CoChat
Sign Up
Cited by 259Psychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTreatment of Major Depression

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial

Open access
Goodyer, Ian M, Reynolds, Shirley, Barrett, Barbara, Byford, Sarah, Dubicka, Bernadka, Hill, Jonathan, Holland, Fiona, Kelvin, Raphael, Midgley, Nick, Roberts, Chris, Senior, Rob, Target, Mary, Widmer, Barry, Wilkinson, Paul, Fonagy, Peter·2017·The Lancet Psychiatry
DOI 10.1016/s2215-0366(16)30378-9PMC PMC5285447
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Psychological treatments for adolescents with unipolar major depressive disorder are associated with diagnostic remission within 28 weeks in 65-70% of patients. We aimed to assess the medium-term effects and costs of psychological therapies on maintenance of reduced depression symptoms 12 months after treatment. METHODS: We did this multicentre, pragmatic, observer-blind, randomised controlled superiority trial (IMPACT) at 15 National Health Service child and adolescent mental health service (CAMHS) clinics in three regions in England. Adolescent patients (aged 11-17 years) with a diagnosis of DSM IV major depressive disorder were randomly assigned (1:1:1), via a web-based randomisation service, to receive cognitive behavioural therapy (CBT) or short-term psychoanalytical therapy versus a reference brief psychological intervention. Randomisation was stochastically minimised by age, sex, self-reported depression sum score, and region. Patients and clinicians were aware of group allocation, but allocation was concealed from outcome assessors. Patients were followed up and reassessed at weeks 6, 12, 36, 52, and 86 post-randomisation. The primary outcome was self-reported depression symptoms at weeks 36, 52, and 86, as measured with the self-reported Mood and Feelings Questionnaire (MFQ). Because our aim was to compare the two psychological therapies with the brief psychosocial intervention, we first established whether CBT was inferior to short-term psychoanalytical psychotherapy for the same outcome. Primary analysis was by intention to treat. This trial is registered with Current Controlled Trials, number ISRCTN83033550. FINDINGS: Between June 29, 2010, and Jan 17, 2013, we randomly assigned 470 patients to receive the brief psychosocial intervention (n=158), CBT (n=155), or short-term psychoanalytical therapy (n=157); 465 patients comprised the intention-to-treat population. 392 (84%) patients had available data for primary analysis by the end of follow-up. Treatment fidelity and differentiation were established between the three interventions. The median number of treatment sessions differed significantly between patients in the brief psychosocial intervention group (n=6 [IQR 4-11]), CBT group (n=9 [5-14]), and short-term psychoanalytical therapy group (n=11 [5-23]; p<0·0001), but there was no difference between groups in the average duration of treatment (27·5 [SD 21·5], 24·9 [17·7], 27·9 [16·8] weeks, respectively; Kruskal-Wallis p=0·238). Self-reported depression symptoms did not differ significantly between patients given CBT and those given short-term psychoanalytical therapy at weeks 36 (treatment effect 0·179, 95% CI -3·731 to 4·088; p=0·929), 52 (0·307, -3·161 to 3·774; p=0·862), or 86 (0·578, -2·948 to 4·104; p=0·748). These two psychological treatments had no superiority effect compared with brief psychosocial intervention at weeks 36 (treatment effect -3·234, 95% CI -6·611 to 0·143; p=0·061), 52 (-2·806, -5·790 to 0·177; p=0·065), or 86 (-1·898, -4·922 to 1·126; p=0·219). Physical adverse events (self-reported breathing problems, sleep disturbances, drowsiness or tiredness, nausea, sweating, and being restless or overactive) did not differ between the groups. Total costs of the trial interventions did not differ significantly between treatment groups. INTERPRETATION: We found no evidence for the superiority of CBT or short-term psychoanalytical therapy compared with a brief psychosocial intervention in maintenance of reduced depression symptoms 12 months after treatment. Short-term psychoanalytical therapy was as effective as CBT and, together with brief psychosocial intervention, offers additional patient choice for psychological therapy, alongside CBT, for adolescents with moderate to severe depression who are attending routine specialist CAMHS clinics. FUNDING: National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme, and the Department of Health.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/s2215-0366(16)30378-9

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Figures

Figure Trial profile BPI=brief psychological intervention. CBT=cognitive behavioural therapy. STPP=short-term psychoanalytical psychotherapy. *The primary hypothesis was analysed in 392 (84%) of 465 patients who were randomised, accepted treatment, and provided one or more self-reported depression symptom score over the 36, 52, or 86 week assessment points. Five patients withdrew consent before starting treatment (n=3 in the BPI group, n=1 each in the CBT and STPP groups) and requested their data be deleted.
Figure Trial profile BPI=brief psychological intervention. CBT=cognitive behavioural therapy. STPP=short-term psychoanalytical psychotherapy. *The primary hypothesis was analysed in 392 (84%) of 465 patients who were randomised, accepted treatment, and provided one or more self-reported depression symptom score over the 36, 52, or 86 week assessment points. Five patients withdrew consent before starting treatment (n=3 in the BPI group, n=1 each in the CBT and STPP groups) and requested their data be deleted.CC BY-NC-ND · PubMed Central

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Show all 32 references

Research works printed but not linked: 1

  1. Byford, 2007, Cost-effectiveness of selective serotonin reuptake inhibitors and routine specialist care with and without cognitive behavioural therapy in adolescents with major depression, Br J Psychiatry, 191, 521, 10.1192/bjp.bp.107.038984 · DOI

Cited by

Sorted by citations

Items 101–200 of 259

Related

See all

Metadata

Authors
Goodyer, I. M., Reynolds, S., Barrett, B., Byford, S., Dubicka, B., Hill, J., Holland, F., Kelvin, R., Midgley, N., Roberts, C., Senior, R., Target, M., Widmer, B., Wilkinson, P., & Fonagy, P.
Affiliations
  • University of Cambridge (GB)
  • University of Reading (GB)
  • King's College London (GB)
  • University of Manchester (GB)
  • Anna Freud Centre (GB)
  • The Tavistock and Portman NHS Foundation Trust (GB)
  • University College London (GB)
Corresponding author
Goodyer, Ian M
ORCID
Venue
The Lancet Psychiatry
Publisher
Elsevier BV
Published
2017-02
Volume
4
Issue
2
Pages
109-119
ISSN
2215-0366 (ISSN-L)
DOI
10.1016/s2215-0366(16)30378-9
PMC
PMC5285447
OpenAlex
W2558778675
Cited by
259
References
32
Citations by year
2026: 12 · 2025: 24 · 2024: 32 · 2023: 18 · 2022: 30 · 2021: 42 · 2020: 34 · 2019: 34 · 2018: 17 · 2017: 13
FWCI
29.87
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Psychiatry (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Staff Publications Online (The Tavistock and Portman) (acceptedVersion)
  • CentAUR (University of Reading) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
  • Apollo (University of Cambridge) (submittedVersion, cc-by-nc-nd)
  • UCL Discovery (University College London) (submittedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion, other-oa)
  • Apollo
Funders
National Institute for Health and Care Research (97/29/01, 06-05-01, NF-SI-0514-10157)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Keywords
adolescent depression, unipolar major depression, cognitive behavioral therapy, brief psychosocial intervention, remission maintenance, intervention fidelity, child and adolescent mental health services, treatment costs, IMPACT trial, Mood and Feelings Questionnaire
MeSH terms
Adolescent, Child, Cost-Benefit Analysis, Major Depressive Disorder, England, Female, Humans, Male, Psychiatric Status Rating Scales, State Medicine, Cognitive Behavioral Therapy, Linear Models, Treatment Outcome, Self Report

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review