Review: How has cognitive behaviour therapy been adapted for adolescents with comorbid depression and chronic illness? A scoping review
Open accessAbstract
Background: Depression becomes increasingly common in adolescence. Around 10%–20% of adolescents have a chronic illness, and they are more likely to experience depression. There is emerging evidence for cognitive behaviour therapy (CBT) interventions to treat depression in adolescents with chronic illnesses, yet no review has been undertaken of how these CBT interventions are delivered in practice. Methods: We conducted a scoping review to summarise how CBT has been delivered in adolescents with chronic illness and depression. We included studies that evaluated CBT aimed at treating depression/depressive symptoms in adolescents with chronic illness. Searches were carried out across Embase and PsycNET. Results: Twelve studies met our inclusion criteria. These included diabetes ( n = 3), inflammatory bowel disease ( n = 3), polycystic ovary syndrome ( n = 2), chronic headache ( n = 1), chronic pain ( n = 1), chronic fatigue syndrome ( n = 1) and Fanconi anaemia ( n = 1). Adaptations made to the delivery of CBT included cognitive restructuring of illness‐related thoughts, behavioural activation balancing illness‐related and enjoyable activities, psychoeducation of the comorbidity and link between the chronic illness and depression, relationship building, skill building and parental or familial involvement. CBT was typically delivered by trained professionals with expertise in working with adolescents, who worked under supervision. Conclusions: CBT for depression is commonly adapted for this population, and the nature of cognitions and behaviours targeted in CBT may typically depend on how the chronic illness presents. There is relatively little evidence to date, and a need for more research into the efficacy and effectiveness of treatments for adolescent depression in this vulnerable population specifically.
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CBT is effective when specifically targeting adolescents and young adults with chronic conditions and comorbid symptoms of anxiety and depression.
“Studies also suggest the effectiveness of CBT when specifically targeting AYA with chronic conditions and comorbid symptoms of anxiety and depression [13].”
From Feasibility and potential efficacy of a guided internet- and mobile-based CBT for adolescents and young adults with chronic medical conditions and comorbid depression or anxiety symptoms (youthCOACHCD): a randomized controlled pilot trial (2022) · cites this paper as [13]
The Abstract (page not provided) says there is emerging evidence that CBT is effective for depression in adolescents with chronic illness. The Eligibility criteria limit the review to adolescents aged 11–19 or samples with a mean age in that range, and the Discussion says the review did not evaluate intervention efficacy. It therefore does not establish effectiveness for the broader adolescent-and-young-adult population or for comorbid anxiety symptoms. (LLM, conf=0.86)
Experimental — accuracy not yet measuredCBT has been shown to help in several chronic conditions, including chronic pain, diabetes, irritable bowel syndrome, and polycystic ovarian syndrome.
“A variety of evidence-based psychotherapeutic treatments for depression are available (American Psychiatric Association, 2000), chief among them being CBT, shown to help in several chronic conditions, including chronic pain, diabetes, irritable bowel syndrome, and polycystic ovarian syndrome [37,38].”
From Psychological and Psychiatric Comorbidities in Youth with Serious Physical Illness (2022) · cites this paper as [38]
The Introduction (page unavailable) says CBT may reduce mental-health symptoms in children and adolescents with inflammatory bowel disease and chronic pain. The Results include studies involving diabetes and polycystic ovary syndrome, but the Discussion says this review did not evaluate intervention efficacy. The claim also names irritable bowel syndrome, whereas the paper names inflammatory bowel disease; it does not establish that CBT helps with all four listed conditions. (LLM, conf=0.88)
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- Authors
- Morey, A., & Loades, M. E.
- Affiliations
- University of Bath (GB)
- University of Bristol (GB)
- Corresponding author
- Loades, Maria E.
- ORCID
- Loades, Maria E.
- Venue
- Child and Adolescent Mental Health
- Publisher
- Wiley
- Published
- 2020-09-20
- Volume
- 26
- Issue
- 3
- Pages
- 252-264
- ISSN
- 1475-357X (ISSN-L)
- 1475-3588
- OpenAlex
- W3045247450
- Cited by
- 20
- References
- 52
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 2
- FWCI
- 0.18
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Child and Adolescent Mental Health (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Explore Bristol Research (submittedVersion, other-oa)
- Funders
- National Institute for Health and Care Research (DRF-2016-09-021)
- Department of Health and Social Care
- University of Bath
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- cognitive behavioral therapy, adolescent depression, chronic disease, comorbidities, treatment adaptation, diabetes mellitus, inflammatory bowel disease, polycystic ovary syndrome, chronic pain, chronic fatigue syndrome, Fanconi anaemia, behavioral activation, cognitive restructuring, psychoeducation, parental involvement, relationship building, skill development
- MeSH terms
- Adolescent, Chronic Disease, Depression, Female, Humans, Parents, Cognitive Behavioral Therapy, Chronic Pain
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