Predictors of outcome after a time-limited psychosocial intervention for adolescent depression

Parhiala, Pauliina; Marttunen, Mauri; Gergov, Vera; Torppa, Minna; Ranta, Klaus

doi:10.3389/fpsyg.2022.955261

Cited by 3 publications

References 78 publications

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Psychobiologische Einflussfaktoren für den Schweregrad einer Depression bei jungen Mädchen

Laessle

2024

Zeitschrift für Klinische Psychologie und Psychotherapie

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Zusammenfassung: Hintergrund: Depressionen bereits bei Kindern und Jugendlichen kommen häufig vor. Es besteht ein dringender Bedarf zur Aufklärung von Faktoren, die die Entstehung und Aufrechterhaltung der Störung beeinflussen. Stress und Stressverarbeitung sind aufgrund der vorliegenden Literatur bedeutsam beteiligt. Ergebnisse: Die psychische Stressbelastung führt zu einer Verstärkung der Depression. Dies gilt auch für die mangelnde Suche nach sozialer Unterstützung und aggressive sowie resignative Stressbewältigungsstrategien. Unabhängig von diesen Faktoren spielt auch die Hyperaktivität der HNA-Achse eine Rolle. Schlussfolgerung: Die Ergebnisse passen zum kognitiven Modell von Beck, wenn auch die Hyperaktivität der HNA-Achse berücksichtigt wird.

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Psychobiologische Einflussfaktoren für den Schweregrad einer Depression bei jungen Mädchen

Laessle

2024

Zeitschrift für Klinische Psychologie und Psychotherapie

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Comorbid anxiety, loneliness, and chronic pain as predictors of intervention outcomes for subclinical depressive symptoms in older adults: evidence from a large community-based study in Hong Kong

Wong,

Leung,

Liu

et al. 2024

BMC Psychiatry

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Background Depression is among the leading causes of the global burden of disease and is associated with substantial morbidity in old age. The importance of providing timely intervention, particularly those with subclinical symptoms, has thus increasingly been emphasised. Despite their overall effectiveness, a small but notable subgroup tends to be less responsive to interventions. Identifying predictors of non-remission and non-response is critical to inform future strategies for optimising intervention outcomes. Methods A total of 4153 older adults aged 60 years and above with subclinical depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] = 5–19) were recruited from JC JoyAge, a large-scale collaborative stepped-care intervention service across Hong Kong. A wide range of clinical and modifiable risk and protective factors at baseline were assessed, including depressive symptoms, anxiety symptoms, loneliness, suicidal ideation, cognitive capacity, multimorbidity, chronic pain, need for informal care due to mental health reasons, history of abuse, and sociodemographic characteristics. Separate multivariable logistic regression models were applied to identify predictors of non-remission (PHQ-9 ≥ 5) and non-response (< 50% reduction in PHQ-9) following intervention. Results The rates of non-remission and non-response were 18.9% (n = 784) and 23.0% (n = 956), respectively. Comorbid anxiety symptoms (adjusted odds ratio [aOR] = 2.08, CI = 1.72–2.51; 1.28, 1.05–1.57), loneliness (2.00, 1.66–2.42; 1.67, 1.38–2.01), need for informal care (1.86, 1.49–2.33; 1.48, 1.18–1.85), lower cognitive capacity (0.95, 0.93–0.97; 0.94, 0.92–0.96), and absence of chronic pain (0.59, 0.48–0.72; 0.76, 0.64–0.91) predicted both non-remission and non-response. Meanwhile, moderate-to-severe depressive symptoms predicted higher odds of non-remission (1.41, 1.18–1.69) and lower odds of non-response (0.28, 0.23–0.34), respectively. Subgroup analyses conducted separately in older adults with mild and moderate-to-severe depressive symptoms at baseline revealed that comorbid anxiety, loneliness, need for informal care, and absence of chronic pain were consistent predictors of non-remission. Those with non-remission and non-response showed more depression-related functional impairments and poorer health-related quality of life post-intervention. Conclusions Older adults with subclinical depressive symptoms showing comorbid anxiety, higher loneliness, need for informal care, and chronic pain may be offered more targeted interventions in future services. A personalised risk-stratification approach may be helpful. Trial registration ClinicalTrials.gov identifiers: NCT03593889 (registered 29 May 2018), NCT04863300 (registered 23 April 2021).

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Adolescent depression treatment pathways in Primary Care – protocol for a longitudinal Cohort Study Describing Naturalistic Flow of Treatment and Evaluating Effectiveness and Cost- effectiveness of Interpersonal Counseling Compared to Treatment as Usual

Linnaranta,

Myllyniemi,

Salusjärvi

et al. 2024

Preprint

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Background:Implementation of evidence-based interventions is one of the proposed responses to increased demand for treatment of adolescent depression. While the efficacy of interpersonal psychotherapy to treat depression of adolescents (IPT-A) is well established, the effectiveness and cost-effectiveness of the shorter adolescent interpersonal counseling (IPC-A) remains open. Objective: We present a protocol for a prospective evaluation of the naturalistic treatment flow of adolescents with sustained depression, and effectiveness and cost-effectiveness of IPC-A, as compared to treatment as usual or no treatment of sustained depression. Methods: We will collect a prospective cohort of grade 7 to 9 adolescents (13–16-year-olds) in selected Finnish schools using convenience sampling (n=9000). We will compare three groups as defined at 6 months (targeting with IPC-A, n=100; with treatment as usual (TAU), n=200; or no treatment, n=100). The primary outcome measure will be the proportion of adolescents who received specialized psychiatric services by 2 years after baseline. Secondary outcome measures will include longitudinal changes in PHQ-9-A scores by 12 months, positive mental health, social inclusion, and quality of life. Cost-effectiveness will be evaluated using survey data at 12 months, and an economic evaluation using register data and information on service use 12 months before and up to 10 years after baseline. A universal evaluation of all adolescents, independent of mood, will provide prospective description of adolescents a) with sustained depression over the follow-up period (Patient Health Questionnaire 9 items, adolescent version, PHQ-9-A ≥ 10 in two measurements over 6 months), b) with a self-reported need and motivation for support, c) with therapeutic intervention, and d) benefits and harms of treatment. We will describe the treatment received and predictors of treatment and outcome based on reports from adolescents, caretakers, and therapists, as well as electronic patient records. Impact of training in IPC-A on competence and access to treatment will be evaluated. Conclusions: The study will describe need for, pathways to, and content of mental health services for depressed adolescents. The results can improve detection and equal access to care, and inform decision -makers about the best practices for prevention, including utility of the implementation of IPC-A. Trial registration: ClinicalTrials.com NCT06390462 registered 2024-03-19

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Predictors of outcome after a time-limited psychosocial intervention for adolescent depression

Cited by 3 publications

References 78 publications

Psychobiologische Einflussfaktoren für den Schweregrad einer Depression bei jungen Mädchen

Psychobiologische Einflussfaktoren für den Schweregrad einer Depression bei jungen Mädchen

Comorbid anxiety, loneliness, and chronic pain as predictors of intervention outcomes for subclinical depressive symptoms in older adults: evidence from a large community-based study in Hong Kong

Adolescent depression treatment pathways in Primary Care – protocol for a longitudinal Cohort Study Describing Naturalistic Flow of Treatment and Evaluating Effectiveness and Cost- effectiveness of Interpersonal Counseling Compared to Treatment as Usual

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