Please select the eligibility criteria that correspond to the clinical trial below.
Title: Reducing Depressive Symptoms in Physically Ill Youth
Brief Summary: Children and adolescents with inflammatory bowel disease (IBD) have high rates of depressive symptoms and more trouble with daily functioning than those without physical illness. The proposed study will investigate if cognitive behavioral therapy (CBT) is better than supportive therapy (SNDT) in reducing emotional distress and improving functioning in youth ages 9-17 with Crohn's disease or Ulcerative Colitis and depression. This study will also assess the effect of CBT on IBD-related factors such as disease severity, medication adherence, and physical-health related quality of life.

Hypothesis

- Individuals who receive CBT will show more improvement than individuals who receive SNDT.


Options:
A: - Outpatients aged 18 to 75 years old with nonpsychotic major depressive disorder (HAMD score 14 or greater)
B: Inclusion Criteria:

Step 1:

* ages 9 to 17 inclusive
* capable of completing CDI
* meeting diagnostic criteria for CD (the date of diagnosis = date of the first diagnostic test confirming CD)
* absence of mental retardation by history
* having at least one appointment at the GI clinic (this will include patients followed in these clinics as well as those seeking consultation)

Step 2:

* CDI or CDI-P greater than or equal to 10 at Step 1.
* ages between 9-17 inclusive
* having CD

Exclusion Criteria:

* history or current episode of bipolar disorder, eating disorder, or psychotic disorder by DSM-IV criteria
* mental retardation by history
* antidepressant medications within one month of assessment
* suicidality with plan or of severity requiring immediate psychiatric hospitalization or significant act involving intentional self-harm (e.g., cutting or overdose, resulting in medical attention)
* unacceptable risk for dangerousness to others as indicated by homicidal (or other violent) ideation, intent or plan or action, or use of illegal weapons
* current pregnancy by history
* substance abuse by history within one month of enrollment other than nicotine dependence
* current treatment with CBT or failure of previous CBT trial for depression judged adequate by at least 12 treatment sessions over a period of less than 1 year conducted by an appropriately trained mental health provider using a manual
* if currently receiving other psychotherapy modalities willingness to suspend treatment for 12-week acute treatment phase of study
C: Inclusion Criteria:

* Step One

  1. Ages 11 to 17 inclusive.
  2. Capable of completing CDI
  3. English-speaking.
  4. Meeting diagnostic criteria for IBD (The date of diagnosis = date of the first diagnostic test confirming IBD)
  5. Absence of mental retardation by history
  6. Having at least one appointment at the gastroenterology clinic at CHP.
* Step Two: Assessment

  1) CDI and/or CDI-P equal to or more than 9 at Step 1
* At Intervention Phase

  1. CDI score equal to or more than 9 AND/OR CDI-P score equal to or more than 9 at T0.
  2. Absence of recent suicide attempt (within one month of study enrollment) or depression severity requiring acute psychiatric hospitalization),
  3. Age 11-17 years inclusive,
  4. Presence of at least one biological parent.

Exclusion Criteria:

1. Current major depression or dysthymia by Diagnostic and Statistical Manual (DSM)-IV criteria
2. History or current episode of bipolar disorder, eating disorder, or psychotic disorder by DSM-IV criteria.
3. Mental retardation by history
4. Antidepressant or stimulant medications within one month of assessment
5. Suicidality with plan or of severity requiring immediate psychiatric hospitalization or significant act involving intentional self-harm, e.g. cutting or overdose, resulting in medical attention.
6. Unacceptable risk for dangerousness to others as indicated by homicidal (or other violent) ideation, intent or plan or action, or use of illegal weapons.
7. Current pregnancy by history.
8. Substance abuse within one month of enrollment other than nicotine dependence.
9. Current treatment with cognitive behavioral therapy (CBT) or failure of previous CBT trial for depression judged adequate by at least 12 treatment sessions over a period of less than 1 year conducted by an appropriately trained mental health provider.
D: Inclusion Criteria:

* Diagnosis of JPFS based upon widespread pain for over 3 months, at least 5 tender points, and associated features such as sleep difficulty, fatigue, and abdominal discomfort
* Average pain intensity greater than 4 on the Visual Analog Scale
* Functional disability score greater than 7
* Stable medications for 8 weeks prior to study entry

Exclusion Criteria:

* Other chronic rheumatic diseases, such as juvenile rheumatoid arthritis or lupus
* Significant developmental delay or impairments, such as autism, cerebral palsy, or mental retardation
* Present or lifetime psychiatric diagnosis that meets DSM-IV criteria for panic disorder, bipolar disorder, major depressive disorder, or psychosis
* Opioid medications are disallowed when used on an ongoing basis for treatment of fibromyalgia pain

Answer: B