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Tindall L, Kerrigan P, Li J, Hayward E, Gega L. Is behavioural activation an effective treatment for depression in children and adolescents? An updated systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02429-3. [PMID: 38615316 DOI: 10.1007/s00787-024-02429-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/25/2024] [Indexed: 04/15/2024]
Abstract
Behavioural Activation (BA)-a brief therapy based on the scheduling of enjoyable, purposeful and rewarding activities-is an effective and cost-effective treatment for depression in adults that shows promise for children and adolescents. We provide an update on a previous systematic review of evidence on BA-delivered in-person, telephone, or online-for depression and comorbid anxiety in children and adolescents. We conducted systematic literature searches in 6 databases up to February 2024. We included all study designs evaluating BA with participants up to 18 years old with diagnosable depression, as established by a validated screening tool or diagnostic manual. We used the Moncrieff Scale and the Cochrane Risk of Bias tool to assess study quality. We summarised the findings of all study types with a narrative synthesis and of randomised controlled trials (RCTs) with a meta-analysis. Overall, 24 studies (6 RCTs, 18 pre-post evaluations, n = 2,758) met our inclusion criteria. A meta-analysis of 4 RCTs (n = 156) showed that BA has a small effect of 0.24 (Hedge's adjusted g) in reducing depression symptoms compared to a waiting-list control, usual care and other therapies. Online and telephone-facilitated BA was shown to be feasible in 3 studies and effective in 1. Outcomes on comorbid anxiety were mixed. No economic evaluations met our inclusion criteria. BA shows sufficient promise as an intervention for reducing depression symptoms in children and adolescents to justify the need for further RCTs, providing that five conditions are met: studies are powered to detect a minimal clinically important difference; BA materials are fit-for-purpose to produce clinically meaningful change; follow-ups are longer than 6 months; primary outcomes are child-reported; and intervention costs, resource use and adverse events are reported.
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Affiliation(s)
- Lucy Tindall
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.
| | - Philip Kerrigan
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Jinshuo Li
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Emily Hayward
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Lina Gega
- Hull York Medical School, University of York, Heslington, UK
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Angulo F, Goger P, Brent DA, Rozenman M, Gonzalez A, Schwartz KTG, Porta G, Lynch FL, Dickerson JF, Weersing VR. Impact of trauma exposure and depression comorbidity on response to transdiagnostic behavioral therapy for pediatric anxiety and depression. NPJ MENTAL HEALTH RESEARCH 2024; 3:8. [PMID: 38609501 PMCID: PMC10955846 DOI: 10.1038/s44184-023-00049-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/12/2023] [Indexed: 04/14/2024]
Abstract
By adolescence, two-thirds of youth report exposure to at least one traumatic event, yet the impact of trauma history is not routinely considered when evaluating the effect of psychotherapeutic interventions. Trauma may be a particularly important moderator of the effects of transdiagnostic therapies for emotional disorders, as trauma exposure is associated with risk for the development of comorbid depression and anxiety. The current study examined the history of trauma exposure and the presence of clinically significant depression as moderators of treatment outcomes in the Brief Behavioral Therapy (BBT) trial, the largest study of transdiagnostic psychotherapy for youth. Youths (age 8-16 years) were randomized to BBT (n = 89) based in pediatric primary care or assisted referral to outpatient community care (ARC; n = 86). Clinical response, functioning, anxiety symptoms, and depression symptoms were assessed at post-treatment (Week 16) and at follow-up (Week 32). A significant three-way interaction emerged between the treatment group, comorbid depression, and trauma exposure. BBT was broadly effective for 3/4 of the sample, but, for anxious-depressed youth with trauma exposure, BBT never significantly separated from ARC. Differences in outcome were not accounted for by other participant characteristics or by therapist-rated measures of alliance, youth engagement, or homework completion. Implications for models of learning and for intervention theory and development are discussed.
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Affiliation(s)
- Felix Angulo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Pauline Goger
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - David A Brent
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, USA
| | | | - Araceli Gonzalez
- Department of Psychology, California State University Long Beach, Long Beach, CA, USA
| | | | | | - Frances L Lynch
- Kaiser Permanente Center for Health Research, Portland, OR, USA
| | | | - V Robin Weersing
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
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Goger P, Rozenman M, Gonzalez A, Brent DA, Porta G, Lynch FL, Dickerson JF, Weersing VR. Early indicators of response to transdiagnostic treatment of pediatric anxiety and depression. J Child Psychol Psychiatry 2023; 64:1689-1698. [PMID: 37605294 PMCID: PMC10841059 DOI: 10.1111/jcpp.13881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Pediatric anxiety and depression are prevalent, impairing, and highly comorbid. Available evidence-based treatments have an average response rate of 60%. One path to increasing response may be to identify likely non-responders midway through treatment to adjust course prior to completing an episode of care. The aims of this study, thus, were to identify predictors of post-intervention response assessing (a) mid-treatment symptom severity, (b) session-by-session treatment process factors, and (c) a model optimizing the combination of these. METHOD Data were drawn from the treatment arm (N = 95, ages 8-16) of a randomized transdiagnostic intervention trial (Msessions = 11.2). Mid-point measures of youth- and parent-reported anxiety and depression were collected, and therapists rated homework completion, youth and parent engagement, and youth therapeutic alliance at each session. Logistic regression was used to predict response on the Clinical Global Impression Improvement Scale (CGI-I ≤2) rated by independent evaluators masked to treatment condition. RESULTS Mid-point symptom measures were significant predictors of treatment response, as were therapist-ratings of youth and parent engagement, therapeutic alliance, and homework completion. Therapist ratings were significant when tested as mean ratings summing across the first eight sessions of treatment (all ps < .004) and at individual session points (all ps <0.05). A combined prediction model included youth-reported anxiety, parent-reported depression, youth engagement at Session 2, and parent engagement at Session 8. This model correctly classified 76.5% of youth as non-responders and 91.3% as responders at post-treatment (Nagelkerke R2 = .59, χ2 (4, 80) = 46.54, p < .001). CONCLUSION This study provides initial evidence that response to transdiagnostic intervention for pediatric anxiety and depression may be reliably predicted by mid-point. These data may serve as foundational evidence to develop adaptive treatment strategies to personalize intervention, correct treatment course, and optimize outcomes for youth with anxiety and depression.
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Affiliation(s)
- Pauline Goger
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Michelle Rozenman
- UCLA Division of Child and Adolescent Psychiatry, Department of Psychology, University of Denver, Denver, CO, USA
| | - Araceli Gonzalez
- Department of Psychology, California State University Long Beach, Long Beach, CA, USA
| | - David A Brent
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
| | - Giovanna Porta
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Frances L Lynch
- Kaiser Permanente Center for Health Research, Portland, OR, USA
| | | | - V Robin Weersing
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
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Szigethy E, Wolfson D, Sinclair-McBride K, Williams K, Jhe G, Lee EH, Bialostozky M, Wallace M, Bhatnagar S, Demaso DR, Yealy DM, Hollenbach K. Efficacy of a digital mental health intervention embedded in routine care compared with treatment as usual in adolescents and young adults with moderate depressive symptoms: protocol for randomised controlled trial. BMJ Open 2023; 13:e067141. [PMID: 37001917 PMCID: PMC10069502 DOI: 10.1136/bmjopen-2022-067141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
INTRODUCTION There are unmet mental health needs of depressed adolescents and young adults (AYAs) across the USA. Behavioural technology adequately integrated into clinical care delivery has potential to improve care access and efficiency. This multisite randomised controlled trial evaluates how a coach-enhanced digital cognitive behavioural intervention (dCBI) enhances usual care for depressed AYAs in paediatric practices with minority enriched samples. METHODS AND ANALYSIS Participants (n=750) ages 16-22 who meet threshold criteria for depressive severity (Patient Health Questionnaire-9; PHQ-9 score 10-24) will be recruited through paediatric practices across three academic institutions (Boston, Pittsburgh and San Diego). Participants will be randomised to 12 weeks of dCBI+treatment as usual (TAU) (n=450) or TAU alone (n=300) in outpatient paediatric practices. Assessments will be completed at baseline, 6 weeks and 12 weeks with the primary outcome being improvement in clinician-rated and self-reported depressive severity (Children's Depression Rating Scale-Revised and PHQ-9) and secondary outcomes being self-reported suicidal ideation (item 9 on PHQ-9), anxiety severity (Generalised Anxiety Disorder), general quality of life (Satisfaction with Life Scale) and general functioning (Children's Global Assessment Scale). The study design is an intent-to-treat mixed effects regression with group, and covariates nested within the sites. ETHICS AND DISSEMINATION All participants or their parent/guardian (under 18 years or unemancipated) will give informed consent to a study team member. All data are expected to be collected over 18 months. The Institutional Review Board (IRB) is a board at each institution in the United States that reviews and monitors research involving human subjects. IRB approval from the University of Pittsburgh was obtained on 30 November 2021 (STUDY21080150), from the University of California San Diego's Human Research Protection Program IRB on 14 July 2022 (802047), and from the Boston Children's Hospital IRB on 25 October 2022 (P00040987). Full study results are planned to be published within 2 years of initial study recruitment (October 2024). Dissemination of findings will occur in peer-reviewed journals, professional conferences and through reports to participating entities and stakeholders. TRIAL REGISTRATION NUMBER NCT05159713; ClinicalTrials.gov.
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Affiliation(s)
- Eva Szigethy
- Department of Psychiatry and Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - David Wolfson
- Department of Pediatrics, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
| | | | - Kelly Williams
- University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
| | - Grace Jhe
- Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Erica H Lee
- Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts, USA
| | | | | | - Sonika Bhatnagar
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
| | - D R Demaso
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Donald M Yealy
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Brief Behavioral Therapy for Anxiety and Depression in Pediatric Primary Care: Breadth of Intervention Impact. J Am Acad Child Adolesc Psychiatry 2023; 62:230-243. [PMID: 36030033 DOI: 10.1016/j.jaac.2022.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/01/2022] [Accepted: 08/17/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To report on broad-based outcomes of the Brief Behavioral Therapy (BBT) trial for pediatric anxiety and depression. Secondary data analyses expand on previous reports by assessing diagnostic remission and independent functioning, impact on targeted psychopathology, and spillover effects on non-targeted outcomes. METHOD Youth (N = 185; 8-16.9 years; 58% female; 78% White; 21% Hispanic) with anxiety and/or depression were eligible for this multi-site trial. Enrolled youth were randomly assigned to receive 8 to 12 sessions of BBT in primary care or assisted referral to outpatient care (ARC). Assessments were conducted 16 and 32 weeks post randomization. RESULTS BBT was superior to ARC on remission of all targeted diagnoses (week 16: 56.8% vs 28.2%, p < .001; week 32: 62.5% vs 38.9%, p = .004), clinician-rated independent functioning (week 16: 75.0% vs 45.7%, p < .001; week 32: 81.2% vs 55.7%, p < .001), and on measures of anxiety, depression, suicide items, total comorbid behavioral and emotional problems, and hyperactivity (d = 0.21-0.49). Moderation analyses revealed superior outcomes for Hispanic youth in BBT vs ARC for diagnostic remission, anxiety, emotional problems, and parent-child conflict. Youth depression at baseline moderated effects on peer problems and parent-child conflict, with effects favoring BBT. Significant main and moderated effects of BBT on change in non-targeted outcomes were largely mediated by change in anxiety (24.2%-49.3% of total effects mediated). CONCLUSION BBT has positive effects on youth, mediated by the strong impact of the intervention on anxiety. Analyses continue to support positive outcomes for Hispanic youth, suggesting that BBT is a broadly effective transdiagnostic treatment option for diverse populations. CLINICAL TRIAL REGISTRATION INFORMATION Brief Cognitive Behavioral Therapy (CBT) for Pediatric Anxiety and Depression in Primary Care; https://clinicaltrials.gov; NCT01147614.
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Szigethy EM, Silfee V, Marroquin MA, Pavlick AN, Wallace ML, Williams KR, Hoberman AM. A Digital Cognitive-Behavioral Intervention for Depression and Anxiety Among Adolescents and Young Adults. Psychiatr Serv 2022; 74:437-440. [PMID: 36164775 DOI: 10.1176/appi.ps.202200045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Adolescents and young adults frequently experience anxiety and depression. The authors evaluated engagement in and effects of a coach-enhanced digital cognitive-behavioral intervention (dCBI; RxWell) targeting emotional distress in this age group. The dCBI app was prescribed to 506 adolescents and young adults at 35 pediatric practices; 278 enrolled in the app, of whom 58% engaged and 63% messaged their coach. Patients completed monthly General Anxiety Disorder-7 and eight-item Patient Health Questionnaire assessments, and a subset completed qualitative interviews. The dCBI app was associated with a significant reduction in anxiety and depression at 1 and 3 months. A dCBI is feasible as part of routine pediatric care and associated with reduced emotional distress.
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Affiliation(s)
- Eva M Szigethy
- Departments of Psychiatry (Szigethy, Marroquin, Pavlick, Wallace) and Pediatrics (Szigethy, Hoberman), University of Pittsburgh, Pittsburgh; UPMC Insurance Services Division (Silfee) and UPMC Center for High Value Health Care (Williams), Pittsburgh
| | - Valerie Silfee
- Departments of Psychiatry (Szigethy, Marroquin, Pavlick, Wallace) and Pediatrics (Szigethy, Hoberman), University of Pittsburgh, Pittsburgh; UPMC Insurance Services Division (Silfee) and UPMC Center for High Value Health Care (Williams), Pittsburgh
| | - Maria A Marroquin
- Departments of Psychiatry (Szigethy, Marroquin, Pavlick, Wallace) and Pediatrics (Szigethy, Hoberman), University of Pittsburgh, Pittsburgh; UPMC Insurance Services Division (Silfee) and UPMC Center for High Value Health Care (Williams), Pittsburgh
| | - Alexa N Pavlick
- Departments of Psychiatry (Szigethy, Marroquin, Pavlick, Wallace) and Pediatrics (Szigethy, Hoberman), University of Pittsburgh, Pittsburgh; UPMC Insurance Services Division (Silfee) and UPMC Center for High Value Health Care (Williams), Pittsburgh
| | - Meredith L Wallace
- Departments of Psychiatry (Szigethy, Marroquin, Pavlick, Wallace) and Pediatrics (Szigethy, Hoberman), University of Pittsburgh, Pittsburgh; UPMC Insurance Services Division (Silfee) and UPMC Center for High Value Health Care (Williams), Pittsburgh
| | - Kelly R Williams
- Departments of Psychiatry (Szigethy, Marroquin, Pavlick, Wallace) and Pediatrics (Szigethy, Hoberman), University of Pittsburgh, Pittsburgh; UPMC Insurance Services Division (Silfee) and UPMC Center for High Value Health Care (Williams), Pittsburgh
| | - Alejandro M Hoberman
- Departments of Psychiatry (Szigethy, Marroquin, Pavlick, Wallace) and Pediatrics (Szigethy, Hoberman), University of Pittsburgh, Pittsburgh; UPMC Insurance Services Division (Silfee) and UPMC Center for High Value Health Care (Williams), Pittsburgh
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7
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Weersing VR, Gonzalez A, Hatch B, Lynch FL. Promoting Racial/Ethnic Equity in Psychosocial Treatment Outcomes for Child and Adolescent Anxiety and Depression. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2022; 4:80-88. [PMID: 36177440 PMCID: PMC9477232 DOI: 10.1176/appi.prcp.20210044] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 05/26/2022] [Accepted: 07/05/2022] [Indexed: 12/01/2022] Open
Abstract
Anxiety and depression are the most prevalent and least treated pediatric mental health problems. Racial/ethnic minority youths face greater risks for developing anxiety and depression and experience higher burden as they are less likely to receive adequate mental health services for these conditions or to have their needs met. Further, standard evidence‐based interventions for youth anxiety and depression may show diminished effects with racial/ethnic minority youths and with families of lower socioeconomic status. While community‐level interventions to combat structural racism and reduce population‐level risk are sorely needed, many youths will continue to require acute treatment services for anxiety and depression and interventionists must understand how to bring equity to the forefront of care. In this review, we adopt a health system framework to examine racial/ethnic disparities in system‐, intervention‐, provider‐, and patient‐level factors for psychosocial treatment of pediatric anxiety and depression. Current evidence on disparities in access and in efficacy of psychosocial intervention for anxious and depressed youths is summarized, and we use our work in primary care as a case example of adapting an intervention to mitigate disparities and increase equity. We conclude with recommendations for disparity action targets at each level of the health system framework and provide example strategies for intervening on these mechanisms to improve the outcomes of racial/ethnic minority youths. Racial/ethnic minority youths face greater risks for developing anxiety and depression and experience higher burden from disorder as they are less likely to receive adequate mental health services for these conditions or to have their needs met. Increasing access to services for anxiety and depression is of critical and immediate importance for racial/ethnic minority families. Issues of access may be associated with the physical location of services (e.g., primary care or telehealth) or with barriers of language, income, or financing. Both service settings and research treatment protocols frequently require families of ethnic/racial minority youths to fit themselves to the demands of care, in ways that may not be culturally compatible (e.g., little parent involvement in treatment) or practically feasible (i.e., weekly sessions during parent working hours). Whenever possible, non‐essential aspects of intervention should be freed to match patient preferences and constraints, and interventions for anxiety and depression should be adopted that have broad impacts and options for personalization of goals.
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Affiliation(s)
- V. Robin Weersing
- SDSU‐UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA (V. R. Weersing); California State University Long Beach, Long Beach, California, USA (A. Gonzalez); OCHIN Research, Oregon Health Sciences University (B. Hatch); OCHIN Research, Kaiser Permanente Center for Health Research, Portland, Oregon, USA (F. L. Lynch)
| | - Araceli Gonzalez
- SDSU‐UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA (V. R. Weersing); California State University Long Beach, Long Beach, California, USA (A. Gonzalez); OCHIN Research, Oregon Health Sciences University (B. Hatch); OCHIN Research, Kaiser Permanente Center for Health Research, Portland, Oregon, USA (F. L. Lynch)
| | - Brigit Hatch
- SDSU‐UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA (V. R. Weersing); California State University Long Beach, Long Beach, California, USA (A. Gonzalez); OCHIN Research, Oregon Health Sciences University (B. Hatch); OCHIN Research, Kaiser Permanente Center for Health Research, Portland, Oregon, USA (F. L. Lynch)
| | - Frances L. Lynch
- SDSU‐UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA (V. R. Weersing); California State University Long Beach, Long Beach, California, USA (A. Gonzalez); OCHIN Research, Oregon Health Sciences University (B. Hatch); OCHIN Research, Kaiser Permanente Center for Health Research, Portland, Oregon, USA (F. L. Lynch)
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Catanzano M, Bennett SD, Tibber MS, Coughtrey AE, Liang H, Heyman I, Shafran R. A Mental Health Drop-In Centre Offering Brief Transdiagnostic Psychological Assessment and Treatment in a Paediatric Hospital Setting: A One-Year Descriptive Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105369. [PMID: 34069973 PMCID: PMC8157880 DOI: 10.3390/ijerph18105369] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022]
Abstract
AIM This study was part of a broader project to examine the acceptability, feasibility and impact of a transdiagnostic mental health drop-in centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long-term physical health conditions (LTCs). The aims of this investigation were to characterise: (i) the use of such a centre, (ii) the demographics and symptoms of those presenting to the centre, and (iii) the types of support that are requested and/or indicated. METHODS A mental health "booth" was located in reception of a national paediatric hospital over one year. Characteristics of young people with LTCs and their siblings/parents attending the booth were defined. Emotional/behavioural symptoms were measured using standardised questionnaires including the Strengths and Difficulties Questionnaire (SDQ). Participants subsequently received one of four categories of intervention: brief transdiagnostic cognitive behaviour therapy (CBT), referral to other services, neurodevelopmental assessment or signposting to resources. RESULTS One hundred and twenty-eight participants were recruited. The mean age of young people was 9.14 years (standard deviation: 4.28); 61% identified as white and 45% were male. Over half of young people recruited scored in the clinical range with respect to the SDQ. Presenting problems included: anxiety (49%), challenging behaviour (35%), low mood (22%) and other (15%). CONCLUSIONS A considerable proportion of young people with LTC in a paediatric hospital scored in the clinical range for common mental health problems, indicating a potential for psychological interventions.
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Affiliation(s)
- Matteo Catanzano
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
- Correspondence: ; Tel.: +44-(0)20-7405-9200
| | - Sophie D Bennett
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - Marc S Tibber
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK;
| | - Anna E Coughtrey
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - Holan Liang
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - The Lucy Project Team
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
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