Cognitive-behavioral therapy for adolescents with inflammatory bowel disease and subsyndromal depression.
OBJECTIVE
To examine the feasibility and efficacy of a manual-based cognitive-behavioral therapy (CBT) in reducing depressive symptomatology in adolescents with inflammatory bowel disease (IBD). Primary and Secondary Control Enhancement Therapy-Physical Illness (PASCET-PI) modified for youths with IBD was compared to treatment as usual (TAU), plus an information sheet about depression, without therapist contact using assessable patient analysis.


METHODS
Following assessment, participants 11 to 17 years old with IBD and mild to moderate subsyndromal depression were randomly assigned to PASCET-PI (n = 22) or comparison treatment (n = 19). Primary outcome measures at baseline (T1) and 12 to 14 weeks posttreatment (T2) were Children's Depression Inventory (child/parent report), Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS), Children's Global Assessment Scale, and Perceived Control Scale for Children.


RESULTS
The PASCET-PI group showed significantly greater improvement in Children's Depression Inventory (child/parent report), Children's Global Assessment Scale, and Perceived Control Scale for Children posttreatment than the comparison group.


CONCLUSIONS
Screening and treatment of depressive symptoms in pediatric settings is feasible. PASCET-PI may be an efficacious intervention for subsyndromal depression in adolescents with IBD, although comparison with a more active treatment is necessary to attribute the improvement to PASCET-PI.


BACKGROUND
URL: http://clinicaltrials.gov. Unique identifier: NCT00446238.
Szigethy
Eva
E
Drs. Szigethy, Keljo, and Noll and Ms. Hardy are with Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Departments of Psychiatry and Pediatrics; Drs. Bousvaros, Beardslee, DeMaso, Ms. Kenney, and Ms. Carpenter are with Children's Hospital Boston/Harvard Medical School, Departments of Psychiatry and Pediatrics; Dr. Fairclough is with the University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometry; Dr. Weisz is with the Judge Baker Children's Center/Harvard Medical School. Electronic address: szigethye@upmc.edu.
Kenney
Elyse
E
Drs. Szigethy, Keljo, and Noll and Ms. Hardy are with Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Departments of Psychiatry and Pediatrics; Drs. Bousvaros, Beardslee, DeMaso, Ms. Kenney, and Ms. Carpenter are with Children's Hospital Boston/Harvard Medical School, Departments of Psychiatry and Pediatrics; Dr. Fairclough is with the University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometry; Dr. Weisz is with the Judge Baker Children's Center/Harvard Medical School.
Carpenter
Johanna
J
Drs. Szigethy, Keljo, and Noll and Ms. Hardy are with Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Departments of Psychiatry and Pediatrics; Drs. Bousvaros, Beardslee, DeMaso, Ms. Kenney, and Ms. Carpenter are with Children's Hospital Boston/Harvard Medical School, Departments of Psychiatry and Pediatrics; Dr. Fairclough is with the University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometry; Dr. Weisz is with the Judge Baker Children's Center/Harvard Medical School.
Hardy
Diana M
DM
Drs. Szigethy, Keljo, and Noll and Ms. Hardy are with Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Departments of Psychiatry and Pediatrics; Drs. Bousvaros, Beardslee, DeMaso, Ms. Kenney, and Ms. Carpenter are with Children's Hospital Boston/Harvard Medical School, Departments of Psychiatry and Pediatrics; Dr. Fairclough is with the University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometry; Dr. Weisz is with the Judge Baker Children's Center/Harvard Medical School.
Fairclough
Diane
D
Drs. Szigethy, Keljo, and Noll and Ms. Hardy are with Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Departments of Psychiatry and Pediatrics; Drs. Bousvaros, Beardslee, DeMaso, Ms. Kenney, and Ms. Carpenter are with Children's Hospital Boston/Harvard Medical School, Departments of Psychiatry and Pediatrics; Dr. Fairclough is with the University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometry; Dr. Weisz is with the Judge Baker Children's Center/Harvard Medical School.
Bousvaros
Athos
A
Drs. Szigethy, Keljo, and Noll and Ms. Hardy are with Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Departments of Psychiatry and Pediatrics; Drs. Bousvaros, Beardslee, DeMaso, Ms. Kenney, and Ms. Carpenter are with Children's Hospital Boston/Harvard Medical School, Departments of Psychiatry and Pediatrics; Dr. Fairclough is with the University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometry; Dr. Weisz is with the Judge Baker Children's Center/Harvard Medical School.
Keljo
David
D
Drs. Szigethy, Keljo, and Noll and Ms. Hardy are with Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Departments of Psychiatry and Pediatrics; Drs. Bousvaros, Beardslee, DeMaso, Ms. Kenney, and Ms. Carpenter are with Children's Hospital Boston/Harvard Medical School, Departments of Psychiatry and Pediatrics; Dr. Fairclough is with the University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometry; Dr. Weisz is with the Judge Baker Children's Center/Harvard Medical School.
Weisz
John
J
Drs. Szigethy, Keljo, and Noll and Ms. Hardy are with Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Departments of Psychiatry and Pediatrics; Drs. Bousvaros, Beardslee, DeMaso, Ms. Kenney, and Ms. Carpenter are with Children's Hospital Boston/Harvard Medical School, Departments of Psychiatry and Pediatrics; Dr. Fairclough is with the University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometry; Dr. Weisz is with the Judge Baker Children's Center/Harvard Medical School.
Beardslee
William R
WR
Drs. Szigethy, Keljo, and Noll and Ms. Hardy are with Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Departments of Psychiatry and Pediatrics; Drs. Bousvaros, Beardslee, DeMaso, Ms. Kenney, and Ms. Carpenter are with Children's Hospital Boston/Harvard Medical School, Departments of Psychiatry and Pediatrics; Dr. Fairclough is with the University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometry; Dr. Weisz is with the Judge Baker Children's Center/Harvard Medical School.
Noll
Robert
R
Drs. Szigethy, Keljo, and Noll and Ms. Hardy are with Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Departments of Psychiatry and Pediatrics; Drs. Bousvaros, Beardslee, DeMaso, Ms. Kenney, and Ms. Carpenter are with Children's Hospital Boston/Harvard Medical School, Departments of Psychiatry and Pediatrics; Dr. Fairclough is with the University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometry; Dr. Weisz is with the Judge Baker Children's Center/Harvard Medical School.
DeMASO
David Ray
DR
Drs. Szigethy, Keljo, and Noll and Ms. Hardy are with Children's Hospital of Pittsburgh/University of Pittsburgh Medical Center, Departments of Psychiatry and Pediatrics; Drs. Bousvaros, Beardslee, DeMaso, Ms. Kenney, and Ms. Carpenter are with Children's Hospital Boston/Harvard Medical School, Departments of Psychiatry and Pediatrics; Dr. Fairclough is with the University of Colorado Health Sciences Center, Department of Preventive Medicine and Biometry; Dr. Weisz is with the Judge Baker Children's Center/Harvard Medical School.
D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*; D008297:Male; D012720:Severity of Illness Index; D016896:Treatment Outcome