the American Foundation for Suicide Prevention, the APA Committee on Division/APA Relations, and the Society of Clinical Child and Adolescent Psychology (Division 53 of the APA). She has served as a consultant on quality improvement interventions for depression and suicidal and self-harm behavior. |
Vol 56 - N° 6
P. 515-523 - juin 2017 Retour au numéro
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