App-enhanced transdiagnostic CBT for adolescents with mood or psychotic spectrum disorders.
Unified Protocol
bipolar
clinical high risk
cognitive behavioral therapy
depression
mHealth
psychosis
unipolar
youth
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
15 08 2022
15 08 2022
Historique:
received:
07
01
2022
revised:
25
04
2022
accepted:
15
05
2022
pubmed:
21
5
2022
medline:
22
6
2022
entrez:
20
5
2022
Statut:
ppublish
Résumé
Although transdiagnostic forms of cognitive-behavioral therapy (CBT) have been evaluated in individuals with depressive and anxiety disorders, few studies have examined their suitability for more severe disorders, such as recurrent or persistent major depressive disorder, bipolar disorder, or psychotic spectrum disorders. This study examined the acceptability and initial efficacy of an app-enhanced Unified Protocol for Adolescents [UP-A] when including youth with more severe mood disorders or psychotic spectrum disorders. We first adapted a mobile application (app), based on user-centered feedback from adolescents and their parents, to assist participants in reviewing session content, practicing skills learned in previous treatment sessions, and monitoring symptomatic progress. A total of 24 adolescents (M age = 15.2 years, SD = 1.6) with mood or psychotic spectrum disorders and their parents then participated in an open trial of the app-enhanced group treatment given over 9 weekly sessions. Adolescent participants and their parents rated the group treatment and mobile app as acceptable and useful. We observed significant improvements over the 9-week treatment in adolescents' depressive symptoms, attenuated psychotic symptoms, and global functioning. The frequency with which adolescents used the mobile app between sessions was positively related to symptomatic and functional gains. Initial findings suggest the acceptability and feasibility of a mobile app that enabled adolescent participants and their parents to review session content and practice treatment skills. Findings also indicated improvements in psychiatric and functional outcomes among the adolescent participants over the course of the app-enhanced treatment. Randomized clinical trials are needed to evaluate the efficacy of app-enhanced CBT in improving symptoms and functioning in adolescents with mood or psychotic spectrum disorders.
Sections du résumé
BACKGROUND
Although transdiagnostic forms of cognitive-behavioral therapy (CBT) have been evaluated in individuals with depressive and anxiety disorders, few studies have examined their suitability for more severe disorders, such as recurrent or persistent major depressive disorder, bipolar disorder, or psychotic spectrum disorders. This study examined the acceptability and initial efficacy of an app-enhanced Unified Protocol for Adolescents [UP-A] when including youth with more severe mood disorders or psychotic spectrum disorders.
METHODS
We first adapted a mobile application (app), based on user-centered feedback from adolescents and their parents, to assist participants in reviewing session content, practicing skills learned in previous treatment sessions, and monitoring symptomatic progress. A total of 24 adolescents (M age = 15.2 years, SD = 1.6) with mood or psychotic spectrum disorders and their parents then participated in an open trial of the app-enhanced group treatment given over 9 weekly sessions.
RESULTS
Adolescent participants and their parents rated the group treatment and mobile app as acceptable and useful. We observed significant improvements over the 9-week treatment in adolescents' depressive symptoms, attenuated psychotic symptoms, and global functioning. The frequency with which adolescents used the mobile app between sessions was positively related to symptomatic and functional gains.
CONCLUSIONS
Initial findings suggest the acceptability and feasibility of a mobile app that enabled adolescent participants and their parents to review session content and practice treatment skills. Findings also indicated improvements in psychiatric and functional outcomes among the adolescent participants over the course of the app-enhanced treatment. Randomized clinical trials are needed to evaluate the efficacy of app-enhanced CBT in improving symptoms and functioning in adolescents with mood or psychotic spectrum disorders.
Identifiants
pubmed: 35594972
pii: S0165-0327(22)00609-7
doi: 10.1016/j.jad.2022.05.094
pmc: PMC9728252
mid: NIHMS1852224
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
319-326Subventions
Organisme : NIMH NIH HHS
ID : K23 MH124015
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH123575
Pays : United States
Organisme : NIMH NIH HHS
ID : R34 MH117200
Pays : United States
Informations de copyright
Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.
Références
J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57
pubmed: 9881538
Behav Ther. 2016 Sep;47(5):755-772
pubmed: 27816086
JMIR Serious Games. 2018 May 10;6(2):e9
pubmed: 29748165
Behav Cogn Psychother. 2016 Mar;44(2):225-35
pubmed: 26853497
J Affect Disord. 2020 Mar 1;264:438-445
pubmed: 31759672
Trials. 2014 May 08;15:161
pubmed: 24886581
Cogn Behav Pract. 2020 May;27(2):202-214
pubmed: 33519172
Arch Gen Psychiatry. 2012 Mar;69(3):220-9
pubmed: 22393215
Behav Modif. 2006 Sep;30(5):647-72
pubmed: 16894234
Am Psychol. 2010 Feb-Mar;65(2):73-84
pubmed: 20141263
Behav Ther (N Y N Y). 2012 Apr;35(4):65-73
pubmed: 25530659
J Am Acad Child Adolesc Psychiatry. 2014 Aug;53(8):848-58
pubmed: 25062592
Schizophr Bull. 2003;29(4):703-15
pubmed: 14989408
Schizophr Res. 2017 Dec;190:90-95
pubmed: 28372906
Schizophr Res. 2011 Jun;129(1):42-6
pubmed: 21511440
J Clin Psychiatry. 2010 Mar;71(3):313-26
pubmed: 20331933
Child Fam Behav Ther. 2009 Jan;31(1):20-37
pubmed: 19617930
J Anxiety Disord. 2017 Mar;46:46-55
pubmed: 27771133
Psychol Med. 2014 Jan;44(1):17-24
pubmed: 23414600
JMIR Res Protoc. 2016 Nov 10;5(4):e209
pubmed: 27833071
J Affect Disord. 2007 Jun;100(1-3):279-81
pubmed: 17433450
Bipolar Disord. 2018 Jul 15;:
pubmed: 30009578
Early Interv Psychiatry. 2019 Apr;13(2):208-216
pubmed: 28776930
Arch Gen Psychiatry. 1983 Nov;40(11):1228-31
pubmed: 6639293
J Affect Disord. 2021 Feb 15;281:438-446
pubmed: 33360365
JAMA Psychiatry. 2016 Mar;73(3):191-2
pubmed: 26765254
Schizophr Res. 2011 Jan;125(1):54-61
pubmed: 21074974
World Psychiatry. 2018 Jun;17(2):133-142
pubmed: 29856558
Depress Anxiety. 2015 Dec;32(12):935-43
pubmed: 26372401