Arnott Bronia, Kitchen Charlotte Emma Wray, Ekers David, Gega Lina, Tiffin Paul Alexander
Population Health Sciences Institute Newcastle University, Newcastle upon Tyne, UK.
Department of Health Sciences, University of York, York, North Yorkshire, UK.
BMJ Paediatr Open. 2020 Apr 26;4(1):e000624. doi: 10.1136/bmjpo-2019-000624. eCollection 2020.
Mood and weight problems are common in young people, yet few treatments address both conditions concurrently. Behavioural activation (BA) has shown promise as a treatment for adults with comorbid obesity and depression. This study aimed to examine the feasibility and acceptability of a manualised BA treatment targeting weight and mood problems in young people.
Young people with low mood and weight difficulties were identified via a school-based screening process. Following a diagnostic interview, young people with clinically significant mood problems and concurrent overweight/obesity were invited to participate. A total of 8-12 sessions of BA were delivered by a graduate therapist to eight adolescents (four male) aged 12-15 years. Weight, mood and functioning were assessed before, during and after treatment, and a semistructured qualitative interview was conducted, along with selected outcome measures at 4 months' follow-up.
Low attrition and positive qualitative feedback suggested the intervention was acceptable. Trends towards a reduction in reported depression symptoms and improved functioning scores were observed at follow-up, with more mixed results for change in body mass index. Of those attending the 4-month follow-up, 57% (4/7) no longer met the screening threshold for major depressive disorder. However, low screening and baseline recruitment rates would pose challenges to executing a larger trial.
BA delivered by a graduate therapist in a British community setting is an acceptable, feasible treatment for comorbid mood and weight problems in adolescence, and its effectiveness should be evaluated in an adequately powered randomised controlled trial.
情绪和体重问题在年轻人中很常见，但很少有治疗方法能同时解决这两个问题。行为激活（BA）已显示出有望成为治疗合并肥胖和抑郁症成年人的方法。本研究旨在探讨针对年轻人体重和情绪问题的手册化BA治疗的可行性和可接受性。
通过基于学校的筛查程序识别情绪低落和体重有问题的年轻人。经过诊断访谈后，邀请有临床显著情绪问题且同时存在超重/肥胖的年轻人参与。一名研究生治疗师为8名年龄在12至15岁的青少年（4名男性）提供了总共8至12节BA课程。在治疗前、治疗期间和治疗后对体重、情绪和功能进行评估，并进行半结构化定性访谈，同时在4个月随访时进行选定的结局测量。
低脱落率和积极的定性反馈表明该干预是可接受的。随访时观察到报告的抑郁症状有减轻趋势且功能评分有所改善，体重指数变化的结果则更为复杂。在参加4个月随访的人中，57%（4/7）不再符合重度抑郁症的筛查阈值。然而，低筛查率和基线招募率将对开展更大规模的试验构成挑战。
在英国社区环境中，由研究生治疗师提供的BA是治疗青少年合并情绪和体重问题的一种可接受、可行的治疗方法，其有效性应在有足够样本量的随机对照试验中进行评估。
