Achievement and Maintenance of Sustained Response During the Treatment for Adolescents With Depression Study Continuation and Maintenance Therapy

Abstract

clinicaltrials.gov Identifier: NCT00006286.

The clinical effectiveness and cost-effectiveness of low-intensity psychological interventions for the secondary prevention of relapse after depression: a systematic review.

“…In the following sections, reference will be made to the primary study only; the other linked 61,66 were non-randomised with concurrent control patients. Eight of the RCTs recruited participants from multiple centres, 45,46,51,56,63,65,68,72 one of which used cluster randomisation. 56 Ongoing studies All three ongoing studies are RCTs.…”

“…61 Four studies evaluated brief therapy interventions delivered by mental health professionals to participants on an individual basis. 45,52,56,65 One such intervention 51 provided individuals with a brief CBT-based intervention (30 minutes every other week for 20 weeks) alongside ongoing pharmacotherapy. A second intervention 56 incorporated a multimodal skills-based approach, providing support materials and general practitioner (GP) training to allow tailoring of evidencebased psychosocial strategies to individual patients in Australian primary care ('Keeping The Blues Away'); this is a small pilot study for which it may be that the intervention could potentially be delivered by PWPs or equivalent but it is unclear from the detail provided what level of training is required.…”

“…A second intervention 56 incorporated a multimodal skills-based approach, providing support materials and general practitioner (GP) training to allow tailoring of evidencebased psychosocial strategies to individual patients in Australian primary care ('Keeping The Blues Away'); this is a small pilot study for which it may be that the intervention could potentially be delivered by PWPs or equivalent but it is unclear from the detail provided what level of training is required. One study 65 evaluated the effects of 'continuation CBT' (around 6 hours per patient) following initial CBT treatment in adolescents with depression. Another study 45 evaluated a 'multifaceted relapse prevention programme' for patients who were at high risk of relapse, which is described in more detail below.…”

“…45,46,51,54,61,63,64,67 Of these, seven explicitly stated that they established this outcome using SCID. 45,46,51,54,63,64,67 Elsewhere, relapse was established using other criteria [Research Diagnostic Criteria (RDC)] 52 or a variety of self-report and clinician-administered symptom scales [Beck Depression Inventory (BDI), 55,66 MontgomeryÅsberg Depression Rating Scale (MADRS), 68 Clinical Global Impression Improvement scale (CGI-I), 65 Depression Anxiety Stress Scales (DASS) 56 ].…”

“…56 The study of 'continuation CBT' in adolescents reported significant benefits of the intervention alone over both antidepressant medication treatment and combined continuation CBT/medication. 65 Katon et al Five articles reported the findings of just one study (Katon et al). 45,[57][58][59][60] Although the practitioners in this study were predominantly mental health professionals, and therefore did not strictly meet our part A inclusion criteria, it was unclear whether or not delivery by a mental health professional was mandatory for the implementation of the intervention.…”