@Article{info:doi/10.2196/18047,
author="Lindqvist, Karin
and Mechler, Jakob
and Carlbring, Per
and Lilliengren, Peter
and Falkenstr{\"o}m, Fredrik
and Andersson, Gerhard
and Johansson, Robert
and Edbrooke-Childs, Julian
and Dahl, Hanne-Sofie J
and Lindert Bergsten, Katja
and Midgley, Nick
and Sandell, Rolf
and Thor{\'e}n, Agneta
and Topooco, Naira
and Ulberg, Randi
and Philips, Bj{\"o}rn",
title="Affect-Focused Psychodynamic Internet-Based Therapy for Adolescent Depression: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2020",
month="Mar",
day="30",
volume="22",
number="3",
pages="e18047",
keywords="depressive disorder; adolescents; psychodynamic; internet-based treatment; treatment outcome; mobile phone",
abstract="Background: Adolescent depression is one of the largest health issues in the world and there is a pressing need for effective and accessible treatments. Objective: This trial examines whether affect-focused internet-based psychodynamic therapy (IPDT) with therapist support is more effective than an internet-based supportive control condition on reducing depression in adolescents. Methods: The trial included 76 adolescents (61/76, 80{\%} female; mean age 16.6 years), self-referred via an open access website and fulfilling criteria for major depressive disorder. Adolescents were randomized to 8 weeks of IPDT (38/76, 50{\%}) or supportive control (38/76, 50{\%}). The primary outcome was self-reported depressive symptoms, measured with the Quick Inventory of Depressive Symptomatology for Adolescents (QIDS-A17-SR). Secondary outcomes were anxiety severity, emotion regulation, self-compassion, and an additional depression measure. Assessments were made at baseline, postassessment, and at 6 months follow-up, in addition to weekly assessments of the primary outcome measure as well as emotion regulation during treatment. Results: IPDT was significantly more effective than the control condition in reducing depression (d=0.82, P=.01), the result of which was corroborated by the second depression measure (d=0.80, P<.001). IPDT was also significantly more effective in reducing anxiety (d=0.78, P<.001) and increasing emotion regulation (d=0.97, P<.001) and self-compassion (d=0.65, P=.003). Significantly more patients in the IPDT group compared to the control group met criteria for response (56{\%} vs 21{\%}, respectively) and remission (35{\%} vs 8{\%}, respectively). Results on depression and anxiety symptoms were stable at 6 months follow-up. On average, participants completed 5.8 (SD 2.4) of the 8 modules. Conclusions: IPDT may be an effective intervention to reduce adolescent depression. Further research is needed, including comparisons with other treatments. Trial Registration: International Standard Randomised Controlled Trial Number (ISRCTN) 16206254; http://www.isrctn.com/ISRCTN16206254 ",
issn="1438-8871",
doi="10.2196/18047",
url="http://www.jmir.org/2020/3/e18047/",
url="https://doi.org/10.2196/18047",
url="http://www.ncbi.nlm.nih.gov/pubmed/32224489"
}