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Affect-Focused Psychodynamic Internet-Based Therapy for Adolescent Depression: Randomized Controlled Trial
Stockholms universitet.ORCID iD: 0000-0001-6325-4380
Stockholms universitet.ORCID iD: 0000-0002-1296-3432
Stockholms universitet.ORCID iD: 0000-0002-2172-8813
Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.ORCID iD: 0000-0003-1978-5322
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2020 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 22, no 3, p. 1-15, article id e18047Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Adolescent depression is one of the largest health issues in the world and there is a pressing need for effective and accessible treatments.

OBJECTIVE: This trial examines whether affect-focused internet-based psychodynamic therapy (IPDT) with therapist support is more effective than an internet-based supportive control condition on reducing depression in adolescents.

METHODS: The trial included 76 adolescents (61/76, 80% female; mean age 16.6 years), self-referred via an open access website and fulfilling criteria for major depressive disorder. Adolescents were randomized to 8 weeks of IPDT (38/76, 50%) or supportive control (38/76, 50%). The primary outcome was self-reported depressive symptoms, measured with the Quick Inventory of Depressive Symptomatology for Adolescents (QIDS-A17-SR). Secondary outcomes were anxiety severity, emotion regulation, self-compassion, and an additional depression measure. Assessments were made at baseline, postassessment, and at 6 months follow-up, in addition to weekly assessments of the primary outcome measure as well as emotion regulation during treatment.

RESULTS: IPDT was significantly more effective than the control condition in reducing depression (d=0.82, P=.01), the result of which was corroborated by the second depression measure (d=0.80, P<.001). IPDT was also significantly more effective in reducing anxiety (d=0.78, P<.001) and increasing emotion regulation (d=0.97, P<.001) and self-compassion (d=0.65, P=.003). Significantly more patients in the IPDT group compared to the control group met criteria for response (56% vs 21%, respectively) and remission (35% vs 8%, respectively). Results on depression and anxiety symptoms were stable at 6 months follow-up. On average, participants completed 5.8 (SD 2.4) of the 8 modules.

CONCLUSIONS: IPDT may be an effective intervention to reduce adolescent depression. Further research is needed, including comparisons with other treatments.

TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number (ISRCTN) 16206254; http://www.isrctn.com/ISRCTN16206254.

Place, publisher, year, edition, pages
2020. Vol. 22, no 3, p. 1-15, article id e18047
Keywords [en]
Adolescents, Depressive disorder, Internet-based treatment, Mobile phone, Psychodynamic, Treatment outcome
National Category
Applied Psychology
Identifiers
URN: urn:nbn:se:esh:diva-8409DOI: 10.2196/18047PubMedID: 32224489OAI: oai:DiVA.org:esh-8409DiVA, id: diva2:1503014
Available from: 2020-11-23 Created: 2020-11-23 Last updated: 2024-01-17Bibliographically approved

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Lilliengren, Peter

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Lindqvist, KarinMechler, JakobCarlbring, PerLilliengren, PeterFalkenström, FredrikAndersson, GerhardJohansson, RobertEdbrooke-Childs, JulianDahl, Hanne-Sofie J.Lindert Bergsten, KatjaMidgley, NickSandell, RolfThorén, AgnetaTopooco, NairaUlberg, RandiPhilips, Björn
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