TY  - JOUR
AU  - Lindqvist, Karin
AU  - Mechler, Jakob
AU  - Carlbring, Per
AU  - Lilliengren, Peter
AU  - Falkenström, Fredrik
AU  - Andersson, Gerhard
AU  - Johansson, Robert
AU  - Edbrooke-Childs, Julian
AU  - Dahl, Hanne-Sofie J
AU  - Lindert Bergsten, Katja
AU  - Midgley, Nick
AU  - Sandell, Rolf
AU  - Thorén, Agneta
AU  - Topooco, Naira
AU  - Ulberg, Randi
AU  - Philips, Björn
PY  - 2020
DA  - 2020/3/30
TI  - Affect-Focused Psychodynamic Internet-Based Therapy for Adolescent Depression: Randomized Controlled Trial
JO  - J Med Internet Res
SP  - e18047
VL  - 22
IS  - 3
KW  - depressive disorder
KW  - adolescents
KW  - psychodynamic
KW  - internet-based treatment
KW  - treatment outcome
KW  - mobile phone
AB  - 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 
SN  - 1438-8871
UR  - http://www.jmir.org/2020/3/e18047/
UR  - https://doi.org/10.2196/18047
UR  - http://www.ncbi.nlm.nih.gov/pubmed/32224489
DO  - 10.2196/18047
ID  - info:doi/10.2196/18047
ER  -