Treatment of Depressed Adolescents With Physical Illness
The purpose of this study is a randomized trial of cognitive-behavioral intervention (CBI) for eligible adolescents who have Inflammatory Bowel Disease and subsyndromal depressive symptoms, but who did not meet diagnostic criteria for major depressive disorder at the time of randomization into the study.
- This preliminary randomized trial will demonstrate the feasibility of a large-scale research initiative.
- Subjects will experience no adverse events, and the CBI group will demonstrate improved negative cognitions, depressive symptomatology, and functioning at the post-intervention and 6- through 12-month follow-ups.
Inflammatory Bowel Disease
Behavioral: PASCET - a manual-based Cognitive Behavorial Therapy
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Treatment of Depressed Adolescents With Physical Illness|
- Schedule for Affective Disorders and Schizophrenia for School-Age Children
- (K-SADS; parent and child)
- Children's Depression Inventory (CDI)
- Children's Depression Inventory—Parent(CDI-P)
- Children's Depression Rating Scale-Revised (CDRS)
- Children's Attributional Style Questionnaire-Revised (CASQ)
- Perceived Control Scale (PCS)
- Child Health Questionnaire (CHQ; parent and child)
- Children's Global Assessment Scale (CGAS)
- Pediatric Crohn's Disease Activity Index (PCDAI; for Crohn's disease)
- Clinical Score of Kozarek (CSK; for ulcerative colitis)
|Study Start Date:||September 2002|
|Study Completion Date:||August 2007|
This study is a pilot study, which will serve to determine the feasibility of a larger research initiative. The broader research is aimed at the prevention of depressive disorders in adolescents with inflammatory bowel disease (IBD) who have risk factors for depression, using a psychotherapeutic intervention. The intervention is based on a cognitive-behavioral approach to treating depression, the Primary and Secondary Control Enhancement Training (PASCET), that has been modified and enhanced with physical illness narrative, social skills, and family components (PASCET-Physical Illness), to make it more appropriate for physically ill adolescents at risk for major depression. The cognitive-behavioral intervention (CBI) draws on an etiological hypothesis that depression in adolescents with chronic physical illness results from cumulative risk factors such as distorted cognitive processes, negative physical illness experience, poor social functioning, and ineffective family interactions. Thus, the development of depression may be prevented by teaching adolescents effective strategies to 1) cope using cognitive-behavioral skills, 2) enhance social functioning, 3) develop a more cohesive illness narrative, and 4) improve family communication skills.
The study is a randomized trial of the CBI for adolescents with IBD and depressive symptoms, using the provision of psychoeducational materials as the attention control group. This study is a pilot study designed to show feasibility of assessing and treating youth with sub-syndromal depressive symptoms and IBD using a randomized clinical design at Children's Hospital Pittsburgh (CHP) as a preliminary step for designing a two-site randomized trial Children's Hospital of Pittsburgh and Children's Hospital Boston powered to test preventive effects of this CBI in this medically co-morbid population.
In this study, eligible adolescents who are at risk for developing depression due to having a chronic physical illness (IBD) as well as having subsyndromal depressive symptoms but who do not currently meet diagnostic criteria for major depressive disorder according to a diagnostic interview will be randomly assigned either to receive CBI or psychoeducation.
|United States, Massachusetts|
|Children's Hospital Boston|
|Boston, Massachusetts, United States, 02115|
|United States, Pennsylvania|
|Children's Hospital of Pittsburgh|
|Pittsburgh, Pennsylvania, United States, 15213|
|Principal Investigator:||Eva Szigethy, MD, PhD||University of Pittsburgh / Children's Hospital of Pittsburgh|
|Principal Investigator:||David DeMaso, MD||Harvard University / Children's Hospital Boston|