Efficacy and acceptability of interpersonal psychotherapy for depression in adolescents: A meta-analysis of randomized controlled trials

Pu, Juncai; Zhou, Xinyu; Liu, Lanxiang; Zhang, Yuqing; Yang, Lining; Yuan, Shuai; Zhang, Hanpin; Han, Yu; Zou, Dezhi; Xie, Peng

doi:10.1016/j.psychres.2017.03.023

Cited by 45 publications

(36 citation statements)

References 53 publications

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“…In these studies a variety of formats was used including conjoint family sessions (e.g. attachment‐based family therapy (Diamond et al ., )); child‐focused CBT (Klein et al ., ) or interpersonal therapy (Pu et al ., ) sessions combined with some family or parent sessions; and concurrent group‐based parent and child training sessions (e.g. the Adolescent Coping with Depression programme (Rhode, )).…”

Section: Emotional Problemsmentioning

confidence: 99%

Family therapy and systemic interventions for child‐focused problems: the current evidence base

Carr

2018

Journal of Family Therapy

209

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This review updates previous similar papers published in JFT in 2000, 2009 and 2014. It presents evidence from meta‐analyses, systematic literature reviews, narrative literature reviews and controlled trials for the effectiveness of systemic interventions for families of children and adolescents with common mental health problems and other difficulties. In this context, systemic interventions include both family therapy and other family‐based approaches such as parent training, or parent implemented behavioural programmes. The evidence supports the effectiveness of systemic interventions either alone or as part of multimodal programmes for sleep, feeding and attachment problems in infancy; recovery from child abuse and neglect; conduct problems, emotional problems, eating disorders, somatic problems, and first episode psychosis.

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Section: Emotional Problemsmentioning

confidence: 99%

Family therapy and systemic interventions for child‐focused problems: the current evidence base

Carr

2018

Journal of Family Therapy

209

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“…Variations of cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) have been most widely researched and identified as empirically supported psychotherapy approaches to treat adolescents with depression (7). With the accumulation of empirical data from randomized controlled trials (RCT) over the past decades, several meta-analyses on treatment of adolescents with depression suggest CBT and IPT to be efficacious treatments with moderate effect sizes (8)(9)(10)(11)(12)(13)(14). CBT and IPT are efficacious for adolescents with MDD when adequately implemented, but response rates are moderate (around 60 % in clinical trials) and a substantial proportion of adolescents fail to remit (15).…”

Section: Treatment Of Depression In Adolescentsmentioning

confidence: 99%

“…Intraclass coffefficient (ICC) for GRID-HAMD scores was .89 based on a two-way mixed consistency, average measures ICC. GRID-HAMD scores are classified as no depression (0-7); mild depression (8)(9)(10)(11)(12)(13)(14)(15)(16); moderate depression (17-23); and severe depression (>24) (31). Clinical response is defined as improvement in GRID-HAMD total score by ≥ 50% from baseline and remission from depression as GRID-HAMD score <5.…”

Section: Assessmentsmentioning

confidence: 99%

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Efficacy of Attachment-Based Family Therapy compared to Treatment as Usual for Depressed Adolescents in Community Mental Health Clinics

Waraan¹,

Rognli²,

Czajkowski³

et al. 2020

Preprint

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Background: Major Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent's quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship.Objective: To study the efficacy of ABFT compared with Treatment as Usual (TAU) delivered within child-and adolescent mental health services (CAMHS) to adolescents with MDD.Method: Sixty adolescents, aged 13-18 years, with MDD referred to two CAMHS were randomized to receive 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were clinician-rated (Hamilton Depression Scale, HAMD) and self-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms assessed at baseline and post-treatment by blinded evaluators for HAMD and at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks for BDI-II. Analyses were performed according to intent-to-treat principles.Results: At post-treatment, clinician-rated remission rates on the HAMD (5 % in ABFT and 3.33% in TAU, p =1, OR=1.54, Fisher's exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups (X 2 [2, N = 60] =0.06 , p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority of adolescents were still in the clinical range after 16 weeks of treatment. Treatment of Depression in AdolescentsConclusion: In this sample of adolescents treated for MDD in community mental health clinics, ABFT was not associated with more favorable outcomes than TAU in terms of remission rates on clinician rated and self-reported depressive symptoms. Remission and response rates were low in both groups, suggesting a need for continued improvement of the treatment methods.Trial Registration:Clinicaltrials.gov identifier: NCT01830088

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“…A key limitation of this review is that one‐quarter of all the included IPT RCTs, and all IPT studies used to explore follow‐up, were based on the preventative IPT‐AST model (Young et al., , ), which explicitly excludes young people who meet diagnostic threshold for depression. This limitation was replicated in a recent meta‐analysis investigating the efficacy of IPT for adolescents (Pu et al., ) that concluded that IPT was significantly more effective than control conditions in reducing depressive symptoms at post‐treatment and follow‐up, and had superior acceptability, based on all‐cause discontinuation. However, the inclusion of preventative work and the exclusion of key RCTs comparing different formats of IPT‐A (e.g.…”

Section: Introductionmentioning

confidence: 99%

Review: The effectiveness of interpersonal psychotherapy for adolescents with depression – a systematic review and meta‐analysis

Duffy

Sharpe

Schwannauer

2019

Child Adoles Ment Health

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Background Interpersonal psychotherapy for adolescents (IPT‐A) is a manualised, time‐limited intervention for young people with depression. This systematic review aimed to determine the effectiveness of IPT‐A for treating adolescent depression. Method A systematic search of relevant electronic databases and study reference lists was conducted. Any study investigating the effectiveness of IPT‐A in 12‐ to 20‐year‐olds with a depressive disorder was eligible. Synthesis was via narrative summary and meta‐analysis. Results Twenty studies were identified (10 randomised trials and 10 open trials/case studies), many of which had small sample sizes and were of varying quality. Following IPT‐A, participants experienced large improvements in depression symptoms (d = −1.48, p < .0001, k = 17), interpersonal difficulties with a medium effect (d = −0.68, p < .001, k = 8) and in general functioning with a very large effect (d = 2.85, p < .001, k = 8). When compared against control interventions, IPT‐A was more effective than non‐CBT active controls in reducing depression symptoms (d = −0.64, p < .001, k = 5) and was no different from CBT (d = 0.05, p = .88, k = 2). There was no difference between IPT‐A and active control interventions in reducing interpersonal difficulties (d = −0.26, p = .25, k = 5). Conclusions Interpersonal psychotherapy for adolescents is an effective intervention for adolescent depression, improving a range of relevant outcomes. IPT‐A is consistently superior to less structured interventions and performs similarly to CBT. However, these conclusions are cautious, as they are based on a small number of controlled studies, with minor adaptations to the standard IPT‐A protocol, and/or were conducted by the intervention developers. Further robust RCTs are therefore required. The lack of superiority in IPT‐A for improving interpersonal difficulties highlights a need for studies to explore the underpinning mechanisms of change.

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Efficacy and acceptability of interpersonal psychotherapy for depression in adolescents: A meta-analysis of randomized controlled trials

Cited by 45 publications

References 53 publications

Family therapy and systemic interventions for child‐focused problems: the current evidence base

Family therapy and systemic interventions for child‐focused problems: the current evidence base

Efficacy of Attachment-Based Family Therapy compared to Treatment as Usual for Depressed Adolescents in Community Mental Health Clinics

Review: The effectiveness of interpersonal psychotherapy for adolescents with depression – a systematic review and meta‐analysis

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