Automated Interactive Text Messaging to Assess Adolescent Depression

描述(由申请者提供)：互联网是临床医生获取治疗培训材料和资源的日益重要的资源，提供循证治疗，如认知行为治疗(CBT)和抗抑郁药物。该项目建议开发一个安全的、基于网络的资源，为治疗师提供指导材料，以安排向治疗中的抑郁青少年发送量身定做的互动短信。可选择的短信服务(SMS)互动的内容将旨在吸引青少年参与，鼓励合规，并支持通过密码保护网站提供的各种治疗模块的临床目标。治疗师将能够审查客户对自动短信查询的回应，允许根据两次就诊之间测量的进度调整治疗计划。8名治疗师(4名来自德克萨斯西南大学，4名来自内布拉斯加大学医学院)将被要求完成为该网站开发的培训材料。他们将把短信增强的治疗模块纳入四名抑郁青少年(12-17岁)为期12周的治疗方案。治疗方案将包括每周治疗一次(总共N=32次，每个部位16次)。将在基线、6、12和24周获得基于临床医生的评分(QDS-A、CGI-S、CGI-C)和患者报告的结果(互联网K-SADS抑郁模块，QDS-A-PAT)。心理咨询中心将招募一批治疗抑郁青少年的社区治疗师，以确定接受照常治疗(TAU)的32名青少年的社区对照样本。社区控制的TAU患者也将在基线以及第6、12和24周用相同的结果测量进行评估。主要比较6周、12周和24周接受短信强化治疗的患者和接受TAU治疗的患者之间的临床结果差异。二级临床分析将检验是否在第6周症状改善更快，特别是在短信增强组，是否预示着在第24周抑郁症持续缓解。

DESCRIPTION (provided by applicant): The internet is an increasingly important resource for clinicians to access training materials and resources for treatment delivery of evidence-based treatments such as cognitive behavioral therapy (CBT) and antidepressant medications. This project proposes to develop a secure, web-based resource to provide therapists with instructional materials for scheduling tailored, interactive text messages for delivery to depressed adolescents in treatment. The content of the selectable, short message service (SMS) interactions will be designed to engage the adolescents, encourage compliance, and support clinical objectives of various treatment modules available through the password-protected website. The therapists will be able to review clients' responses to the automated SMS queries, permitting treatment plan adjustments to be based on measured progress between visits. Eight therapists (4 from the University of Texas Southwestern and 4 from University of Nebraska Medical School) will be asked to complete the training materials developed for the website. They will incorporate the SMS-augmented treatment modules into a 12-week treatment protocol for four depressed adolescents (12-17 years old). The treatment protocol will include weekly therapeutic sessions (total N = 32, 16 from each site). Clinician-based ratings (QIDS-A, CGI-S, CGI-C) and patient-reported outcomes (internet K-SADs depression module, QIDS-A-Pat) will be obtained at baseline, and at weeks 6, 12, and 24. The Center for Psychological Consultation will recruit a cohort of community-based therapists who treat depressed adolescents to identify a community-control sample of 32 adolescents receiving treatment-as-usual (TAU). The community-control TAU patients will also be assessed at baseline and weeks 6, 12, and 24 with the same outcome measures. Primary comparisons will be clinical outcome differences between the SMS- augmented treated patients and those receiving TAU at weeks 6, 12, and 24. Secondary clinical analyses will examine whether more rapid onset of symptomatic improvement at week 6, particularly in the SMS-augmented group, is predictive of sustained remission from depression at week 24.