Automated Interactive Text Messaging to Assess Adolescent Depression

描述（由申请人提供）：互联网是临床医生获取循证治疗（如认知行为治疗（CBT）和抗抑郁药物）的培训材料和资源的日益重要的资源。该项目建议开发一个安全的，基于网络的资源，为治疗师提供教学材料，用于安排量身定制的，交互式的文本信息，以交付给抑郁症青少年的治疗。可选择的短消息服务（SMS）交互的内容将被设计为吸引青少年，鼓励依从性，并支持通过密码保护的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反应，允许根据两次访问之间的测量进展调整治疗计划。 八名治疗师（4名来自德克萨斯大学西南分校，4名来自内布拉斯加大学医学院）将被要求完成为网站开发的培训材料。他们将SMS增强治疗模块纳入为期12周的治疗方案，用于4名抑郁症青少年（12-17岁）。治疗方案将包括每周一次的治疗疗程（总计N = 32，每个研究中心16例）。将在基线以及第6、12和24周获得基于临床医生的评级（QIDS-A、CGI-S、CGI-C）和患者报告的结局（互联网K-SAD抑郁模块，QIDS-A-Pat）。心理咨询中心将招募一组治疗抑郁症青少年的社区治疗师，以确定32名接受常规治疗（TAU）的青少年的社区对照样本。社区对照TAU患者也将在基线和第6、12和24周进行评估，结局指标相同。 主要比较是第6、12和24周时SMS增强治疗患者与接受TAU治疗患者之间的临床结局差异。次要临床分析将检查第6周时症状改善的更快发作，特别是SMS增强组，是否预示着第24周时抑郁症的持续缓解。

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.