Klomek AB, Catalan LH, Apter A. Ultra-brief crisis interpersonal psychotherapy based intervention for suicidal children and adolescents. World J Psychiatr 2021; 11(8): 403-411 [PMID: 34513604 DOI: 10.5498/wjp.v11.i8.403]
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05348805
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September 13, 2021, 06:26
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Reader Comments:
Suicidal thoughts and behaviors seem to be an important issue for spiritual and psychological practitioners around the world. A recent study showed that approximately half of the children who experienced suicidal thoughts and behaviors in adolescence first exhibited STBs in early childhood and comprised a trajectory suggesting increasing STBs. The other half probably developed suicidal thoughts and behaviors in early adolescence[1]. In addition to major depression, a mental illness with a high incidence among adolescents, subthreshold-depression and subthreshold-anxiety are also significantly associated with an increased suicide risk of adolescence[2]. Thus, Early screening and identification of at-risk youth during both preschool and late childhood is important for early intervention regarding Suicidal thoughts and behaviors. In China, we also face such serious problems. According to a recent study of China's continental regions, being a female and coming from a rural area are still potential risk factors for developing depressive traits among adolescent students in China[3].
How to reduce the self-injury and suicide behavior of adolescents with depression and adopt effective treatment methods has always been a difficult problem for doctors and their families.
No pharmacotherapy alone was more effective than psychotherapy alone. Babeva et al [4] affirmed the potential value of personalized treatment approaches based on pretreatment characteristics. Zhou X et al[5] reported that only fluoxetine plus CBT and fluoxetine were significantly more effective than pill placebo or psychological controls, and only interpersonal therapy was more effective than all psychological controls. However, they also acknowledged that the effects of these interventions might vary between individuals. Due to the harmfulness of self-injury-suicide and the possibility of irreparable consequences, how to treat it quickly and effectively is also the concern of researchers. This paper, from researchers in Israel, offers a way to do it,In addition, the procedures and methods of Interpersonal psychotherapy for Adolescents (IPT-A) are illustrated in the form of individual cases, which is more practical.
Interpersonal relationship has always been a major area of adolescent psychological problems, including the relationship with family members, friends, classmates, teachers, lovers and so on. In addition, there is something to be noted that, beginning in the teenage years, adolescents become less reliant on their parents for support and begin to turn to their peer group for support. Interpersonal psychotherapy for adolescents is an effective intervention for adolescent depression, improving a range of relevant outcomes. IPT-A may be particularly beneficial for adolescents who report a high level of avoidant attachment. However, IPT-A lacks an advantage in improving interpersonal difficulties[6], and has a weak effect on the prevention of adolescent depression[7]. Therefore, although IPT-A is recommended as A psychological treatment for adolescent depression, more clinical practice is needed to confirm it. In previous IPT-A studies, the treatment duration was about 10 weeks, while the ultra-short-term IPTA treatment duration was about 5 weeks. The specific clinical effect and the duration of the curative effect need to be verified by large-sample studies.
All in all, as a psychiatrist who treats many children and adolescents with depression, this study may provide me with a more practical method for my work, however, further large sample studies are needed for clinical effectiveness.
References
[1] Whalen DJ, Hennefield L, Elsayed NM, Tillman R, Barch DM, Luby JL. Trajectories of Suicidal Thoughts and Behaviors From Preschool Through Late Adolescence. J Am Acad Child Adolesc Psychiatry 2021; S0890-8567(21)01364-2. Epub ahead of print. doi: 10.1016/j.jaac.2021.08.020. PMID: 34506928.
[2] Balázs J, Miklósi M, Keresztény A, Hoven CW, Carli V, Wasserman C, Apter A, Bobes J, Brunner R, Cosman D, Cotter P, Haring C, Iosue M, Kaess M, Kahn JP, Keeley H, Marusic D, Postuvan V, Resch F, Saiz PA, Sisask M, Snir A, Tubiana A, Varnik A, Sarchiapone M, Wasserman D. Adolescent subthreshold-depression and anxiety: psychopathology, functional impairment and increased suicide risk. J Child Psychol Psychiatry 2013; 54(6):670-7. doi: 10.1111/jcpp.12016. PMID: 23330982.
[3] Chen W, Huang Y, Riad A. Gender Differences in Depressive Traits among Rural and Urban Chinese Adolescent Students: Secondary Data Analysis of Nationwide Survey CFPS. Int J Environ Res Public Health 2021; 18(17):9124. doi: 10.3390/ijerph18179124. PMID: 34501714.
[4] Babeva KN, Klomhaus AM, Sugar CA, Fitzpatrick O, Asarnow JR. Adolescent Suicide Attempt Prevention: Predictors of Response to a Cognitive-Behavioral Family and Youth Centered Intervention. Suicide Life Threat Behav 2020; 50(1):56-71. doi: 10.1111/sltb.12573. PMID: 31350782.
[5] Zhou X, Teng T, Zhang Y, Del Giovane C, Furukawa TA, Weisz JR, Li X, Cuijpers P, Coghill D, Xiang Y, Hetrick SE, Leucht S, Qin M, Barth J, Ravindran AV, Yang L, Curry J, Fan L, Silva SG, Cipriani A, Xie P. Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis. Lancet Psychiatry 2020; 7(7):581-601. doi: 10.1016/S2215-0366(20)30137-1. PMID: 32563306.
[6] Duffy F, Sharpe H, Schwannauer M. Review: The effectiveness of interpersonal psychotherapy for adolescents with depression - a systematic review and meta-analysis. Child Adolesc Ment Health 2019; 24(4):307-317. doi: 10.1111/camh.12342. PMID: 32677350.
[7] Hetrick SE, Cox GR, Witt KG, Bir JJ, Merry SN. Cognitive behavioural therapy (CBT), third-wave CBT and interpersonal therapy (IPT) based interventions for preventing depression in children and adolescents. Cochrane Database Syst Rev 2016; 2016(8):CD003380. doi: 10.1002/14651858.CD003380.pub4. PMID: 27501438; PMCID: PMC8407360.
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