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Contenido archivado el 2024-05-14

Psychotherapy for childhood depression

Objetivo

Objectives:
To conduct a clinical trial of two fundamentally different, but equally well established, forms of psychotherapy interventions undertaken by skilled psychotherapists, appropriately trained and supervised with 96 young adolescents, aged 10-14, with DSM IV diagnosed Major Depression. The therapies will be individual psychotherapy (focused individual child psychodynamic psychotherapy) and family therapy (systems integrative family therapy).

The aims of this project are to conduct a clinical trial of two fundamentally different, but equally well established, forms of psychotherapy interventions undertaken by skilled psychotherapists, appropriately trained and supervised with 96 young adolescents, aged 10-14, with DSM IV diagnosed Major Depression. The therapies will be focused individual child psychodynamic psychotherapy and systems integrative family therapy. The treatments will be undertaken on an outpatient basis. The length of the treatments will be of sufficient frequency and duration for psychotherapists to consider the therapy to be of good quality but will be complemented by limits of length to ensure their exportability to wider settings than major university centres. The therapies will be supplemented by supportive therapy sessions for parents. Outcome and change will be explored in diverse modalities. A battery of measures will be selected to be administered at baseline (baseline assessments) and an identical battery will be completed at termination (9) and at follow-up (15) months after the beginning of the treatment. These will be supplemented by depression self-rating scales on a monthly basis and also for the first 9 months, and then six months later. The effects of treatment and also change over time will be compared using basic outcome measures and also appropriate multivariate analyses.

Processes which appear to mediate between therapy and outcome will also be explored. Each therapy will be monitored for consistency and fidelity through training and supervision and the availability of manuals. There will be ratings of videotaped and audiotaped sessions.

Major depression in child and adolescent clinical populations is relatively common and is a highly significant risk factor in parasuicide and suicide. There is evidence that childhood major depression is not a transitory condition: among referrals who meet DSM IIIR diagnostic criteria, the first episode tends to last an average of about 11 months from onset to symptomatic recovery; 1 in 5 have a chronic first episode that lasts longer than 18 months. In addition, there is the risk of continuity of depression into adulthood. Further, the finding that antidepressants do not appear to be effective with children and adolescents adds impetus to psychosocial treatment research. While cognitive therapy approaches appear promising, psychodynamic psychotherapy holds the promise of more fundamental and lasting changes in childhood depression by improving the subjects capacity to resolve internal and external conflicts as they grow up.06 06

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CON - Coordination of research actions

Coordinador

The Tavistock & Portman NHS Trust
Aportación de la UE
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Dirección
120,Belsize Lane
NW3 5BA London
Reino Unido

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