Abstract
BackgroundDepression in adolescents seems to be a growing problem that causes mental suffering and prevents young people from joining the workforce. There is also a high risk of relapse during adult life. There is emerging evidence for the effect of psychodynamic psychotherapy in adolescents. In-session relational intervention (that is, transference intervention) is a key component of psychodynamic psychotherapy. However, whether depressed adolescents profit most from psychodynamic psychotherapy with or without transference interventions has not been stated.ObjectThe effect of transference interventions in depressed adolescents and the moderator moderating effect of quality of object relations, personality disorder and gender will be explored.Methods and study designThe First Experimental Study of Transference Work–In Teenagers (FEST–IT) will be a randomized clinical trial with a dismantling design. The study is aimed to explore the effects of transference work in psychodynamic psychotherapy for adolescents with depression. One hundred patients ages 16 to 18 years old will be randomized to one of two treatment groups, in both of which general psychodynamic techniques will be used. The patients will be treated over 28 weeks with either a moderate level of transference intervention or no transference intervention. Follow-up will be at 1 year after treatment termination. The outcome measures will be the Psychodynamic Functioning Scales (PFS), Inventory of Interpersonal Problems–Circumplex Version (IIP-C), Global Assessment of Functioning (GAF), and the total mean score of Symptom Checklist–90 (Global Severity Index; GSI), Beck Depression Inventory (BDI), and Montgomery Åsberg Rating Scale (MADRS). The quality of adolescents’ relationships will be a central focus of the study, and the Adolescent Relationship Scales (ARS) and Differentiation–Relatedness Scale (DRS) will also be used. Change will be assessed using linear-mixed models. Gender personality disorder (PD) and quality of object relations (QOR) will be the preselected putative moderators.DiscussionThe object of this clinical trial is to explore the effect of transference interventions in psychodynamic psychotherapy in adolescents with a major depressive disorder. Using a randomized and dismantling design, we hope that the study will add more specific knowledge to the evidence base.Trial registrationClinicalTrials.gov Identifier: NCT01531101First Experimental Study of Transference work Work–In Teenagers (FEST-IT)
Highlights
Depression in adolescents seems to be a growing problem that causes mental suffering and prevents young people from joining the workforce
Gender personality disorder (PD) and quality of object relations (QOR) will be the preselected putative moderators. The object of this clinical trial is to explore the effect of transference interventions in psychodynamic psychotherapy in adolescents with a major depressive disorder
Moderators specified in advance are QOR, Personality Disorder, and gender
Summary
Depression in adolescents might relapse, and treating and preventing further symptoms can help young people find their way into adult relationships and into the workforce. To guide therapists in which therapy works for patients with different characteristics, there is a need for more studies to investigate the effect of psychotherapy. Real patients will be randomized to therapy (treatment and comparison group) and treated by specially trained therapists. Assessments will be conducted at three time points with the primary outcome variables using the PFS-5 and the secondary outcome measure using GAF. Assessments will be undertaken at four time points using the primary outcome measure IIP–C and the secondary outcome measure GSI. The present study aims to explore the effect of transference interventions in psychodynamic psychotherapy, and we hope it will add more knowledge to the evidence base for treatment of adolescents with major depression. Functioning Scale; QOR–2: Quality of Object Relation Score; RCT: randomized clinical trial; SIDP-IV: Structured Interview for DSM-IV Personality; STPP: shortterm psychodynamic/psychoanalytic therapy; WAI: Working Alliance Inventory.
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