Critical Decision Points for Augmenting Interpersonal Psychotherapy for Depressed Adolescents: A Pilot Sequential Multiple Assignment Randomized Trial.
Critical Decision Points for Augmenting Interpersonal Psychotherapy for Depressed Adolescents: A Pilot Sequential Multiple Assignment Randomized Trial.
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DOI：
10.1016/j.jaac.2018.06.032
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发表时间：
2019-01
影响因子：
13.3
通讯作者：
Vock D
中科院分区：
文献类型：
--
作者：
Gunlicks-Stoessel M;Mufson L;Bernstein G;Westervelt A;Reigstad K;Klimes-Dougan B;Cullen K;Murray A;Vock D
实践参数建议在治疗过程中对抑郁症症状进行系统评估，以告知治疗计划;然而，目前还没有关于如何使用症状监测来指导心理治疗决策的指南。本研究比较了两个时间点（第4周和第8周）评估抑郁症青少年人际心理治疗（IPT-A）期间的症状，并探讨了四种使用症状评估来选择后续治疗的算法。40名被诊断患有抑郁症的青少年（12-17岁）开始接受IPT-A，最初的治疗计划是在16周内进行12次治疗。青少年被随机分配到第4周或第8周的决定点，以考虑改变治疗。在任一时间点的应答不足者被第二次随机分配至增加IPT-A频率（每周两次）或添加氟西汀。在基线和第4、8、12和16周进行测量。第4周的决策点，评估反应和实施治疗不足的反应者增强更有效地减少抑郁症状比第8周的决策点。算法在抑郁和心理社会功能结果方面存在显著差异。实施IPT-A的治疗师应定期监测抑郁症状，并考虑早在治疗第4周就对反应不足者进行强化治疗。青少年抑郁症的适应性治疗策略。https://clinicaltrials.gov; NCT02017535.
Practice parameters recommend systematic assessment of depression symptoms over the course of treatment to inform treatment planning; however, there are currently no guidelines regarding how to use symptom monitoring to guide treatment decisions for psychotherapy. The current study compared two time points (week 4 and week 8) for assessing symptoms during interpersonal psychotherapy for depressed adolescents (IPT-A) and explored four algorithms that use the symptom assessments to select the subsequent treatment. Forty adolescents (aged 12–17 years) with a depression diagnosis began IPT-A with an initial treatment plan of 12 sessions delivered over 16 weeks. Adolescents were randomized to a week 4 or week 8 decision point for considering a change in treatment. Insufficient responders at either time point were randomized a second time to increased frequency of IPT-A (twice per week) or addition of fluoxetine. Measures were administered at baseline and weeks 4, 8, 12, and 16. The week 4 decision point for assessing response and implementing treatment augmentation for insufficient responders was more efficacious for reducing depression symptoms than the week 8 decision point. There were significant differences between algorithms in depression and psychosocial functioning outcomes. Therapists implementing IPT-A should routinely monitor depression symptoms and consider augmenting treatment for insufficient responders as early as week 4 of treatment. An Adaptive Treatment Strategy for Adolescent Depression. https://clinicaltrials.gov; NCT02017535.
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影响因子：
7.4
作者：
Gunlicks-Stoessel, Meredith;Mufson, Laura
通讯作者：
Mufson, Laura
影响因子：
3.7
作者：
LEWINSOHN, PM;CLARKE, GN;ANDREWS, J
通讯作者：
ANDREWS, J
DOI：
10.1191/1740774s04cn002oa
发表时间：
2004-02-01
期刊：
Clinical trials (London, England)
影响因子：
--
作者：
Lavori, Philip W;Dawson, Ree
通讯作者：
Dawson, Ree
影响因子：
--
作者：
DeRubeis, RJ;Hollon, SD;Gallop, R
通讯作者：
Gallop, R
DOI：
10.1097/01.chi.0000240838.78984.e2
发表时间：
2006-12-01
影响因子：
13.3
作者：
Curry, John;Rohde, Paul;March, John
通讯作者：
March, John