Fiorini Guilherme, Saunders Rob, Fonagy Peter, Midgley Nick
Research Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, United Kingdom.
Department of Psychiatry, Cambridge University, Cambridge, United Kingdom.
Psychother Res. 2023 Jan;33(1):96-107. doi: 10.1080/10503307.2022.2040751. Epub 2022 Feb 18.
to identify and describe trajectories of change in general psychopathology () levels among depressed adolescents who received one of three types of short-term therapies (namely Cognitive-Behavioural Therapy, Short-Term Psychoanalytic Psychotherapy, and a Brief Psychosocial Intervention).
Participants were 465 adolescents with MDD who participated in an RCT comparing three treatments for depression. Narrow-band measures of depression, anxiety, obsessions-compulsions, and conduct problems were assessed at six-time points, and bifactor analysis was performed to extract factor scores. These scores were submitted to Latent Class Growth Analyses to identify patterns of change over time.
Three different trajectories of change in were identified. Two trajectories displayed reductions in across time-points: one a rapid decrease, and the other slower but steady improvement. The third trajectory indicated a limited decrease in up until the 12th week after baseline but no further improvement at subsequent time-points. Patients' baseline significantly predicted their outcome trajectories.
Exploring change in seemed to describe more parsimoniously the patients' outcomes than the narrow-band assessment of depressive symptoms. Patients with high baseline were more likely to have poorer outcomes, potentially indicating a need to develop more intensive and tailored treatments for this population.
识别并描述接受三种短期治疗（即认知行为疗法、短期精神分析心理治疗和简短心理社会干预）之一的抑郁青少年的一般精神病理学（）水平变化轨迹。
参与者为465名患有重度抑郁症（MDD）的青少年，他们参与了一项比较三种抑郁症治疗方法的随机对照试验（RCT）。在六个时间点评估了抑郁、焦虑、强迫观念-强迫行为和行为问题的窄带测量指标，并进行双因素分析以提取因素得分。将这些得分提交给潜在类别增长分析，以识别随时间的变化模式。
确定了三种不同的变化轨迹。两条轨迹显示随着时间点的推移一般精神病理学水平降低：一条是快速下降，另一条是下降较慢但持续改善。第三条轨迹表明在基线后第12周之前一般精神病理学水平有限下降，但在随后的时间点没有进一步改善。患者的基线一般精神病理学水平显著预测了他们的结果轨迹。
与对抑郁症状的窄带评估相比，探索一般精神病理学水平的变化似乎更简洁地描述了患者的结果。基线一般精神病理学水平高的患者更有可能有较差的结果，这可能表明需要为该人群开发更强化和量身定制的治疗方法。
