Abstract
Youths with chronic physical illnesses face increased rates of psychological problems and the burden of coping with physical illness-related challenges. The following data describes treatment outcome maintenance results from a randomized clinical trial investigating the impact of a cognitive behavioral intervention Primary and Secondary Control Enhancement Therapy-Physical Illness (PASCET-PI) as compared to treatment as usual (TAU) on youths with inflammatory bowel disease (IBD). Forty-one participants aged 11–17 with IBD and concurrent depressive symptomatology were randomized to PASCET-PI (n = 22) or TAU (n = 19). Self-reported depressive features, global functioning, and DSM-IV depressive symptomatology were assessed immediately post-treatment (T2), followed by assessments at 6-months (T3) and 12-months (T4) post-treatment initiation. Repeated measure models revealed significantly improved global psychosocial functioning in youths randomized to PASCET-PI compared to youths randomized to TAU. Improvements in self-reported depressive features and DSM-IV depressive symptoms were found at the trend level for youths randomized to PASCET-PI relative to those receiving TAU. Effect size estimates for all outcome variables suggested large to medium treatment effects.
Similar content being viewed by others
References
American Academy of Child and Adolescent Psychiatry (AACAP). (2002). Facts for families of the depressed child. Retrieved May 11, 2009, from http://www.aacap.org/.
Band, E. B., & Weisz, J. R. (1990). Developmental differences in primary and secondary control coping and adjustment to juvenile diabetes. Journal of Clinical Child Psychology, 19, 150–158.
Burke, P., & Elliot, M. (1999). Depression in pediatric chronic illness. A diathesis-stress model. Psychosomatics, 40, 5–17.
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17–31.
Clarke, G. N., Rohde, P., Lewinsohn, P. M., Hops, H., & Seeley, J. R. (1999). Cognitive- behavioral treatment of adolescent depression: Efficacy of acute group treatment and booster sessions. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 272–279.
Cooper, L. A., Gonzales, J. J., Gallo, J. J., Rost, K. M., Meredith, L. S., & Rubenstein, L. V. (2003). The acceptability of treatment for depression among African–American, Hispanic, and White primary care patients. Medical Care, 41, 479–489.
Engstrom, I. (1992). Mental health and psychological functioning in children and adolescents with inflammatory bowel disease: A comparison with children having other chronic illnesses and with healthy children. Journal of Child Psychology and Psychiatry, 33, 563–582.
Goodhand, J. R., Wahed, M., & Rampton, D. S. (2009). Management of stress in inflammatory bowel disease: A therapeutic option? Expert Review of Gastroenterology and Hepatology, 3, 661–679.
Hyams, J. S., Ferry, G. D., Mandel, F. S., Gryboski, J. D., Kibort, P. M., Kirschner, B. S., et al. (1991). Development and validation of a Pediatric Crohn’s Disease Activity Index. Journal of Pediatric Gastroenterology and Nutrition, 12, 439–447.
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for Affective Disorders and Schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988.
Kovacs, M. (1992). Children’s Depression Inventory manual. New York: Multi-health Systems.
Kozarek, R. A., Patterson, D. J., Gelfand, M. D., Botoman, V. A., Ball, T. J., & Wilske, K. R. (1989). Methotrexate induces clinical and histologic remission in patients with refractory inflammatory bowel disease. Annals of Internal Medicine, 110, 353–356.
Lernmark, B., Persson, B., Fisher, L., & Rydelius, P. A. (1999). Symptoms of depression are important to psychological adaptation and metabolic control in children with diabetes mellitus. Diabetic Medicine, 16, 14–22.
Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1998). Major depressive disorder in older adolescents: Prevalence, risk factors, and clinical implications. Clinical Psychology Review, 18, 765–794.
Lewinsohn, P. M., Seeley, J. R., Hibbard, J., Rohde, P., & Sack, W. H. (1996). Cross-sectional and prospective relationships between physical morbidity and depression in older adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1120–1129.
Mackner, L. M., Crandall, W. V., & Szigethy, E. (2006). Psychosocial functioning in pediatric inflammatory bowel disease. Inflammatory Bowel Diseases, 12, 239–244.
March, J., Silva, S., Curry, J., Wells, K., Fairbank, J., Burns, B., et al. (2009). The Treatment of Adolescents with Depression Study (TADS): Outcomes over 1 year of naturalistic follow-up. American Journal of Psychiatry, 166, 1141–1149.
Murch, S. H., Baldassano, R., Buller, H., Chin, S., Griffiths, A. M., Hildebrand, H., et al. (2004). Inflammatory bowel disease: Working group report group report of the second world congress of pediatric gastroenterology, hepatology, and nutrition. Journal of Pediatric Gastroenterology and Nutrition, 39, S647–S654.
Orvaschel, H., Puig-Antich, J., Chambers, W., Tabrizi, M. A., & Johnson, R. (1982). Retrospective assessment of prepubertal major depression with the kiddie-SADS-E. Journal of the American Academy of Child and Adolescent Psychiatry, 21, 392–397.
Pavuluri, M., & Birmaher, B. (2004). A practical guide to using ratings of depression and anxiety in child psychiatric practice. Current Psychiatry Reports, 6, 108–116.
Rofey, D. L., Szigethy, E. M., Noll, R. B., Dahl, R. E., Iobst, E., & Arslanian, S. A. (2009). Cognitive behavioral therapy for physical and emotional disturbances in adolescents with polycystic ovary syndrome: A pilot study. Journal of Pediatric Psychology, 34, 156–163.
Rubin, D. T., Dubinsky, M. C., Panaccione, R., Siegel, C. A., Binion, D. G., Kane, S. V., et al. (2010). The impact of ulcerative colitis on patients’ lives compared to other chronic diseases: A patient survey. Digestive Diseases and Sciences, 55, 1044–1052.
Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, P., Fisher, P., Bird, H., et al. (1983). A Children’s Global Assessment Scale (CGAS). Archives of General Psychiatry, 40, 1228–1231.
Sitarenios, G., & Stein, S. (2004). Use of the Children’s Depression Inventory. In M. E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment (Vol. 2, pp. 1–37). Mahwah, NJ: Lawrence Erlbaum Associates.
Smucker, M. R., Craighead, W. E., Craighead, L. W., & Green, B. J. (1986). Normative and reliability data for the Children’s Depression Inventory. Journal of Abnormal Child Psychology, 14, 25–39.
Strunk, R. (1987). Deaths from asthma in childhood: Patterns before and after professional intervention. Pediatric Asthma Allergy and Immunology, 1, 5–13.
Szigethy, E., Kenney, E., Carpenter, J., Hardy, D. M., Fairclough, D., Bousvaros, A., et al. (2007). Cognitive-behavioral therapy for adolescents with inflammatory bowel disease and subsyndromal depression. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1290–1298.
Szigethy, E. M., Levy-Warren, A., Whitton, S., Bousvaros, A., Gauvreau, K., Leichtner, A. M., et al. (2004a). Depressive symptoms and inflammatory bowel disease in children and adolescents: A cross-sectional study. Journal of Pediatric Gastroenterology and Nutrition, 39, 395–403.
Szigethy, E. M., & Low, C. (2009). Cytokines. In R. E. Ingram (Ed.), International encyclopedia of depression (pp. 200–204). New York: Springer.
Szigethy, E. M., Whitton, S., Levy-Warren, A., DeMaso, D. R., Weisz, J., & Beardslee, W. R. (2004b). Cognitive behavioral therapy for depression in adolescents with inflammatory bowel disease: A pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, Psychiatry, 43, 1469–1477.
Tang, Y., Preuss, F., Turek, F. W., Jakate, S., & Keshavarzian, A. (2009). Sleep deprivation worsens inflammation and delays recovery in a mouse model of colitis. Sleep Medicine, 10, 597–603.
Thompson, R. D., Delaney, P., Flores, I., & Szigethy, E. (2011). Cognitive-behavioral therapy for children with comorbid physical illness. Child and Adolescent Psychiatric Clinics of North America, 20, 329–348.
Weisz, J. R., McCabe, M. A., & Dennig, M. D. (1994). Primary and secondary control among children undergoing medical procedures: Adjustment as a function of coping style. Journal of Consulting and Clinical Psychology, 62, 324–332.
Weisz, J. R., Thurber, C. A., Sweeney, L., Proffitt, V. D., & LeGagnoux, G. L. (1997). Brief treatment of mild-to-moderate child depression using primary and secondary control enhancement training. Journal of Consulting and Clinical Psychology, 65, 703–707.
Acknowledgments
We would like to thank Elyse Kenney for her efforts in recruiting study participants and administering the follow-up assessments. Without her assistance, this project would not have been possible. This work was supported by Grant No. MH064604 from the National Institutes of Health and the Wolpow Family Fund.
Conflict of interest
The authors have no conflicts of interest to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Thompson, R.D., Craig, A., Crawford, E.A. et al. Longitudinal Results of Cognitive Behavioral Treatment for Youths with Inflammatory Bowel Disease and Depressive Symptoms. J Clin Psychol Med Settings 19, 329–337 (2012). https://doi.org/10.1007/s10880-012-9301-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10880-012-9301-8