Telehealth-delivered depression prevention: Short-term outcomes from a school-based randomized controlled trial.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2024-10-31 DOI:10.1037/ccp0000913

Jami F Young, Jason D Jones, Karen T G Schwartz, Amy So, Gillian C Dysart, Rebecca M Kanine, Jane E Gillham, Robert Gallop, Molly Davis

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Abstract

Objective: To examine short-term (i.e., postintervention) outcomes from a randomized controlled trial comparing a school-based telehealth-delivered depression prevention program, Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), to services as usual (SAU). We expected IPT-AST would be acceptable and feasible and that IPT-AST adolescents would experience greater reductions in depression symptoms, anxiety symptoms, and impairment compared with SAU.

Method: Adolescents (N = 242; M_age = 14.80 years, SD = 0.70; 65% female; 21% Black; 13% Hispanic/Latinx) with elevated scores on the Center for Epidemiologic Studies Depression Scale (Radloff, 1977) at screening provided data at baseline, 2-month (midpoint of IPT-AST), and 3-month (postintervention) assessments. They reported depression symptoms on the Center for Epidemiologic Studies Depression Scale, anxiety symptoms on the Screen for Child Anxiety Related Emotional Disorders (Birmaher et al., 1997), and impairment on the Columbia Impairment Scale (Bird et al., 1993). Baseline depression diagnosis was examined as a moderator.

Results: Hierarchical linear models showed that adolescents reported significant reductions in depression symptoms and impairment across conditions. IPT-AST adolescents reported significantly greater reductions in anxiety symptoms than SAU adolescents, d = .39, 95% CI [.05, .72], p = .003. Depression diagnosis moderated outcomes (ds = .33-.34, ps ≤ .05), such that IPT-AST adolescents without a diagnosis at baseline showed greater improvements in depression and anxiety symptoms than SAU adolescents. Adolescents in SAU with a depression diagnosis at baseline showed greater improvements in impairment compared with IPT-AST. Attendance and satisfaction data demonstrated the feasibility and acceptability of telehealth-delivered IPT-AST.

Conclusions: Results support telehealth-delivered IPT-AST as a promising intervention for improving short-term outcomes among adolescents with depression symptoms but without a depression diagnosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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远程医疗预防抑郁症：基于学校的随机对照试验的短期结果。

目的研究一项随机对照试验的短期（即干预后）结果，该试验比较了基于学校的远程医疗抑郁症预防项目--人际心理治疗-青少年技能培训（IPT-AST）和常规服务（SAU）。我们希望IPT-AST是可接受的、可行的，而且与SAU相比，IPT-AST能更有效地减少青少年的抑郁症状、焦虑症状和障碍：筛查时在流行病学研究中心抑郁量表（Radloff，1977 年）上得分较高的青少年（N = 242；年龄 = 14.80 岁，SD = 0.70；65% 为女性；21% 为黑人；13% 为西班牙裔/拉丁裔）提供了基线、2 个月（IPT-AST 中点）和 3 个月（干预后）的评估数据。他们根据流行病学研究中心抑郁量表报告了抑郁症状，根据儿童焦虑相关情绪障碍筛查（Birmaher 等人，1997 年）报告了焦虑症状，并根据哥伦比亚障碍量表（Bird 等人，1993 年）报告了障碍情况。基线抑郁症诊断作为调节因素进行了研究：分层线性模型显示，青少年在不同条件下的抑郁症状和障碍均有显著减少。与 SAU 青少年相比，IPT-AST 青少年的焦虑症状明显减轻，d = .39，95% CI [.05, .72]，p = .003。抑郁诊断对结果有调节作用（ds = .33-.34，Ps ≤ .05），因此，与 SAU 青少年相比，基线时未确诊抑郁的 IPT-AST 青少年在抑郁和焦虑症状方面有更大的改善。与 IPT-AST 相比，基线诊断为抑郁症的 SAU 青少年在障碍方面的改善更大。出勤率和满意度数据证明了远程医疗提供的 IPT-AST 的可行性和可接受性：研究结果表明，远程医疗提供的 IPT-AST 是一种很有前景的干预措施，可改善有抑郁症状但未确诊为抑郁症的青少年的短期疗效。(PsycInfo Database Record (c) 2024 APA, 版权所有）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.