title: Randomized efficacy trial of two psychotherapies for depression in youth with inflammatory bowel disease.
abstract: OBJECTIVE
  Pediatric inflammatory bowel disease (IBD) is associated with high rates of depression. This study compared the efficacy of cognitive behavioral therapy (CBT) to supportive nondirective therapy (SNDT) in treating youth with comorbid IBD and depression.
  
  
  METHODS
  Youth (51% female and 49% male; age 9-17 years, mean age 14.3 years) with depression and Crohn's disease (n = 161) or ulcerative colitis (n = 56) were randomly assigned to a 3-month course of CBT or SNDT. The primary outcome was comparative reduction in depressive symptom severity; secondary outcomes were depression remission, increase in depression response, and improved health-related adjustment and IBD activity.
  
  
  RESULTS
  A total of 178 participants (82%) completed the 3-month intervention. Both psychotherapies resulted in significant reductions in total Children's Depression Rating Scale Revised score (37.3% for CBT and 31.9% for SNDT), but the difference between the 2 treatments was not significant (p = .16). There were large pre-post effect sizes for each treatment (d = 1.31 for CBT and d = 1.30 for SNDT). More than 65% of youth had a complete remission of depression at 3 months, with no difference between CBT and SNDT (67.8% and 63.2%, respectively). Compared to SNDT, CBT was associated with a greater reduction in IBD activity (p = .04) but no greater improvement on the Clinical Global Assessment Scale (p = .06) and health-related quality of life (IMPACT-III scale) (p = .07).
  
  
  CONCLUSIONS
  This is the first randomized controlled study to suggest improvements in depression severity, global functioning, quality of life, and disease activity in a physically ill pediatric cohort treated with psychotherapy. Clinical trial registration information-Reducing Depressive Symptoms in Physically Ill Youth; http://clinical trials.gov; NCT00534911.
authors: University of Pittsburgh. Electronic address: szigethye@upmc.edu.
authors: Eva
authors: E
authors: Szigethy
authors: Boston Children's Hospital.
authors: Simona I
authors: SI
authors: Bujoreanu
authors: University of Pittsburgh.
authors: Ada O
authors: AO
authors: Youk
authors: Harvard University.
authors: John
authors: J
authors: Weisz
authors: University of Pittsburgh.
authors: David
authors: D
authors: Benhayon
authors: Colorado School of Public Health.
authors: Diane
authors: D
authors: Fairclough
authors: Boston Children's Hospital.
authors: Peter
authors: P
authors: Ducharme
authors: Boston Children's Hospital.
authors: Joseph
authors: J
authors: Gonzalez-Heydrich
authors: University of Pittsburgh.
authors: David
authors: D
authors: Keljo
authors: University of Pittsburgh.
authors: Arvind
authors: A
authors: Srinath
authors: Boston Children's Hospital.
authors: Athos
authors: A
authors: Bousvaros
authors: University of Pittsburgh.
authors: Margaret
authors: M
authors: Kirshner
authors: University of Pittsburgh.
authors: Melissa
authors: M
authors: Newara
authors: University of Pittsburgh.
authors: David
authors: D
authors: Kupfer
authors: Boston Children's Hospital.
authors: David R
authors: DR
authors: DeMaso
mesh_terms: D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D008297:Male; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome
keywords: depression; inflammatory bowel disease; physical illness; psychotherapy; quality of life