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Prognostic Implications for Adolescents With Depression Who Drop Out of Psychological Treatment During a Randomized Controlled Trial.

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Title: Prognostic Implications for Adolescents With Depression Who Drop Out of Psychological Treatment During a Randomized Controlled Trial.
Authors: IMPACT Consortium, O'Keeffe, Sally1, Midgley, Nick1, Martin, Peter2, Goodyer, Ian M3, Kelvin, Raphael4, Dubicka, Bernadka5
Source: Journal of the American Academy of Child & Adolescent Psychiatry. Apr2019, Vol. 58 Issue 4, pN.PAG-N.PAG. 1p.
Subject Terms: *Adolescence, *Cognitive therapy, *Research, *Self-evaluation, *Research methodology, *Evaluation research, *Psychological tests, *Comparative studies, *Mental depression, Randomized controlled trials, Therapeutics, Brief psychotherapy, Patient dropouts, Medical cooperation, Treatment effectiveness, Psychosocial factors, Questionnaires, Logistic regression analysis
Abstract: Objective: High therapy dropout rates among adolescents have been reported, but little is known about whether dropout is associated with poor outcomes. This study aimed to examine clinical outcomes in adolescents with depression who dropped out of psychological therapy and to determine whether this varied by treatment type.Method: Data were drawn from the Improving Mood with Psychoanalytic and Cognitive Therapies (IMPACT) study, a randomized controlled trial, comparing a brief psychosocial intervention, cognitive-behavioral therapy, and short-term psychoanalytic psychotherapy in the treatment of adolescent major depression. The sample comprised 406 adolescents with a diagnosis of major depression, 169 of whom dropped out of treatment before the planned end of therapy. Primary outcome was self-report Mood and Feelings Questionnaire (MFQ); secondary outcomes were Health of the Nation Outcome Scale for Children and Adolescents, Revised Children's Manifest Anxiety Scale, Modified Leyton Obsessional Inventory, and clinical diagnosis.Results: During follow-up, there was a nonsignificant trend for dropouts to report higher depressive symptoms than completers. However, modeling showed insufficient evidence for an association between dropout and outcomes.Conclusion: In contrast to studies of adult therapy, there was no strong evidence that adolescent patients who dropped out had poorer clinical outcomes compared with those who completed therapy, when dropout was defined as ending treatment without agreement of the therapist. This challenges us to understand why adolescents stop going to therapy, how dropout should be defined, and whether what is prescribed is what is always needed.Clinical Trial Registration Information: Improving Mood and Preventing Relapse With Psychoanalytic Psychotherapy and Cognitive Behavior Therapy; http://www.isrctn.com/; 83033550. [ABSTRACT FROM AUTHOR]
Copyright of Journal of the American Academy of Child & Adolescent Psychiatry is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: Prognostic Implications for Adolescents With Depression Who Drop Out of Psychological Treatment During a Randomized Controlled Trial.
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  Data: <searchLink fieldCode="AR" term="%22IMPACT+Consortium%22">IMPACT Consortium</searchLink><br /><searchLink fieldCode="AR" term="%22O'Keeffe%2C+Sally%22">O'Keeffe, Sally</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Midgley%2C+Nick%22">Midgley, Nick</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Martin%2C+Peter%22">Martin, Peter</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Goodyer%2C+Ian+M%22">Goodyer, Ian M</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Kelvin%2C+Raphael%22">Kelvin, Raphael</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Dubicka%2C+Bernadka%22">Dubicka, Bernadka</searchLink><relatesTo>5</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+the+American+Academy+of+Child+%26+Adolescent+Psychiatry%22">Journal of the American Academy of Child & Adolescent Psychiatry</searchLink>. Apr2019, Vol. 58 Issue 4, pN.PAG-N.PAG. 1p.
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  Data: *<searchLink fieldCode="DE" term="%22Adolescence%22">Adolescence</searchLink><br />*<searchLink fieldCode="DE" term="%22Cognitive+therapy%22">Cognitive therapy</searchLink><br />*<searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br />*<searchLink fieldCode="DE" term="%22Self-evaluation%22">Self-evaluation</searchLink><br />*<searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br />*<searchLink fieldCode="DE" term="%22Evaluation+research%22">Evaluation research</searchLink><br />*<searchLink fieldCode="DE" term="%22Psychological+tests%22">Psychological tests</searchLink><br />*<searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br />*<searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink><br /><searchLink fieldCode="DE" term="%22Brief+psychotherapy%22">Brief psychotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+dropouts%22">Patient dropouts</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+cooperation%22">Medical cooperation</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Psychosocial+factors%22">Psychosocial factors</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Logistic+regression+analysis%22">Logistic regression analysis</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: <bold>Objective: </bold>High therapy dropout rates among adolescents have been reported, but little is known about whether dropout is associated with poor outcomes. This study aimed to examine clinical outcomes in adolescents with depression who dropped out of psychological therapy and to determine whether this varied by treatment type.<bold>Method: </bold>Data were drawn from the Improving Mood with Psychoanalytic and Cognitive Therapies (IMPACT) study, a randomized controlled trial, comparing a brief psychosocial intervention, cognitive-behavioral therapy, and short-term psychoanalytic psychotherapy in the treatment of adolescent major depression. The sample comprised 406 adolescents with a diagnosis of major depression, 169 of whom dropped out of treatment before the planned end of therapy. Primary outcome was self-report Mood and Feelings Questionnaire (MFQ); secondary outcomes were Health of the Nation Outcome Scale for Children and Adolescents, Revised Children's Manifest Anxiety Scale, Modified Leyton Obsessional Inventory, and clinical diagnosis.<bold>Results: </bold>During follow-up, there was a nonsignificant trend for dropouts to report higher depressive symptoms than completers. However, modeling showed insufficient evidence for an association between dropout and outcomes.<bold>Conclusion: </bold>In contrast to studies of adult therapy, there was no strong evidence that adolescent patients who dropped out had poorer clinical outcomes compared with those who completed therapy, when dropout was defined as ending treatment without agreement of the therapist. This challenges us to understand why adolescents stop going to therapy, how dropout should be defined, and whether what is prescribed is what is always needed.<bold>Clinical Trial Registration Information: </bold>Improving Mood and Preventing Relapse With Psychoanalytic Psychotherapy and Cognitive Behavior Therapy; http://www.isrctn.com/; 83033550. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Journal of the American Academy of Child & Adolescent Psychiatry is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ehh&AN=135741619
RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1016/j.jaac.2018.11.019
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      – Code: eng
        Text: English
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        PageCount: 1
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    Subjects:
      – SubjectFull: Adolescence
        Type: general
      – SubjectFull: Cognitive therapy
        Type: general
      – SubjectFull: Research
        Type: general
      – SubjectFull: Self-evaluation
        Type: general
      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Evaluation research
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      – SubjectFull: Psychological tests
        Type: general
      – SubjectFull: Comparative studies
        Type: general
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Randomized controlled trials
        Type: general
      – SubjectFull: Therapeutics
        Type: general
      – SubjectFull: Brief psychotherapy
        Type: general
      – SubjectFull: Patient dropouts
        Type: general
      – SubjectFull: Medical cooperation
        Type: general
      – SubjectFull: Treatment effectiveness
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      – SubjectFull: Psychosocial factors
        Type: general
      – SubjectFull: Questionnaires
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      – SubjectFull: Logistic regression analysis
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      – TitleFull: Prognostic Implications for Adolescents With Depression Who Drop Out of Psychological Treatment During a Randomized Controlled Trial.
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              Text: Apr2019
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              Y: 2019
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