Gunlicks-Stoessel Meredith, Mufson Laura
Department of Psychiatry, University of Minnesota, 2450 Riverside Ave, F256/2B West, Minneapolis, MN, 55454, USA.
Division of Child & Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York City, NY, USA.
Child Adolesc Ment Health. 2016 Nov;21(4):225-230. doi: 10.1111/camh.12167. Epub 2016 May 9.
Problems in adolescents' relationships with their parents are a significant risk factor for the development and maintenance of depression. The purpose of this pilot study was to examine the feasibility and acceptability of an adaptation of interpersonal psychotherapy for depressed adolescents (IPT-A) who were also experiencing problems in their relationships with parents. The adaptation includes greater and more structured parent involvement in the treatment (IPT-AP).
Fifteen adolescents (age 12-17) who were diagnosed with depression and were also experiencing conflictual or emotionally disengaged relationships with their parents (based on adolescent or parent report on the Conflict Behavior Questionnaire) participated in a 16 week randomized clinical trial of individually delivered IPT-A versus IPT-AP. Data regarding the feasibility and acceptability of IPT-AP were collected. Assessments of depression and family functioning were completed at baseline and weeks 4, 8, 12, and 16 by evaluators blind to treatment condition.
IPT-AP was feasible to implement, and adolescents and parents reported high treatment satisfaction. Adolescents demonstrated significant improvements in depressive symptoms, general functioning, and family functioning. IPT-AP was more efficacious than individual IPT-A in improving adolescents' perceptions of father-adolescent relations and mothers' perceptions of mother-adolescent relations.
Interpersonal psychotherapy for depressed adolescents and their parents was feasible to implement and acceptable to families, indicating that a full-scale randomized controlled trial to evaluate its efficacy is warranted.
青少年与父母关系中的问题是抑郁症发生和维持的一个重要风险因素。本试点研究的目的是检验针对与父母关系也存在问题的抑郁青少年的人际心理治疗(IPT-A)改编版(包括让父母更多且更有组织地参与治疗,即IPT-AP)的可行性和可接受性。
15名年龄在12至17岁、被诊断为抑郁症且与父母存在冲突或情感疏离关系(基于青少年或父母对冲突行为问卷的报告)的青少年参加了一项为期16周的随机临床试验,该试验将单独进行的IPT-A与IPT-AP进行对比。收集了关于IPT-AP可行性和可接受性的数据。由对治疗情况不知情的评估人员在基线以及第4、8、12和16周完成对抑郁和家庭功能的评估。
IPT-AP实施起来是可行的,青少年和父母报告了较高的治疗满意度。青少年在抑郁症状、总体功能和家庭功能方面有显著改善。在改善青少年对父子关系的认知以及母亲对母子关系的认知方面,IPT-AP比单独的IPT-A更有效。
针对抑郁青少年及其父母的人际心理治疗实施起来可行且为家庭所接受,这表明有必要进行一项全面的随机对照试验来评估其疗效。