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Childhood depression: a place for psychotherapy

An outcome study comparing individual psychodynamic psychotherapy and family therapy

Abstract

Background

Although considered clinically effective, there is little systematic research confirming the use of Individual Psychodynamic Psychotherapy or Family Therapy as treatments for depression in children and young adolescents.

Aims

A clinical trial assessed the effectiveness of these two forms of psychotherapy in treating moderate and severe depression in this age group.

Methods

A randomised control trial was conducted with 72 patients aged 9–15 years allocated to one of two treatment groups.

Results

Significant reductions in disorder rates were seen for both Individual Therapy and Family Therapy. A total of 74.3% of cases were no longer clinically depressed following Individual Therapy and 75.7% of cases were no longer clinically depressed following Family Therapy. This included cases of Dysthymia and “Double Depression” (co-existing Major Depressive Disorder and Dysthymia). There was also an overall reduction in co-morbid conditions across the study. The changes in both treatment groups were persistent and there was ongoing improvement. At follow up six months after treatment had ended, 100% of cases in the Individual Therapy group, and 81% of cases in the Family Therapy group were no longer clinically depressed.

Conclusions

This study provides evidence supporting the use of focused forms of both Individual Psychodynamic Therapy and Family Therapy for moderate to severe depression in children and young adolescents.

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Acknowledgements

Members of the London project team: Anne Alvarez, Sarah Barratt, Vicky Bianco, Susan Bliss, David Campbell, Jane Cassidy, Lois Colling, Carol Desousa (statistician), Emilia Dowling, Elspeth Earle, Anna Fitzgerald, Henia Goldberg, Inge Gregorious, Agathe Gretton, Judith Loose, Ryan Lowe, Sue McNab, Gillian Miles, Renos Papadopoulos, David Pentacost, Maria Rhode, Margaret Rustin.

Members of the Athens project team: Alexandra Alexopoulou, Evi Athanassiadou, Maria Belivanaki, Vaso Chantzara, Stelios Christogiorgos, Kostas Francis, Dimitris Georgiadis, Georgios Gritzelas, Terpsi Korpa, Olga Lanara, Effie Lignos, Dimitris Magriplis, Maria Marangidi, Olga Maratos, Vasso Moula, Valeria Pomini, Eleni Stavrou, Marianna Tassi, Irene Tsanira, L. Tsarouhi.

Members of the Helsinki project team: Christina Bostrom, Taru Forst, Reija Graeffe, Susanne Friman, Kaarina Hastbacka, Liisa Hisinger, Eija Korpinen, Anna Kuikka, Sakari Lehtonen, Helena Lounavaara-Rintala, Kaija Mankinen, Pirkko Pingoud, Liisa Pirhonen, Marja Schulman, Esko Varilo, Leena Varilo, Maija von Fieandt, Pirjo Vuornos, Jan-Christer Wahlbeck, Hanna Westerinen.

We would also like to thank the young people and their families for their contribution to the study.

This study was partly funded by the European Community: Concerted action contract No. BMH4-CT98-3231 DG12-SSMI. Central co-ordination of the project took place at the Tavistock Clinic, London. Prof Kolvin was funded whilst developing the project by the Leverhulme Foundation.

Author information

Correspondence to Judith Trowell MBBS, DCH, DPM, FRCPsych.

Additional information

Original lead researcher: Prof Issy Kolvin (deceased).

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Trowell, J., Joffe, I., Campbell, J. et al. Childhood depression: a place for psychotherapy. Eur Child Adolesc Psychiatry 16, 157–167 (2007). https://doi.org/10.1007/s00787-006-0584-x

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Keywords

  • treatment
  • childhood depression
  • individual psychotherapy
  • family therapy