Depression treatment in youth: effects on anxiety and dropout

Wright, Isobel (2019) Depression treatment in youth: effects on anxiety and dropout. Doctoral thesis, University of East Anglia.

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Background: Depression is a prevalent and disabling condition in youth. Concurrent anxiety symptoms are common. Several psychological treatments have demonstrated effectiveness at reducing depression in youth, but the acceptability of these treatments and impact on concurrent anxiety symptoms are not known.

Aims: To investigate dropout from youth depression treatments as a measure of acceptability. To investigate the trajectory of anxiety symptoms over the course of intervention aimed at depression using longitudinal data from a randomised controlled trial ('IMPACT', Goodyer et al., 2017).

Methods: A meta-analysis calculated dropout rates from randomised controlled trials investigating psychotherapy interventions for depression in youth. For the empirical study, growth mixture modelling was used to identify trajectories of anxiety symptoms in adolescents during depression intervention and follow-up.

Results: The meta-analysis included 37 studies (N=4343), and the overall estimate of dropout from active interventions was 14.6% (CI 12.0, 17.4); in general dropout was equally likely across intervention and control conditions, and interventions offering more sessions had fewer dropouts. From the ‘IMPACT’ trial dataset a 2-class piecewise model was identified. The smaller class (n=46) showed an improvement in anxiety symptoms during but not after treatment, the larger class (n=419) had no change in anxiety symptoms during or after treatment. When gender and baseline anxiety were controlled for, greater impairment in mood, self-esteem and increased suicidal thoughts were associated with membership to the non-improving class.

Conclusions: Depression interventions were acceptable, with little dropout. Anxiety symptoms may not be responsive to depression treatment in youth. Offering more 4 sessions and assessment of non-target symptoms for potential intervention may be beneficial.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Users 11011 not found.
Date Deposited: 28 Oct 2019 11:37
Last Modified: 07 Mar 2022 01:38


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