Department of Psychology, Stockholm University, Stockholm, Sweden.
Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
Psychother Res. 2021 Apr;31(4):455-467. doi: 10.1080/10503307.2020.1804084. Epub 2020 Aug 17.
Sudden gains (SGs) have often been found associated with better treatment outcome across different psychiatric disorders. However, no studies have evaluated SGs in internet-based treatment targeting adolescent depression. The sample consisted of 66 adolescents diagnosed with major depressive disorder, attending psychodynamic internet-based treatment. Effects of SGs were evaluated at posttreatment and 6-month follow-up. We also evaluated effects of large intersession improvements (LIIs; sudden and relatively large gains, between sessions, without the stability criterion). Effects of SGs and LIIs early in treatment were also investigated. A total of 17 patients (25.75%) experienced an SG. The effect of having an SG or early SG was non-significant after treatment ( = 0.48) and at follow-up ( = 0.66). However, having an LII was related to better outcome after treatment (= 0.97) and at follow-up ( =0.76). Early LIIs were associated with significantly better results at end of treatment ( = 0.72). The original criteria of SGs might be overly conservative and thus miss important improvements in depression. Relatively large intersession gains, regardless of stability, seem to be predictive of outcome.
突然增益（SGs）经常在不同的精神障碍的治疗结果中发现与其相关。然而，还没有研究评估针对青少年抑郁症的基于互联网的治疗中的 SGs。 该样本由 66 名被诊断为重度抑郁症的青少年组成，他们接受心理动力学的基于互联网的治疗。在治疗后和 6 个月的随访中评估 SGs 的效果。我们还评估了大会话间改善（LIIs；会话之间突然且相对较大的增益，没有稳定性标准）的效果。还研究了治疗早期 SGs 和 LIIs 的效果。共有 17 名患者（25.75%）经历了 SG。治疗后（= 0.48）和随访时（= 0.66），具有 SG 或早期 SG 的效果并不显著。然而，有 LIIs 与治疗后的更好结果相关（= 0.97）和随访时（= 0.76）。早期 LIIs 与治疗结束时的显著更好结果相关（= 0.72）。SGs 的原始标准可能过于保守，因此可能会错过抑郁症的重要改善。相对较大的会话间增益，无论稳定性如何，似乎都可以预测结果。
