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Early patterns of symptom change signal remission with interpersonal psychotherapy for depressed adolescents
Author(s) -
GunlicksStoessel Meredith,
Mufson Laura
Publication year - 2011
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.20849
Subject(s) - psychology , psychotherapist , interpersonal communication , clinical psychology , interpersonal psychotherapy , interpersonal relationship , medicine , social psychology , randomized controlled trial
Abstract Background: This study examined whether reductions in depression symptoms at different time points over the course of therapy predict remission for depressed adolescents treated with interpersonal psychotherapy (IPT‐A) or treatment as usual (TAU) delivered in school‐based health clinics. Methods: Participants were 63 adolescents (ages 12–18) drawn from a randomized controlled clinical trial examining the effectiveness of IPT‐A Mufson et al. [2004; Archives of General Psychiatry 61:577–584]. Adolescents were randomized to receive IPT‐A or TAU delivered by school‐based mental health clinicians. Assessments were completed at baseline and weeks 4, 8, 12, and 16 (or at early termination) and included the Hamilton Rating Scale for Depression (HRSD; Hamilton [1967; British Journal of Social and Clinical Psychology 6:278–2962]). Results: Receiver operating characteristic analysis was used to identify the time point and degree of reduction in HRSD that best predicted remission (HRSD <7) at the end of the trial (week 16). Week 4 was the best time point for classifying adolescents as likely to remit or not likely to remit for both IPT‐A and TAU. A 16.2% reduction in HRSD from baseline represented the best combined sensitivity and specificity in predicting week 16 remission status for adolescents treated with IPT‐A. A 24.4% reduction in depressive symptoms represented the best combined sensitivity and specificity in predicting remission status for TAU. Conclusions: These findings provide preliminary evidence of one early marker of remission with IPT‐A. Replication with larger samples would suggest that depressed adolescents who have not demonstrated at least a 16.2% reduction in their depressive symptoms after 4 weeks of IPT‐A may benefit from a change in the treatment plan. Depression and Anxiety, 2011. © 2011 Wiley‐Liss, Inc.