Personalized Depression Prevention: A Randomized Controlled Trial to Optimize Effects Through Risk-Informed Personalization.
Personalized Depression Prevention: A Randomized Controlled Trial to Optimize Effects Through Risk-Informed Personalization.
复制标题
个性化抑郁症预防：一项通过风险知情的个性化优化效果的随机对照试验。
DOI：
10.1016/j.jaac.2020.11.004
复制
发表时间：
2021-09
影响因子：
13.3
通讯作者：
Hankin BL
中科院分区：
文献类型：
--
作者：
Young JF;Jones JD;Gallop R;Benas JS;Schueler CM;Garber J;Hankin BL
评估是否可以通过将青少年与解决其心理社会脆弱性的干预措施相匹配来优化基于证据的抑郁症预防计划。这项随机对照试验纳入了 204 名青少年（M = 14.26 岁，SD = 1.65；56.4% 为女性）。青少年被分为抑郁症认知和人际风险高或低的两类，并随机接受认知行为计划“应对压力”(CWS) 或人际心理治疗 - 青少年技能培训(IPT-AST) 人际计划。一些参与者接受了风险与预防之间的匹配（CWS 中的高认知-低人际风险青少年，IPT-AST 中的低认知-高人际风险青少年），其他参与者接受了不匹配（例如，CWS 中的低认知-高人际风险青少年）。结果是干预后 18 个月（总共 21 个月）的抑郁症诊断和症状。从干预后到 18 个月的随访以及整个 21 个月的研究期间，匹配的青少年比不匹配的青少年抑郁症状明显减少（效果大小 [d] = 0.44，95% 置信区间 [CI] = 0.02，0.86）。与不匹配的青少年相比，匹配的青少年的抑郁症发病率没有显着差异（12.0% vs. 18.3%，t(193) = .78，p = .44）。这项研究说明了一种将抑郁症预防个性化作为精准心理健康形式的方法。研究结果表明，基于风险的个性化可能会增强“一刀切”方法之外的效果。通过个性化预防改变青少年抑郁轨迹； https://www.clinicaltrials.gov/； NCT01948167。
To evaluate whether evidence-based depression prevention programs can be optimized by matching youth to interventions that address their psychosocial vulnerabilities. This randomized controlled trial included 204 adolescents (M = 14.26 years, SD = 1.65; 56.4% female). Youth were categorized as high or low on cognitive and interpersonal risks for depression and randomized to Coping with Stress (CWS), a cognitive-behavioral program, or Interpersonal Psychotherapy – Adolescent Skills Training (IPT-AST), an interpersonal program. Some participants received a match between risk and prevention (high cognitive-low interpersonal risk teen in CWS, low cognitive-high interpersonal risk teen in IPT-AST), others received a mismatch (e.g., low cognitive-high interpersonal risk teen in CWS). Outcomes were depression diagnoses and symptoms through 18 months post-intervention (21 months total). Matched adolescents showed significantly greater decreases in depressive symptoms than mismatched adolescents from post-intervention through 18-month follow-up and across the entire 21-month study period (effect size [d] = .44, 95% confidence interval [CI] = .02, .86). There was no significant difference in rates of depressive disorders among matched adolescents as compared to mismatched adolescents (12.0% vs. 18.3%, t(193) = .78, p = .44). This study illustrates one approach to personalizing depression prevention as a form of precision mental health. Findings suggest that risk-informed personalization may enhance effects beyond a “one size fits all” approach. Bending Adolescent Depression Trajectories Through Personalized Prevention; https://www.clinicaltrials.gov/; NCT01948167.