Abstract
BackgroundThis cluster-randomised monocentric controlled trial focuses on improving the uptake symptoms of mental health care in adolescents with chronic medical conditions who have been identified by screening to have depression or anxiety. The study aims to determine the efficacy of motivational interviewing (MI) delivered by trained physicians to increase 12- to 20-year-old adolescents’ utilisation of psychological health care for symptoms of anxiety or depression.Methods/designIn this single-centre approach, n = 1,000 adolescents will be screened (using PHQ-9 and GAD-7), and adolescents with results indicative of anxiety or depressive symptoms (n = 162) will be advised to seek psychological health care in clusters from treating physicians in specialised outpatient departments. Participants who screen positive will receive either two sessions of MI or treatment as usual (TAU; regarded as the typical daily clinical practice), which is focused on recommending them to seek psychological health care for further evaluation. MI efficacy will be compared to the current TAU as the control condition. The primary outcome is the utilisation rate of psychological health care after counselling by an MI-trained physician vs. an untrained physician. Additionally, reasons for not claiming psychological support and changes in disease-related parameters will be evaluated in a 6-month follow-up session.DiscussionThis trial will evaluate the feasibility of MI as a way to improve the utilisation of mental health-care services by adolescents who need further support other than that provided by standard care for chronic diseases. Physicians offering MI to adolescents may serve as a model for optimising health-care management in daily clinical practice, which may improve adolescents’ long-term well-being by improving adherence to medical treatment and preventing negative lifelong consequences into adulthood.Trial registrationGerman Trials Register (DRKS), DRKS00014043. Registered on 26 April 2018. Düsseldorf University study ID: 2017114504.
Highlights
This cluster-randomised monocentric controlled trial focuses on improving the uptake symptoms of mental health care in adolescents with chronic medical conditions who have been identified by screening to have depression or anxiety
This trial will evaluate the feasibility of motivational interviewing (MI) as a way to improve the utilisation of mental health-care services by adolescents who need further support other than that provided by standard care for chronic diseases
Physicians offering MI to adolescents may serve as a model for optimising health-care management in daily clinical practice, which may improve adolescents’ long-term well-being by improving adherence to medical treatment and preventing negative lifelong consequences into adulthood
Summary
This cluster-randomised monocentric controlled trial focuses on improving the uptake symptoms of mental health care in adolescents with chronic medical conditions who have been identified by screening to have depression or anxiety. 15% of German adolescents suffer from chronic medical conditions, such as asthma, diabetes and rheumatic diseases [1]. With these diseases, comorbid psychological symptoms, such as anxiety, depression and behavioural problems, are present in 10–40% of patients [2,3,4,5,6]. Comorbid behavioural and emotional symptoms in adolescents with chronic conditions detrimentally affect medication adherence and adaption and increase the risk for negative long-term health outcomes [7]. Referring adolescents to mental health care without appropriately motivating them often fails
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