Effectiveness of trauma-focused treatment for adolescents with major depressive disorder

Figures & data

Table 1. Sample characteristics.

Characteristics of the study population	N	%
Gender, male	5	16
Nationality, Dutch	28	88
Living condition
Living with both parents	19	59
Living with one parent	8	25
Parents divorced, living with both, alternating	2	6
Other (adoptive parents, grandparents, shared student household)	3	9
Level of education (n = 31)
Low to middle level secondary education or vocational education	12	39
High level: secondary education/high school/professional	18	58
education	1	3
History of mental health service use
Outpatient psychiatric treatment	13	41
No treatment	9	28
Social work/school counselling	7	22
Multiple treatments	2	6
Other treatment	1	3
Receiving psychotropic medication	1	3
Index trauma from UCLA PTSD-RI at T0 (n = 30)
Bullying/humiliation^a	10	33
Being ignored/isolated^a	7	22
Bereavement of a loved one	5	17
Serious accident	2	6
Sexual assault	2	6
Illness/medical trauma	1	3
Natural disaster	1	3
Other experience with violence/serious danger	2	2
Total number of comorbid DSM-IV classifications on ADIS-C at T0 (n = 31)
0	3	10
1	5	16
2	9	29
3	7	23
4	5	16
5	2	7
Comorbid DSM-IV classification on ADIS-C at T0 (n = 31)
Social phobia	18	56
Generalized anxiety disorder	12	38
Dysthymic disorder	9	28
Attention-deficit/hyperactivity disorder	5	16
Specific phobia	5	16
Posttraumatic stress disorder	4	13
Obsessive compulsive disorder	2	6
Panic disorder	2	6
Separation anxiety disorder	2	6
Agoraphobia	1	3

UCLA PTSD-RI: University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index Adolescent version; ADIS-C: Anxiety Disorders Interview Schedule for DSM-IV – Child version.

^aCategory was added to the original list of possible traumatic experiences for this study.

Table 2. Results of linear mixed model analyses.

				T0 vs T1				T0 vs T2
	M (SD) N = 32 T0	M (SD) n = 24 T1	M (SD) n = 25 T2	Unstandardized β (95% CI)	t-test (df)	p value	Cohens’ d	Unstandardized β (95% CI)	t-test (df)	p value	Cohens’ d
CDI	26.59 (7.64)	20.25 (9.74)	16.92 (9.73)	−6.183 (−8.833 to −3.533)	t(50.07) = −4.69*	<.001	0.72	−9.868 (−12.519 to −7.218)	t(50.07) = −7.48*	<.001	1.11
UCLA	36.00 (15.28)	19.22 (13.21)	18.77 (14.54)	−16.488 (−22.651 to −10.324)	t(49.94) = −5.37*	<.001	1.17	−17.881 (−23.044 to −11.717)	t(49.94) = −5.83*	<.001	1.16
SCARED	56.80 (19.28)	37.43 (22.46)	36.70 (22.06)	−18.235 (−23.945 to −12.526)	t(45.54) = −6.43*	<.001	0.93	−19.235 (−25.018 to −13.451)	t(46.14) = −6.69*	<.001	0.97
CSI	36.83 (23.16)	26.35 (19.34)	22.91 (21.14)	−11.373 (−19.429 to −3.317)	t(48.87) = −2.84*	.007	0.49	−15.213 (−23.342 to −7.083)	t(49.84) = −3.76*	<.001	0.63
SDQ total	19.50 (5.05)	15.96 (7.06)	15.17 (6.71)	−37.311 (−43.953 to −30.668)	t(50.33) = −11.28*	<.001	0.58	−38.2997 (−44.971 to −31.629)	t(50.07) = −7.48*	<.001	0.73

CDI: Children’s Depression Inventory; UCLA: University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index Adolescent version; SCARED: Screen for Child Anxiety Related Emotional Disorders; CSI: Children’s Somatization Inventory, SDQ: Strengths and Difficulties Questionnaire.

Figure 1. Patient flow chart.

Table 3. Results of predictor analyses on treatment outcome as measured by level of depressive symptoms (CDI).

	Time × predictor effects
	Β	t (p)	95% CI
Severity of PTSD symptoms	0.27	2.85 (.01)	0.08–0.46
Number of comorbid disorders	1.37	1.23 (.23)	−0.87–3.62
Duration of MDD	1.65	0.52 (.61)	−4.75–8.05
Emotional abuse	0.29	1.02 (.31)	−0.29–0.87
Emotional neglect	0.28	0.92 (.36)	−0.34–0.91
Physical neglect	−0.27	−0.24 (.81)	−2.54–1.99

PTSD:Posttraumatic Stress Disorder, MDD: Major Depressive Disorder.

Figure 2. Proportion of patients completing treatment meeting DSM-IV criteria for MDD (ADIS-C) at different points in time.