While recent research has yielded advances in the psycho-social treatment of depression among adults, few studies have addressed adolescent depression and none have specifically targeted depressed pre-adolescents. Given that earlier onset may be associated with longer time to recovery and greater family history of affective disorders, development of effective treatments for depression in pre-adolescents children is critical. The goal of this project is to adapt family-focused intervention strategies, which have proven efficacy with adult mood disorders, to target school-aged children with depression. The project would consist of two phases. In the first phase, 10 children (ages 8-13) with a diagnosis of major depressive and/or dysthymic disorder (assessed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children) and their parents would participate in a treatment development phage, in which they would receive 8-10 sessions of a family based treatments using a preliminary treatment manual. Goals of treatment development include evaluating the utility of specific treatment components, designing flexible strategies for age-developmental level, developing specific procedures for addressing diagnostic co-morbidity, and determining appropriate treatment length. In the second phase, 24 children with major depressive and/or dysthymic disorders and their parents would participate in a small clinical trial and be randomly assigned to either family-focused treatment or a wait-list control group (to receive family-focused treatment after a three-month interval). Goals in Phase 2 include evaluating the relative efficacy of the new treatment (as compared to the control condition), assessing its impact on psycho-social functioning, and identifying variables potentially mediating treatment effects At study entry, immediately post-treatment (3 months) and at 6- and 12- month follow-up points, participants in both phases would undergo intensive evaluation of clinical state. Psycho-social functioning, cognitive processes, family functioning and environmental context. It is hypothesized that children receiving the family-focused intervention will demonstrate greater improvement in symptoms and psycho-social functioning and be more likely to recover from their depressive episodes than children in the comparison condition. Exploratory analyses will examine changes on potential mediating variables, particularly measures of family functioning.
Tompson, Martha C; Pierre, Claudette B; Haber, Fawn McNeil et al. (2007) Family-focused treatment for childhood-onset depressive disorders: results of an open trial. Clin Child Psychol Psychiatry 12:403-20 |