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Effectiveness of Cognitive Behavioral Therapy in Reducing Depressive Symptoms in Physically Ill Youth - NCT00596869-15213(Clinical Trial 198852)



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City:  Pittsburgh
State:  
PA
Zip Code: 15213
Conditions: Depression - Ulcerative Colitis
Purpose: This study will compare the effectiveness of cognitive behavioral therapy with supportive nondirective therapy in reducing emotional distress and improving functioning in youth with inflammatory bowel disease and depression.
Study summary: Depression is a highly comorbid disorder: people with chronic physical illnesses are more than twice as likely as healthy people to develop symptoms of depression. Specifically, children and adolescents with inflammatory bowel disease (IBD) have higher rates of depressive symptoms and more trouble with daily functioning than those without physical illness. Furthermore, the medications used to treat IBD, such as steroids, may cause depression. Depression can add to the distress already caused by IBD and can inhibit affected individuals from seeking proper health care for their condition, making treatment of any depressive symptoms in youth with IBD particularly important. Cognitive behavioral therapy (CBT), a form of psychotherapy that teaches more effective ways to think and act in order to cope with illness, may improve both emotional and physical outcomes in youth with IBD. This study will compare the effectiveness of CBT with supportive nondirective therapy (SNDT) in reducing emotional distress and improving functioning in youth with IBD and depression. Study participation through follow-up will last 15 months. All participants will undergo initial assessments that will include an interview and questionnaires about their psychological and physical functioning and a blood test to assess current IBD severity. Eligible participants will then be assigned randomly to receive 12 weeks of CBT designed for youth with IBD or SNDT. Both groups will attend 12 weekly 45- to 60-minute sessions of their assigned treatments. Participants in the CBT group will learn new skills to cope better with emotions, physical illness, and pain. Specific topics will include problem solving skills, education about depression, goal setting, mood monitoring, increasing enjoyable activities, relaxation methods, and ways to change negative thinking into positive thinking. Participants in the SNDT group will receive social support and quality information about the warning signs and risk factors of depression. Both groups will have three parent sessions provided at the beginning, middle, and end of treatment to improve family understanding and communication about the physical illness and about risks for developing depression. Both groups of youth will also have booster sessions every 6 months during follow-up. Outcomes of emotional and health-related factors will be assessed at Months 1, 2, 3, 9, 15 and 18.
Criteria: Inclusion Criteria: - Children's Depression Inventory (CDI) or Children's Depression Inventory-Parent Version (CDI-P) greater than or equal to 10 - Meets diagnostic criteria for Crohn's disease or ulcerative colitis - Absence of mental retardation by history - Has at least one appointment at the gastrointestinal clinic (includes patients followed in these clinics as well as those seeking consultation) Exclusion Criteria: - History or current episode of bipolar disorder, eating disorder, or psychotic disorder by DSM-IV criteria - Taking antidepressant medications within 1 month of study entry - Suicidality with severity of intent requiring immediate psychiatric hospitalization or significant act involving intentional self-harm (e.g., cutting or overdose, resulting in medical attention) - Unacceptable risk of harm to others, as indicated by homicidal or other violent ideation, intent, or action OR use of illegal weapons - Pregnant - Substance abuse other than nicotine dependence within 1 month of study entry - Current treatment with CBT or failure of previous CBT trial of at least 12 treatment sessions over a period of less than 1 year conducted by an appropriately trained mental health provider using a manual - If currently receiving other psychotherapy modalities, willing to suspend treatment for 12-week acute treatment phase of study
Study is available at: Children's Hospital of Pittsburgh
Pittsburgh, PA 15213
United States

Primary Contact:
Eva M. Szigethy, MD, PhD
Email: szigethye@upmc.edu
Phone: 412-692-8147

Secondary Contact:
Eva M. Szigethy, MD, PhD
Email: szigethye@upmc.edu
Phone: 412-692-8147
If you are interested in this clinical trial please use the contact information above. If you would like to get additional information about this clinical trial please visit ClinicalTrials.gov.
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Data Source: ClinicalTrials.gov
Date Processed: March 22, 2011
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