Skip to main content
Top
Gepubliceerd in: Journal of Abnormal Child Psychology 5/2017

08-09-2016

Psychoeducational Psychotherapy and Omega-3 Supplementation Improve Co-Occurring Behavioral Problems in Youth with Depression: Results from a Pilot RCT

Auteurs: Andrea S. Young, L. Eugene Arnold, Hannah L. Wolfson, Mary A. Fristad

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 5/2017

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

This pilot randomized controlled trial (RCT) investigated benefits of omega-3 fatty acid supplementation and Individual-Family Psychoeducational Psychotherapy (PEP; a family-focused, cognitive-behavioral therapy) for behavior problems among youth with depression. Participants aged 7–14 with DSM-IV-TR depressive disorders (N = 72; 56.9 % male) were randomized to 1 of 4 treatment conditions: PEP + omega-3, PEP monotherapy (with pill placebo), omega-3 monotherapy, or placebo (without active intervention). At screen, baseline, and 2, 4, 6, 9, and 12 weeks post-baseline, parents completed the SNAP-IV, which assesses attention-deficit/hyperactivity disorder symptoms, oppositional defiant disorder symptoms, and overall behavior problems. At screen, baseline (randomization), 6 and 12 weeks, parents completed the Eyberg Child Behavior Inventory (ECBI), which includes Intensity and Problem scales for child behavior problems. Youth who had a completed SNAP-IV or ECBI for at least two assessments during treatment (n = 48 and 38, respectively) were included in analyses of the respective outcome. ClinicalTrials.gov.:NCT01341925. Linear mixed effects models indicated a significant effect of combined PEP + omega-3 on SNAP-IV Total (p = 0.022, d = 0.80) and Hyperactivity/Impulsivity trajectories (p = 0.008, d = 0.80), such that youth in the combined group saw greater behavioral improvement than those receiving only placebo. Similarly, youth in combined treatment had more favorable ECBI Intensity trajectories than youth who received no active treatment (p = 0.012, d = 1.07). Results from this pilot RCT suggest that combined PEP + omega-3 is a promising treatment for co-occurring behavior symptoms in youth with depression.
Literatuur
go back to reference Ahn, J., Ahn, H. S., Cheong, J. H., & dela Pena, I. (2016). Natural product-derived treatments for attention-deficit/hyperactivity disorder: safety, efficacy, and therapeutic potential of combination therapy. Neural Plasticity. doi:10.1155/2016/1320423. Ahn, J., Ahn, H. S., Cheong, J. H., & dela Pena, I. (2016). Natural product-derived treatments for attention-deficit/hyperactivity disorder: safety, efficacy, and therapeutic potential of combination therapy. Neural Plasticity. doi:10.​1155/​2016/​1320423.
go back to reference American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4th ed., text revision ed.). Washington, DC: American Psychiatric Association. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4th ed., text revision ed.). Washington, DC: American Psychiatric Association.
go back to reference Axelson, D., Birmaher, B. J., Brent, D., Wassick, S., Hoover, C., Bridge, J., & Ryan, N. (2003). A preliminary study of the kiddie schedule for affective disorders and schizophrenia for school-age children mania rating scale for children and adolescents. Journal of Child and Adolescent Psychopharmacology, 13, 463–470. doi:10.1089/104454603322724850.CrossRefPubMed Axelson, D., Birmaher, B. J., Brent, D., Wassick, S., Hoover, C., Bridge, J., & Ryan, N. (2003). A preliminary study of the kiddie schedule for affective disorders and schizophrenia for school-age children mania rating scale for children and adolescents. Journal of Child and Adolescent Psychopharmacology, 13, 463–470. doi:10.​1089/​1044546033227248​50.CrossRefPubMed
go back to reference Birmaher, B., Brent, D., & the AACAP Work Group on Quality Issues (2007). Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1503–1526. doi:10.1097/chi.0b013e318145ae1c.CrossRefPubMed Birmaher, B., Brent, D., & the AACAP Work Group on Quality Issues (2007). Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1503–1526. doi:10.​1097/​chi.​0b013e318145ae1c​.CrossRefPubMed
go back to reference Bos, D. J., Oranje, B., Veerhoek, E. S., Van Diepen, R. M., Weusten, J. M., Demmelmair, H., et al. (2015). Reduced symptoms of inattention after dietary omega-3 fatty acid supplementation in boys with and without attention deficit/hyperactivity disorder. Neuropsychopharmacology, 40, 2298–2306. doi:10.1038/npp.2015.73.CrossRefPubMedPubMedCentral Bos, D. J., Oranje, B., Veerhoek, E. S., Van Diepen, R. M., Weusten, J. M., Demmelmair, H., et al. (2015). Reduced symptoms of inattention after dietary omega-3 fatty acid supplementation in boys with and without attention deficit/hyperactivity disorder. Neuropsychopharmacology, 40, 2298–2306. doi:10.​1038/​npp.​2015.​73.CrossRefPubMedPubMedCentral
go back to reference Boylan, K., MacPherson, H. A., & Fristad, M. A. (2013). Examination of disruptive behavior outcomes and moderation in a randomized psychotherapy trial for mood disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 52, –708. doi:10.1016/j.jaac.2013.04.014. Boylan, K., MacPherson, H. A., & Fristad, M. A. (2013). Examination of disruptive behavior outcomes and moderation in a randomized psychotherapy trial for mood disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 52, –708. doi:10.​1016/​j.​jaac.​2013.​04.​014.
go back to reference Bridge, J. A., Iyengar, S., Salary, C. B., Barbe, R. P., Birmaher, B., Pincus, H. A., et al. (2007). Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA, 297, 1683–1696. doi:10.1001/jama.297.15.1683.CrossRefPubMed Bridge, J. A., Iyengar, S., Salary, C. B., Barbe, R. P., Birmaher, B., Pincus, H. A., et al. (2007). Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA, 297, 1683–1696. doi:10.​1001/​jama.​297.​15.​1683.CrossRefPubMed
go back to reference Bussing, R., Fernandez, M., Harwood, M., Hou, W., Garvan, C. W., Eyberg, S. M., & Swanson, J. M. (2008). Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms psychometric properties and normative ratings from a school district sample. Assessment, 15, 317–328. doi:10.1177/1073191107313888.CrossRefPubMedPubMedCentral Bussing, R., Fernandez, M., Harwood, M., Hou, W., Garvan, C. W., Eyberg, S. M., & Swanson, J. M. (2008). Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms psychometric properties and normative ratings from a school district sample. Assessment, 15, 317–328. doi:10.​1177/​1073191107313888​.CrossRefPubMedPubMedCentral
go back to reference Chambers, W. J., Puig-Antich, J., Hirsch, M., Paez, P., Ambrosini, P. J., Tabrizi, M. A., & Davies, M. (1985). The assessment of affective disorders in children and adolescents by semistructured interview: test-retest reliability of the schedule for affective disorders and schizophrenia for school-age children, present episode version. Archives of General Psychiatry, 42, 696–702. doi:10.1001/archpsyc.1985.01790300064008.CrossRefPubMed Chambers, W. J., Puig-Antich, J., Hirsch, M., Paez, P., Ambrosini, P. J., Tabrizi, M. A., & Davies, M. (1985). The assessment of affective disorders in children and adolescents by semistructured interview: test-retest reliability of the schedule for affective disorders and schizophrenia for school-age children, present episode version. Archives of General Psychiatry, 42, 696–702. doi:10.​1001/​archpsyc.​1985.​01790300064008.CrossRefPubMed
go back to reference 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. doi:10.1097/00004583-199903000-00014.CrossRefPubMed 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. doi:10.​1097/​00004583-199903000-00014.CrossRefPubMed
go back to reference Clayton, E. H., Hanstock, T. L., Hirneth, S. J., Kable, C. J., Garg, M. L., & Hazell, P. L. (2009). Reduced mania and depression in juvenile bipolar disorder associated with long-chain omega-3 polyunsaturated fatty acid supplementation. European Journal of Clinical Nutrition, 63, 1037–1040. doi:10.1038/ejcn.2008.81.CrossRefPubMed Clayton, E. H., Hanstock, T. L., Hirneth, S. J., Kable, C. J., Garg, M. L., & Hazell, P. L. (2009). Reduced mania and depression in juvenile bipolar disorder associated with long-chain omega-3 polyunsaturated fatty acid supplementation. European Journal of Clinical Nutrition, 63, 1037–1040. doi:10.​1038/​ejcn.​2008.​81.CrossRefPubMed
go back to reference Diamond, G. S., Reis, B. F., Diamond, G. M., Siqueland, L., & Isaacs, L. (2002). Attachment-based family therapy for depressed adolescents: a treatment development study. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1190–1196. doi:10.1097/00004583-200210000-00008.CrossRefPubMed Diamond, G. S., Reis, B. F., Diamond, G. M., Siqueland, L., & Isaacs, L. (2002). Attachment-based family therapy for depressed adolescents: a treatment development study. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1190–1196. doi:10.​1097/​00004583-200210000-00008.CrossRefPubMed
go back to reference Eyberg, S. M., & Pincus, D. (1999). Eyberg child behavior inventory & sutter-eyberg student behavior inventory-revised: professional manual. Odessa: Psychological Assessment Resources. Eyberg, S. M., & Pincus, D. (1999). Eyberg child behavior inventory & sutter-eyberg student behavior inventory-revised: professional manual. Odessa: Psychological Assessment Resources.
go back to reference Fristad, M. A., Goldberg-Arnold, J. S., & Leffler, J. M. (2011). Psychotherapy for children with bipolar and depressive disorders. New York: Guilford Press. Fristad, M. A., Goldberg-Arnold, J. S., & Leffler, J. M. (2011). Psychotherapy for children with bipolar and depressive disorders. New York: Guilford Press.
go back to reference Fristad, M. A., Young, A. S., Vesco, A. T., Nader, E. S., Healy, K. Z., Gardner, W., et al. (2015). A randomized controlled trial of individual family psychoeducational psychotherapy & omega-3 fatty acids in youth with subsyndromal bipolar disorder. Journal of Child and Adolescent Psychopharmacology, 25, 764–774. doi:10.1089/cap.2015.0132.CrossRefPubMedPubMedCentral Fristad, M. A., Young, A. S., Vesco, A. T., Nader, E. S., Healy, K. Z., Gardner, W., et al. (2015). A randomized controlled trial of individual family psychoeducational psychotherapy & omega-3 fatty acids in youth with subsyndromal bipolar disorder. Journal of Child and Adolescent Psychopharmacology, 25, 764–774. doi:10.​1089/​cap.​2015.​0132.CrossRefPubMedPubMedCentral
go back to reference Fristad, M. A., Vesco, A. T., Young, A. S., Healy, K. Z., Nader, E. S., Gardner, W.,… Arnold, L. E. (2016). Pilot RCT of omega-3 and individual-family psychoeducational psychotherapy for children and adolescents with depression. Journal of Clinical Child and Adolescent Psychology (in press). Fristad, M. A., Vesco, A. T., Young, A. S., Healy, K. Z., Nader, E. S., Gardner, W.,… Arnold, L. E. (2016). Pilot RCT of omega-3 and individual-family psychoeducational psychotherapy for children and adolescents with depression. Journal of Clinical Child and Adolescent Psychology (in press).
go back to reference Gillies, D., Sinn, J., Lad, S. S., Leach, M. J., & Ross, M. J. (2012). Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database of Systematic Reviews, 7, CD007986. doi:10.1002/14651858.CD007986.pub2. Gillies, D., Sinn, J., Lad, S. S., Leach, M. J., & Ross, M. J. (2012). Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database of Systematic Reviews, 7, CD007986. doi:10.​1002/​14651858.​CD007986.​pub2.
go back to reference 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. doi:10.1097/00004583-199707000-00021.CrossRefPubMed 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. doi:10.​1097/​00004583-199707000-00021.CrossRefPubMed
go back to reference Knapp, M., McCrone, P., Fombonne, E., Beecham, J., & Wostear, G. (2002). The Maudsley long-term follow-up of child and adolescent depression 3. Impact of comorbid conduct disorder on service use and costs in adulthood. British Journal of Psychiatry, 180, 19–23. doi:10.1192/bjp.180.1.19.CrossRefPubMed Knapp, M., McCrone, P., Fombonne, E., Beecham, J., & Wostear, G. (2002). The Maudsley long-term follow-up of child and adolescent depression 3. Impact of comorbid conduct disorder on service use and costs in adulthood. British Journal of Psychiatry, 180, 19–23. doi:10.​1192/​bjp.​180.​1.​19.CrossRefPubMed
go back to reference Pliszka, S., & AACAP Work Group on Quality Issues (2007). Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 894–921. doi:10.1097/chi.0b013e318054e724.CrossRefPubMed Pliszka, S., & AACAP Work Group on Quality Issues (2007). Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 894–921. doi:10.​1097/​chi.​0b013e318054e724​.CrossRefPubMed
go back to reference Raine, A., Portnoy, J., Liu, J., Mahoomed, T., & Hibbeln, J. R. (2015). Reduction in behavior problems with omega-3 supplementation in children aged 8-16 years: a randomized, double-blind, placebo-controlled, stratified, parallel-group trial. Journal of Child Psychology and Psychiatry, 56, 509–520. doi:10.1111/jcpp.12314.CrossRefPubMed Raine, A., Portnoy, J., Liu, J., Mahoomed, T., & Hibbeln, J. R. (2015). Reduction in behavior problems with omega-3 supplementation in children aged 8-16 years: a randomized, double-blind, placebo-controlled, stratified, parallel-group trial. Journal of Child Psychology and Psychiatry, 56, 509–520. doi:10.​1111/​jcpp.​12314.CrossRefPubMed
go back to reference Rohde, P., Clarke, G. N., Lewinsohn, P. M., Seeley, J. R., & Kaufman, N. K. (2001). Impact of comorbidity on a cognitive-behavioral group treatment for adolescent depression. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 795–802. doi:10.1097/00004583-200107000-00014.CrossRefPubMed Rohde, P., Clarke, G. N., Lewinsohn, P. M., Seeley, J. R., & Kaufman, N. K. (2001). Impact of comorbidity on a cognitive-behavioral group treatment for adolescent depression. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 795–802. doi:10.​1097/​00004583-200107000-00014.CrossRefPubMed
go back to reference Smeets, K. C., Leeijen, A. A., van der Molen, M. J., Scheepers, F. E., Buitelaar, J. K., & Rommelse, N. N. (2015). Treatment moderators of cognitive behavior therapy to reduce aggressive behavior: a meta-analysis. European Child & Adolescent Psychiatry, 24, 255–264. doi:10.1007/s00787-014-0592-1.CrossRef Smeets, K. C., Leeijen, A. A., van der Molen, M. J., Scheepers, F. E., Buitelaar, J. K., & Rommelse, N. N. (2015). Treatment moderators of cognitive behavior therapy to reduce aggressive behavior: a meta-analysis. European Child & Adolescent Psychiatry, 24, 255–264. doi:10.​1007/​s00787-014-0592-1.CrossRef
go back to reference Sonuga-Barke, E. J., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., et al. (2013). Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. American Journal of Psychiatry, 170, 275–289. doi:10.1176/appi.ajp.2012.12070991.CrossRefPubMed Sonuga-Barke, E. J., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., et al. (2013). Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. American Journal of Psychiatry, 170, 275–289. doi:10.​1176/​appi.​ajp.​2012.​12070991.CrossRefPubMed
go back to reference Steiner, H., Remsing, L., & AACAP Work Group on Quality Issues (2007). Practice parameter for the assessment and treatment of children and adolescents with oppositional defiant disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 126–141. doi:10.1097/01.chi.0000246060.62706.af.CrossRefPubMed Steiner, H., Remsing, L., & AACAP Work Group on Quality Issues (2007). Practice parameter for the assessment and treatment of children and adolescents with oppositional defiant disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 126–141. doi:10.​1097/​01.​chi.​0000246060.​62706.​af.CrossRefPubMed
go back to reference Swanson, J. M. (1992). School-based assessments and interventions for ADD students. Irvine: KC Publishing. Swanson, J. M. (1992). School-based assessments and interventions for ADD students. Irvine: KC Publishing.
go back to reference Swanson, J. M., Kraemer, H. C., Hinshaw, S. P., Arnold, L. E., Conners, C. K., Abikoff, H. B., et al. (2001). Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at the end of treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 168–179. doi:10.1097/00004583-200102000-00011.CrossRefPubMed Swanson, J. M., Kraemer, H. C., Hinshaw, S. P., Arnold, L. E., Conners, C. K., Abikoff, H. B., et al. (2001). Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at the end of treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 168–179. doi:10.​1097/​00004583-200102000-00011.CrossRefPubMed
go back to reference TADS Team (2004). Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: treatment for adolescents with depression study (TADS) randomized controlled trial. JAMA, 292, 807–820. doi:10.1001/jama.292.7.807.CrossRef TADS Team (2004). Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: treatment for adolescents with depression study (TADS) randomized controlled trial. JAMA, 292, 807–820. doi:10.​1001/​jama.​292.​7.​807.CrossRef
go back to reference Tammam, J. D., Steinsaltz, D., Bester, D. W., Semb-Andenaes, T., & Stein, J. F. (2016). A randomised double-blind placebo-controlled trial investigating the behavioural effects of vitamin, mineral and n-3 fatty acid supplementation in typically developing adolescent schoolchildren. British Journal of Nutrition, 115, 361–373. doi:10.1017/S0007114515004390.CrossRefPubMed Tammam, J. D., Steinsaltz, D., Bester, D. W., Semb-Andenaes, T., & Stein, J. F. (2016). A randomised double-blind placebo-controlled trial investigating the behavioural effects of vitamin, mineral and n-3 fatty acid supplementation in typically developing adolescent schoolchildren. British Journal of Nutrition, 115, 361–373. doi:10.​1017/​S000711451500439​0.CrossRefPubMed
go back to reference U.S. Food and Drug Administration (2004). FDA launches a multi-pronged strategy to strengthen safeguards for children treated with antidepressant medications. Silver Spring: U.S. Food and Drug Administration. U.S. Food and Drug Administration (2004). FDA launches a multi-pronged strategy to strengthen safeguards for children treated with antidepressant medications. Silver Spring: U.S. Food and Drug Administration.
Metagegevens
Titel
Psychoeducational Psychotherapy and Omega-3 Supplementation Improve Co-Occurring Behavioral Problems in Youth with Depression: Results from a Pilot RCT
Auteurs
Andrea S. Young
L. Eugene Arnold
Hannah L. Wolfson
Mary A. Fristad
Publicatiedatum
08-09-2016
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 5/2017
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-016-0203-3

Andere artikelen Uitgave 5/2017

Journal of Abnormal Child Psychology 5/2017 Naar de uitgave