Psychological treatment of depression in children and adolescents

Harrington, Richard; Whittaker, Jane; Shoebridge, Philip

doi:10.1192/bjp.173.4.291

Cited by 106 publications

(63 citation statements)

References 59 publications

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“…Although few studies have examined the efficacy of treatments for adolescent suicidality, a handful of recent reports have demonstrated the benefit of structured psychotherapeutic interventions for adolescent depression (Brent et al, 1997;Harrington, Whittaker, & Shoebridge, 1998). The findings from the present study are similar to those of Renaud et al (1998), who found only one positive result in response to a family-focused cognitivebehavioral therapy for depression (an intervention very similar to the treatment used in this study): symptoms of depression remitted more quickly for youth in the intervention condition compared with those in the control condition.…”

Section: Discussionmentioning

confidence: 99%

The 18-month impact of an emergency room intervention for adolescent female suicide attempters.

Rotheram‐Borus¹,

Piacentini²,

Cantwell³

et al. 2000

Journal of Consulting and Clinical Psychology

161

170

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Following a suicide attempt by female adolescents, the impact of a specialized emergency room (ER) care intervention was evaluated over the subsequent 18 months. Using a quasi-experimental design, this study assigned 140 female adolescent suicide attempters (SA), ages 12-18 years, and their mothers (88% Hispanic) to receive during their ER visit either: (a) specialized ER care aimed at enhancing adherence to outpatient therapy by providing a soap opera video regarding suicidality, a family therapy session, and staff training; or (b) standard ER care. The adjustment of the SA and their mothers was evaluated over 18 months (follow-up, 92%) using linear mixed model regression analyses. SA's adjustment improved over time on most mental health indices. Rates of suicide reattempts (12.4%) and suicidal reideation (29.8%) were lower than anticipated and similar across ER conditions. The specialized ER care condition was associated with significantly lower depression scores by the SA and lower maternal ratings on family cohesion. Significant interactions of intervention condition with the SA's initial level of psychiatric symptomatology indicated that the intervention's impact was greatest on maternal emotional distress and family cohesion among SA who were highly symptomatic. SA's attendance at therapy sessions following the ER visit was significantly associated with only one outcome-family adaptability. Specialized ER interventions may have substantial and sustained impact over time, particularly for the parents of youth with high psychiatric symptomatology. Adolescent suicide attempts are a significant problem, with 7.7% of high school students reporting attempts and 2.6% saying their attempt required medical attention (Centers for Disease Control and Prevention [CDC], 1998). Adolescent suicide attempters (SA) are at increased risk for repeat attempts, long-term psychiatric symptoms, and academic, social, and behavioral problems (Shaffer & Piacentini, 1994). In spite of their great need for mental health intervention, fewer than 50% of adolescent attempters are referred for psychotherapy following their emergency room (ER) visit (Piacentini et al., 1995; Spirito, Brown, Overholser, & Fritz, 1989), and a large proportion of these individuals fail to attend their initial treatment session. Of those who do attend, many do not complete treatment (Piacentini et al., 1995; Spirito et al., 1989). Nonattendance to follow-up treatment by suicidal adolescents is especially disturbing, considering that psychiatric intervention can reduce subsequent attempts and social maladjustment (Rotheram-Borus, Piacentini, Miller, Graae, & Castro-Bianco, 1994; Shaffer & Piacentini, 1994). There are many reasons why individuals fail to attend treatment following an ER visit for a suicide attempt. Repetitive evaluations, lengthy waiting periods, bureaucratic registration procedures, and

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Section: Discussionmentioning

confidence: 99%

The 18-month impact of an emergency room intervention for adolescent female suicide attempters.

Rotheram‐Borus¹,

Piacentini²,

Cantwell³

et al. 2000

Journal of Consulting and Clinical Psychology

161

170

View full text Add to dashboard Cite

show abstract

“…This 'therapeutic identification' of depressive symptoms was constructed from cognitive-behavioural and interpersonal psychotherapeutic techniques known to be effective in treating young persons attending psychiatric services, 21,22 and from the NICE guidelines. 16 The techniques were framed around standardised International Classification of Diseases (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV diagnostic criteria for depressive disorder.…”

Section: Resultsmentioning

confidence: 99%

Therapeutic identification of depression in young people: lessons fromthe introduction of a new technique in general practice

Iliffe¹,

Gallant²,

Kramer³

et al. 2012

Br J Gen Pract

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BackgroundMild-to-moderate depression in young people is associated with impaired social functioning and high rates of affective disorder in adult life. Earlier recognition of depression in young people has the potential to reduce the burden of depression in adulthood. However, depression in teenagers is underdiagnosed and undertreated. AimTo assess the usability and usefulness of a cognitive-behavioural-therapy-based technique for Therapeutic Identification of Depression in Young people (TIDY). Design and settingA qualitative study of four group practices in northwest London. MethodFace-to-face semi-structured interviews were conducted with practitioners who had been trained in the use of the TIDY technique. ResultsTwenty-five GPs and six nurses were interviewed. The key themes that emerged from the interviews were: practitioners were 'making sense of teenage depression' when interpreting signs and symptoms; the training in the technique was variable in its impact on practitioners' attitudes and practice; and time factors constrained practitioners in the application of the technique. ConclusionThe TIDY technique is usable in routine practice, but only if practitioners are allowed to use it selectively. This need for selectivity arises partly from concerns about time management, and partly to avoid medicalisation of psychological distress in young people. The perceived usefulness of the TIDY technique depends on the practitioner's prior knowledge, experience, and awareness. . 16 They specifically recommend that primary care professionals should be trained in the detection of depression but there has been little systematic study of how this can be achieved.There are two problems that must be overcome if the NICE guidelines are to be implemented. First, young people with psychological morbidity are difficult to engage in psychological therapies, 17 although such therapies appear to be effective in reducing symptoms and case prevalence. 18 Second, specialist child and young people's mental health services are already struggling to meet the demand for services. It is therefore important that specialist services are focused on those with the more severe disorder.Improved skills in primary care would improve identification of those with severe depression requiring referral, and facilitate intervention for mild-to-moderate depressive disorders within the primary care setting, thus broadening access to treatment for many young people. While there is at least one suitable and valid screening instrument for detecting depression in young people in primary care, 19 there is no solution to the problem of engaging young people in therapy.An approach that supports GPs in both identifying hidden psychological morbidity and engaging young persons in therapy ('therapeutic identification') in an opportunistic way during routine consultations would fit the NICE proposals.Such an intervention has been developed in a joint project between specialists in adolescent psychiatry and GPs, 20 and consists of a workplace-based trai...

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“…Esses tratamentos são particularmente eficazes para adolescentes (Harrington et al, 1998). Uma revisão sistemática de seis EACs de TCC relatou que essa modalidade é tratamento eficaz para os sintomas depressivos e para transtornos depressivos leves, mas não os graves (Harrington et al, 1998).…”

Section: Tratamento De Fase Aguda Para Crianças E Adolescentes Com Tdmunclassified

Diretrizes da World Federation of Societies of Biological Psychiatry (WFSBP) para tratamento biológico de transtornos depressivos unipolares, 1ª parte: tratamento agudo e de continuação do transtorno depressivo maior

Bauer¹,

Whybrow²,

Angst³

et al. 2009

Rev. psiquiatr. clín.

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Psychological treatment of depression in children and adolescents

Abstract: Studies comparing psychological treatments and medication are now required.

Cited by 106 publications

References 59 publications

The 18-month impact of an emergency room intervention for adolescent female suicide attempters.

The 18-month impact of an emergency room intervention for adolescent female suicide attempters.

Therapeutic identification of depression in young people: lessons fromthe introduction of a new technique in general practice

Diretrizes da World Federation of Societies of Biological Psychiatry (WFSBP) para tratamento biológico de transtornos depressivos unipolares, 1ª parte: tratamento agudo e de continuação do transtorno depressivo maior

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