Dubicka Bernadka, Marwedel Susanne, Banares Sabah, McCulloch Amy, Tahoun Taghrid, Hearn Jasmine, Kroll Leo
Young People's Mental Health Research Unit, Pennine Care NHS Foundation Trust Headquarters, Ashton-under-Lyne, UK.
Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
Child Adolesc Ment Health. 2022 May;27(2):131-137. doi: 10.1111/camh.12474. Epub 2021 May 24.
Behavioural activation (BA) is effective in adults with depression but the evidence for young people (YP) is less clear. We therefore developed and tested a new coproduced BA programme.
In phase one (2014 to 2015 inclusive), we codeveloped with young people attending specialist child and adolescent mental health service (CAMHS) an 8-session BA workbook. In Phase two (2019 to 2020 inclusive), we ran an uncontrolled feasibility study in two specialist CAMHS, with BA being offered to YP by less specialised staff.
In phase one, we tested the workbook with 15 YP with depression and other comorbidities. Satisfaction was good from both YP and staff, and 9 YP reported improvement in mood. In phase two, 51 YP were offered BA; 15 declined to take part. 36 consented with three dropping out after consent. 33 YP (mean age 14.6, 12 males, 24 females) continued treatment attending a mean of 6.6 sessions. At the end of treatment, youth-rated Mood and Feeling Questionnaire (MFQ) mean score decreased from 43.2 to 27.6, difference 14.6 (95% CI 8.7 to 20.2; n = 28), and Clinician Global Assessment Score (CGAS) mean score increased from 52.3 to 69.8, difference 18.0 (95% CI 11.9 to 24.2; n = 29). Of the 33 YP who participated in therapy, 12 (36%) recovered and were discharged.
This programme demonstrated preliminary evidence for effectiveness and utility. Less specialised staff were able to use BA, and this may reduce secondary waits for more specialist therapy. More research is needed about the role of BA in specialist CAMHS.
行为激活（BA）对成年抑郁症患者有效，但对年轻人（YP）的证据尚不明确。因此，我们开发并测试了一种新的共同制定的BA方案。
在第一阶段（2014年至2015年），我们与参加专科儿童和青少年心理健康服务（CAMHS）的年轻人共同制定了一本8节的BA工作手册。在第二阶段（2019年至2020年），我们在两个专科CAMHS进行了一项非对照可行性研究，由不太专业的工作人员向YP提供BA。
在第一阶段，我们对15名患有抑郁症和其他合并症的YP测试了该工作手册。YP和工作人员的满意度都很高，9名YP报告情绪有所改善。在第二阶段，向51名YP提供了BA；15人拒绝参加。36人同意参加，其中3人在同意后退出。33名YP（平均年龄14.6岁，12名男性，24名女性）继续接受治疗，平均参加6.6节课程。治疗结束时，青少年自评的情绪与感受问卷（MFQ）平均得分从43.2降至27.6，差值为14.6（95%CI 8.7至20.2；n = 28），临床医生整体评估得分（CGAS）平均得分从52.3升至69.8，差值为18.0（95%CI 11.9至24.2；n = 29）。在参与治疗的33名YP中，12人（36%）康复并出院。
该方案显示了有效性和实用性的初步证据。不太专业的工作人员能够使用BA，这可能会减少等待更专科治疗的二次等待时间。关于BA在专科CAMHS中的作用，还需要更多的研究。
