A Clinical Trial of IPT-A to Prevent Suicide in Depressed Adolescents With Suicidal Behavior (IPT-A-CSP)
The investigators are adapting Interpersonal Psychotherapy (IPT-A) for adolescents who are referred to emergency services either for a suicide attempt or for being evaluated as high risk for suicidal behavior. The investigators will recruit 15 adolescents ages 12-19 years who present with a diagnosis of major depression, dysthymic disorder, depression disorder not otherwise specified who have a history of a suicide attempt in the past 2 months or a non-medically lethal attempt that may require psychiatric hospitalization, suicide attempt that is or report current suicidal ideation with a plan/intent, and treat them in an open clinical trial. The treatment will be conducted twice weekly for the first 8 weeks of treatment and then weekly for the remaining 12 weeks of the study. Using feedback from clinicians and participants, the investigators will make further modifications to the manual in preparation for conducting a larger controlled clinical trial.
|Study Design:||Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||An Open Clinical Trial of IPT-A to Prevent Suicide in Depressed Adolescents With Suicidal Behavior|
- Score on Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Up to 42 weeks ] [ Designated as safety issue: Yes ]The C-SSRS is a scale that assesses for the presence of suicidal behavior.
- Change in score on Children's Depression Rating Scale (CDRS) [ Time Frame: Week 20 and 3 month follow-up ] [ Designated as safety issue: Yes ]The CDRS is a clinician rated instrument that assesses for the presence and severity of depressive symptoms.
|Study Start Date:||September 2011|
|Estimated Study Completion Date:||June 2014|
|Estimated Primary Completion Date:||June 2014 (Final data collection date for primary outcome measure)|
Experimental: Interpersonal psychotherapy (IPT-A)
Interpersonal psychotherapy for depressed adolescents which focuses on identifying problematic relationships connected to onset or maintenance of depression and suicidal behavior. The treatment teaches skills such as communication and problem-solving to the adolescent and parents.
Interpersonal Psychotherapy for adolescents (IPT-A) is a guideline based treatment with established efficacy as an intervention for adolescent depression
All treatment will be done on the Children's Day Unit (CDU) and the adolescent and his/her family need to agree to participate in the CDU program. The acute phase is biweekly for 8 weeks followed by weekly sessions for the remaining 12 weeks to allow for continued work on the skills and for consolidation of skills to prevent relapse. It is a total of 28 sessions in 20 weeks. There also are up to 4 additional emergency sessions that can be used to handle crises or have additional parent sessions during those 20 weeks. In addition, the child and adolescent psychiatrist will evaluate each study participant in terms of presently prescribed medication or for the need to initiate pharmacological treatment which will follow the evidence based medicine recommendations for pediatric psychopharmacology (Walkup et al., 2009). The child and adolescent psychiatrist will see each study participant weekly for monitoring of illness severity and medication management. Over the course of the 20 week treatment, the investigators will assess their diagnosis, global functioning, severity of depression, anxiety and suicidal ideation, and family factors. At each therapy session, the adolescents will be assessed for suicidal behavior by their clinician. They also will be seen every 4 weeks by an independent evaluator who will track their symptoms and functioning at weeks 4, 8, 12, 16, 20 or early termination and week 32 follow-up assessments. The open trial will allow us to determine the feasibility of recruiting depressed and suicidal youth. It also will allow us to determine the benefits of using IPT-A to treat depressed and suicidal youth.
|Contact: Laura Mufson, PhD||212-543-5561||MufsonL@nyspi.columbia.edu|
|Contact: Moira Rynn, MD||212-543-4506||RynnM@nyspi.columbia.edu|
|United States, New York|
|New York State Psychiatric Institute||Recruiting|
|New York, New York, United States, 10032|
|Contact: Laura Mufson, Ph.D. 212-543-5561 MufsonL@nyspi.columbia.edu|
|Contact: Moira Rynn, M.D. 212-543-4506 RynnM@nyspi.columbia.edu|
|Principal Investigator: Laura Mufson, PhD|
|Principal Investigator: Moira Rynn, MD|
|Principal Investigator: Madelyn Gould, PhD|
|New York Presbyterian Hospital||Recruiting|
|New York, New York, United States, 10032|
|Principal Investigator:||Laura Mufson, PhD||New York State Psychiatric Institute|