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Therapist-guided internet-based psychodynamic therapy versus cognitive behavioural therapy for adolescent depression in Sweden : a randomised, clinical, non-inferiority trial

Mechler, Jakob (författare)
Stockholm University
Lindqvist, Karin (författare)
Stockholm University
Carlbring, Per (författare)
Stockholm University
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Topooco, Naira, 1980- (författare)
Linköping University,Linköpings universitet,Psykologi,Filosofiska fakulteten,Center for m2Health, Palo Alto University, CA, USA,Internet, health and clinical psychology research group
Falkenström, Fredrik, 1972- (författare)
Linnaeus University,Linköpings universitet,Linnéuniversitetet,Institutionen för psykologi (PSY),Linköping University, Sweden,Linköping Univ, Dept Behav Sdences & Learning, Linköping, Sweden.;Linnaeus Univ, Dept Psychol, Växjö, Sweden.,Psykologi,Filosofiska fakulteten,Department of Psychology, Linnaeus University, Växjö, Sweden,Internet, health and clinical psychology research group
Lilliengren, Peter, 1972- (författare)
Ersta Sköndal Bräcke högskola,S:t Lukas utbildningsinstitut,Ersta Sköndal Bräcke University College, Stockholm, Sweden
Andersson, Gerhard, 1966- (författare)
Karolinska Institute,Linköpings universitet,Karolinska Institutet,Linköping University,Psykologi,Filosofiska fakulteten,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden,Internet, health and clinical psychology research group
Johansson, Robert (författare)
Stockholm University
Midgley, Nick (författare)
Anna Freud Natl Ctr Children & Families, Child Attachment & Psychol Therapies Res Unit, London, England.;UCL, Dept Clin Educ & Hlth Psychol, London, England.,Anna Freud National Centre for Children and Families, United Kingdom; University College London, United Kingdom,Child Attachment and Psychological Therapies Research Unit, Anna Freud National Centre for Children and Families, London, UK
Edbrooke-Childs, Julian (författare)
Anna Freud Natl Ctr Children & Families, Evidence Based Practice Unit, London, England.;UCL, Dept Clin Educ & Hlth Psychol, London, England.,Anna Freud National Centre for Children and Families, United Kingdom; University College London, United Kingdom,Evidence-based Practice Unit, Anna Freud National Centre for Children and Families, London, UK and Department of Clinical, Educational and Health Psychology, University College London, London, UK
Dahl, Hanne-Sofie J. (författare)
Univ Oslo, Dept Psychol, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
Sandell, Rolf (författare)
Lund University,Lunds universitet,Institutionen för psykologi,Samhällsvetenskapliga institutioner och centrumbildningar,Samhällsvetenskapliga fakulteten,Department of Psychology,Departments of Administrative, Economic and Social Sciences,Faculty of Social Sciences
Thoren, Agneta (författare)
The Erica Foundation, Stockholm, Sweden,Erica Fdn, Stockholm, Sweden.,Ericastiftelsen, Stockholm
Ulberg, Randi (författare)
Univ Oslo, Inst Clin Med, Oslo, Norway.;Diakonhjemmet Hosp, Dept Psychiat, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway and Department of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
Lindert Bergsten, Katja (författare)
Uppsala University,Uppsala universitet,Institutionen för psykologi,Department of Psychology, Uppsala University, Uppsala, Sweden
Philips, Bjorn (författare)
Stockholm University
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 (creator_code:org_t)
Elsevier, 2022
2022
Engelska.
Ingår i: The Lancet Digital Health. - : Elsevier. - 2589-7500. ; 4:8, s. E594-E603
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Background Adolescent major depressive disorder (MDD) is highly prevalent and associated with lifelong adversity. Evidence-based treatments exist, but accessible treatment alternatives are needed. We aimed to compare internet-based psychodynamic therapy (IPDT) with an established evidence-based treatment (internet-based cognitive behavioural therapy [ICBT]) for the treatment of adolescents with depression. Methods In this randomised, clinical trial, we tested whether IPDT was non-inferior to ICBT in the treatment of adolescent MDD. Eligible participants were 15-19 years old, presenting with a primary diagnosis of MDD according to DSM-5. Participants were recruited nationwide in Sweden through advertisements on social media, as well as contacts with junior and senior high schools, youth associations, social workers, and health-care providers. Adolescents who scored 9 or higher on the Quick Inventory of Depressive Symptomatology for Adolescents (QIDS-A17-SR) in an initial online screening were contacted by telephone for a diagnostic assessment using the Mini International Neuropsychiatric Interview. Participants were randomly assigned to ICBT or IPDT. Both interventions comprised eight self-help modules delivered over 10 weeks on a secure online platform. The primary outcome was change in depression severity measured weekly by the QIDS-A17-SR. Primary analyses were based on an intention -to-treat sample including all participants randomly assigned. A non-inferiority margin of Cohen's d=0.30 was predefined. The study is registered at ISRCTN, ISRCTN12552584. Findings Between Aug 19, 2019, and Oct 7, 2020, 996 young people completed screening; 516 (52%) were contacted for a diagnostic interview. 272 participants were eligible and randomly assigned to ICBT (n=136) or IPDT (n=136). In the ICBT group, 51 (38%) of 136 participants were classified as remitted, and 54 (40%) of 136 participants were classified as remitted in the IPDT group. Within-group effects were large (ICBT: within-group d=1.75, 95% CI 1.49 to 2.01; IPDT: within-group d=1.93, 1.67 to 2.20; both p<0.0001). No statistically significant treatment difference was found in the intention-to-treat analysis. Non-inferiority for IPDT was shown for the estimated change in depression during treatment (d=-0.18, 90% CI -0.49 to 0.13; p=0.34). All secondary outcomes showed non-significant between-group differences. Interpretation IPDT was non-inferior to ICBT in terms of change in depression for the treatment of adolescents with MDD. This finding increases the range of accessible and effective treatment alternatives for adolescents with depression. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Ämnesord

SAMHÄLLSVETENSKAP  -- Psykologi (hsv//swe)
SOCIAL SCIENCES  -- Psychology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)
SAMHÄLLSVETENSKAP  -- Psykologi -- Tillämpad psykologi (hsv//swe)
SOCIAL SCIENCES  -- Psychology -- Applied Psychology (hsv//eng)

Nyckelord

Psychology
Psykologi

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