Early patterns of symptom change signal remission with interpersonal psychotherapy for depressed adolescents

✍ Scribed by Meredith Gunlicks-Stoessel; Laura Mufson

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 108 KB
• Volume: 28
• Category: Article
• ISSN: 1091-4269
• DOI: 10.1002/da.20849

✦ Synopsis

Background:

This study examined whether reductions in depression symptoms at different time points over the course of therapy predict remission for depressed adolescents treated with interpersonal psychotherapy (ipt-a) or treatment as usual (tau) delivered in school-based health clinics.

Methods:

Participants were 63 adolescents (ages 12-18) drawn from a randomized controlled clinical trial examining the effectiveness of ipt-a mufson et al. [2004; archives of general psychiatry 61:577-584]. adolescents were randomized to receive ipt-a or tau delivered by school-based mental health clinicians. assessments were completed at baseline and weeks 4, 8, 12, and 16 (or at early termination) and included the hamilton rating scale for depression (hrsd; hamilton [1967; british journal of social and clinical psychology 6:278-2962]).

Results:

Receiver operating characteristic analysis was used to identify the time point and degree of reduction in hrsd that best predicted remission (hrsd <7) at the end of the trial (week 16). week 4 was the best time point for classifying adolescents as likely to remit or not likely to remit for both ipt-a and tau. a 16.2% reduction in hrsd from baseline represented the best combined sensitivity and specificity in predicting week 16 remission status for adolescents treated with ipt-a. a 24.4% reduction in depressive symptoms represented the best combined sensitivity and specificity in predicting remission status for tau.

Conclusions:

These findings provide preliminary evidence of one early marker of remission with ipt-a. replication with larger samples would suggest that depressed adolescents who have not demonstrated at least a 16.2% reduction in their depressive symptoms after 4 weeks of ipt-a may benefit from a change in the treatment plan.