Family-based, psychosocial intervention for depressed youth with type 1 diabetes

对患有 1 型糖尿病的抑郁青少年进行家庭社会心理干预

• 批准号: 7659241
• 负责人: KOREY K HOOD
• 金额: $ 7.5万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7659241
• 关键词: Address; Adherence; Adolescent; Behavior; Behavioral; Caregivers; Caring; Childhood; Cognitive; Conflict (Psychology); Diabetes Mellitus; Diabetic Ketoacidosis; Disease; Effectiveness; Emotional; Enrollment; Family; Glycosylated hemoglobin A; Growth; Health; Individual; Insulin-Dependent Diabetes Mellitus; Intervention; Link; Nature; Outcome; Phase; Physiological; Puberty; Randomized; Reporting; Symptoms; Testing; Time; Treatment Protocols; Youth; base; clinically significant; cognitive behavior therapy; depressed; depression; depressive symptoms; design; diabetes management; effective intervention; experience; glycemic control; high risk; improved; improved functioning; medical specialties; meetings; multidisciplinary; psychologic; psychosocial; success; treatment as usual

DESCRIPTION (provided by applicant): Despite multidisciplinary specialty care, glycemic control remains suboptimal in many pediatric diabetes centers world-wide. Adolescents with type 1 diabetes are at high risk for suboptimal control due in part to behavioral and emotional challenges. Behavioral challenges come in the form of poor adherence to the diabetes management regimen - a common problem facing adolescents with type 1 diabetes. Emotional challenges include depression, which is 2-3 times more prevalent in adolescents with type 1 diabetes than their adolescent counterparts without diabetes. Further, both poor adherence and depression are linked with problematic family functioning (e.g., family conflict) in promoting suboptimal control. Effective interventions are available, however, these family-based interventions aimed at adherence promotion and improved family functioning do not typically have targeted deployment in adolescents with clinically significant, comorbid depression. These adolescents with significant depressive symptoms may be treated with effective psychological interventions, typically cognitive-behavioral in nature, but these interventions do not always consider the context of type 1 diabetes and its associated management. Thus, there is an unmet treatment need for depressed adolescents with type 1 diabetes. To address this unmet need, this study employs a randomized, controlled design to test a new, family-based, cognitive-behavioral intervention to reduce depressive symptoms, improve family functioning, and improve adherence. The intervention is delivered in two phases (1 - reduction of depressive symptoms and family conflict, 2 - adherence promotion) as efforts to improve adherence will have a greater likelihood of success if individual and family functioning variables are addressed first. Fifty-two adolescents and their primary caregivers will be enrolled in the study. Given the absence of this type of intervention and the significance of the problem, this study is timely and important, as it has the potential to positively impact diabetes-specific health outcomes.

描述（由申请人提供）： 尽管有多学科的专业护理，血糖控制在世界各地的许多儿科糖尿病中心仍然不理想。青少年1型糖尿病患者处于次优控制的高风险中，部分原因是行为和情感挑战。行为挑战表现为对糖尿病管理方案的依从性差-这是1型糖尿病青少年面临的常见问题。情绪挑战包括抑郁症，抑郁症在1型糖尿病青少年中的发病率是非糖尿病青少年的2-3倍。此外，依从性差和抑郁症都与有问题的家庭功能有关（例如，家庭冲突）促进次优控制。有效的干预措施是可用的，然而，这些以家庭为基础的干预措施，旨在促进依从性和改善家庭功能，通常没有针对性的部署在青少年有临床意义，共病抑郁症。这些具有显著抑郁症状的青少年可以通过有效的心理干预（通常是认知行为干预）进行治疗，但这些干预并不总是考虑1型糖尿病及其相关管理的背景。因此，1型糖尿病抑郁青少年的治疗需求尚未得到满足。为了解决这一未满足的需求，本研究采用随机对照设计来测试一种新的、以家庭为基础的认知行为干预，以减少抑郁症状，改善家庭功能，并提高依从性。干预分为两个阶段（1 -减少抑郁症状和家庭冲突，2 -促进依从性），因为如果首先解决个人和家庭功能变量，提高依从性的努力将有更大的成功可能性。52名青少年及其主要照顾者将入组本研究。鉴于缺乏这种类型的干预和问题的重要性，这项研究是及时和重要的，因为它有可能对糖尿病特定的健康结果产生积极影响。