ABSTRACT
Objectives: Depression is one of the most prevalent and impactful mental health disorders for adolescents and is increasing amid the COVID-19 pandemic. While the effectiveness and efficacy of pharmacological and psychotherapy treatment for adolescent depression is well researched, there are mixed conclusions on the impact of comorbid anxiety. This project aimed to identify specific anxiety-related factors that may be interfering with treatment outcomes to enhance clinical care and the interrelationship of multiple symptom measures. Method(s): Archival data from the NIMH-supported Treatment of Adolescents With Depression Study was utilized (TADS team, 2004). Participants included 439 adolescents, aged 12 to 17 years, who were randomly assigned to 4 treatment arms: fluoxetine, CBT, combined fluoxetine and CBT, and placebo, over a period of 36 weeks. Baseline measures included the Multidimensional Anxiety Scale for Children (MASC), Physical Symptom Checklist (PSC), Cognitive Triad Inventory for Children (CTI-C), and Dysfunctional Attitudes Scale (DAS). The Children's Depression Rating Scale-Revised (CDRS-R) was used as an outcome measure. Bivariate Pearson correlation coefficient analyses were conducted to identify relationships between the MASC factors and other baseline assessments. CDRS-R scores were predicted using a linear mixed model with random effects to account for missing scores at different time points. General linear models were used for analyses of predictor and moderators at weeks 12, 24, and 36. Result(s): Physiological symptoms predicted poorer treatment outcomes at weeks 12, 24, and 36. Additionally, MASC subfactors of physical symptoms, humiliation/rejection, and perfectionism were significantly correlated with the PSC, CTI-C relationship items, and the DAS perfectionism scale, respectively. Conclusion(s): Increased physiological symptoms merit treatment via either singular CBT or SSRI or combined CBT and SSRI intervention. Further, the MASC emerged as a robust metric for identifying co-occurring anxiety symptoms in depressed adolescents. DDD, RI, TREAT Copyright © 2022
ABSTRACT
Objectives: Waves and surges continue to characterize the COVID-19 pandemic, fueling heightened uncertainty, anxiety, frustration, depression, and other behavioral health complaints. Mounting numbers of distressed young patients and their families are seeking mental health care. Therefore, child and adolescent psychiatrists need to be equipped to deliver as well as train others to implement effective CBT procedures. These goals are the precise foci of this practitioner-friendly Workshop. Method(s): Attendees will acquire the rudiments for delivering essential CBT changemakers when working with young patients and their families. More specifically, the fundamentals for implementing psychoeducational, target monitoring, basic behavioral tasks, cognitive restructuring, and exposure-based procedures will be explained and illustrated. Creative and innovative modifications of traditional techniques will be delineated. The Workshop material will be presented in a highly engaging and interactive manner. CBT skills will be spelled out through detailed didactic presentations augmented by clinical stories, case vignettes, demonstrations of techniques, experiential exercises, eye-catching graphics, and audio/visual recordings. Result(s): Participants will leave the Workshop with multiple psychoeducational, behavioral, cognitive restructuring, and exposure-based techniques for use with diverse patients in multiple settings. Additionally, attendees will gain familiarity with brief measures suitable for treatment planning and outcome evaluation. Conclusion(s): Child and adolescent psychiatrists will become well prepared to meet the need of an ever-increasing clinical caseload and armed with CBT skills to mitigate patients' distress. Accordingly, the Workshop content is completely aligned with the conference focus on translational research aimed toward improving the quality of clinical care delivered to young patients and their families, enriching training, and upgrading service delivery systems. CBT, AD, DDD Copyright © 2022