Two-year outcome of children treated for depression

Vostanis, Panos; Feehan, Catherine; Grattan, E

doi:10.1007/s007870050039

Cited by 59 publications

(34 citation statements)

References 18 publications

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“…Of these children, 33.3 % showed a clinically significant reduction in level of psychopathology, plus an improvement of QoL. However, in accordance with previous studies [6,11,29] …”

Section: ■ Improvement Of Qolsupporting

confidence: 88%

“…Furthermore, treatment outcome studies in children and adolescents revealed that interventions may result in complete reduction of psychiatric symptoms in a number of patients, but, often, recovery is partial, or even absent [2,18,24,29]. Hence, it might be worthwhile also focussing on minimizing the impact of symptoms on the child's functioning and on improving the child's quality of everyday life [22].…”

Section: Introductionmentioning

confidence: 99%

“…This underscores the need to address QoL in child psychiatric treatment [22]. Current clinical intervention trials in children and adolescents mainly focussed on psychiatric symptoms as treatment outcome, and did not fully address QoL [2, 29,31,32].…”

Section: Introductionmentioning

confidence: 99%

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Psychopathology in children: Improvement of quality of life without psychiatric symptom reduction?

Bastiaansen

Koot

Ferdinand

2005

Europ.Child & Adolescent Psych

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■ Abstract Objective The aim of this study was to assess the association between change in psychopathology and Quality of Life (QoL) across time in children with high levels of psychopathology. Methods A referred sample of 126 seven-to 19-year-olds was studied across a 1-year follow-up period. Information concerning QoL and psychopathology was obtained from parents. Results Overall, 38.1 % of children showed neither psychiatric symptom reduction nor QoL improvement, 33.3 % of children showed both a clinically significant psychiatric symptom reduction and QoL improvement, and 28.6 % of children showed either psychiatric symptom reduction or QoL improvement. In 11

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“…Of these children, 33.3 % showed a clinically significant reduction in level of psychopathology, plus an improvement of QoL. However, in accordance with previous studies [6,11,29] …”

Section: ■ Improvement Of Qolsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Psychopathology in children: Improvement of quality of life without psychiatric symptom reduction?

Bastiaansen

Koot

Ferdinand

2005

Europ.Child & Adolescent Psych

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“…51,107,133 There were no studies on psychosis. Most (31/71) of the studies concerned interventions that could be classified as treatments (see Chapter 1, Intervention levels), [48][49][50][51][52]55,65,66,70,71,74,77,78,81,[83][84][85][86]91,[94][95][96][97][98][101][102][103][104]106,111,112,[121][122][123][124][125][126][127][129][130][131]133,135,139 with the remainder focusing equally on indicated (n = 11), 53,58,59,…”

Section: Description Of the Included Effectiveness Studiesmentioning

confidence: 99%

Developing a model of mental health self-care support for children and young people through an integrated evaluation of available types of provision involving systematic review, meta-analysis and case study

Pryjmachuk

Elvey

Kirk

et al. 2014

Health Services and Delivery Research

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BackgroundThe mental health of children and young people (CYP) is a major UK public health concern. Recent policy reviews have identified that service provision for CYP with mental health needs is not as effective, responsive, accessible or child-centred as it could be. Following on from a previous National Institute for Health Research (NIHR) study into self-care support for CYP with long-term physical health needs, this study explored self-care support’s potential in CYP’s mental health.ObjectivesTo identify and evaluate the types of mental health self-care support used by, and available to, CYP and their parents, and to establish how such support interfaces with statutory and non-statutory service provision.DesignTwo inter-related systematic literature reviews (an effectiveness review with meta-analysis and a perceptions review), together with a service mapping exercise and case study.SettingGlobal (systematic reviews); England and Wales (mapping exercise and case study).Participants (case study)Fifty-two individuals (17 CYP, 16 family members and 19 staff) were interviewed across six sites.Main outcome measures (meta-analysis)A measure of CYP’s mental health symptomatology.Data sources (literature reviews)MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, All Evidence-Based Medicine (EBM) Reviews, Applied Social Sciences Index and Abstracts (ASSIA) and Education Resources Information Center (ERIC).Review methodsTitles and abstracts of papers were screened for relevance then grouped into studies. Two independent reviewers extracted data from studies meeting the inclusion criteria. A descriptive analysis and meta-analysis were conducted for the effectiveness review; descriptive analyses were conducted for the perceptions review. These analyses were integrated to elicit a mixed-methods review.ResultsSixty-five of 71 included studies were meta-analysable. These 65 studies elicited 71 comparisons which, when meta-analysed, suggested that self-care support interventions were effective at 6-month [standardised mean difference (SMD) = −0.20; 95% confidence interval (CI) −0.28 to −0.11] and 12-month (SMD = −0.12; 95% CI −0.17 to −0.06) follow-ups. However, judged against Cochrane criteria, the studies were mostly low quality. Key elements of self-care support identified in the perceptions review were the acquisition of knowledge and skills, peer support and the relationship with the self-care support agent; CYP also had different perceptions from adults about what is important in self-care support. The mapping exercise identified 27 providers of 33 self-care support services. According to the case study data, effective self-care support services are predicated on flexibility; straightforward access; non-judgemental, welcoming organisations and staff; the provision of time and attention; opportunities to learn and practise skills relevant to self-care; and systems of peer support.ConclusionsMental health self-care support interventions for CYP are modestly effective in the short to medium term. Self-care support can be conceptualised as a process which has overlap with ‘recovery’. CYP and their families want choice and flexibility in the provision of such interventions and a continued relationship with services after the nominal therapy period. Those delivering self-care support need to have specific child-centred attributes.Future workFuture work should focus on under-represented conditions (e.g. psychosis, eating disorders, self-harm); the role of technology, leadership and readiness in self-care support; satisfaction in self-care support; the conceptualisation of self-care support in CYP’s mental health; and efficacy and cost-effectiveness.Study registrationPROSPERO number (for the effectiveness review) CRD42012001981.FundingThe NIHR Health Services and Delivery Research programme.

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“…All of these investigations are notable for their use of help-seeking samples, whether depressed adolescent outpatients or youths involved with the social service system. Vostanis and colleagues [35,43,44] compared brief CBT to supportive therapy in a sample of depressed teen outpatients and found no difference between the treatment groups in depression response (86% versus 75%). In this investigation, treatment not only was low dose (mean of six sessions) but also was offered over an extended time frame (1-5 months).…”

Section: Brief Cognitive Behavioral Therapymentioning

confidence: 99%