A Clinical Trial of IPT-A to Prevent Suicide in Depressed Adolescents With Suicidal Behavior
Condition: Unipolar Depression; Dysthymia
MeSH terms: Suicide; Depressive Disorder; Dysthymic Disorder
Study type: Interventional
Phase: Phase 3

Summary: 
      The investigators are adapting Interpersonal Psychotherapy (IPT-A) for adolescents who are
      referred to emergency services either for a suicide attempt or for being evaluated as high
      risk for suicidal behavior. The investigators will recruit 15 adolescents ages 12-19 years
      who present with a diagnosis of major depression, dysthymic disorder, depression disorder not
      otherwise specified who have a history of a suicide attempt in the past 2 months or a
      non-medically lethal attempt that may require psychiatric hospitalization, suicide attempt
      that is or report current suicidal ideation with a plan/intent, and treat them in an open
      clinical trial. The treatment will be conducted twice weekly for the first 8 weeks of
      treatment and then weekly for the remaining 12 weeks of the study. Using feedback from
      clinicians and participants, the investigators will make further modifications to the manual
      in preparation for conducting a larger controlled clinical trial.
    

Detailed description: 
      All treatment will be done on the Children's Day Unit (CDU) and the adolescent and his/her
      family need to agree to participate in the CDU program. The acute phase is biweekly for 8
      weeks followed by weekly sessions for the remaining 12 weeks to allow for continued work on
      the skills and for consolidation of skills to prevent relapse. It is a total of 28 sessions
      in 20 weeks. There also are up to 4 additional emergency sessions that can be used to handle
      crises or have additional parent sessions during those 20 weeks. In addition, the child and
      adolescent psychiatrist will evaluate each study participant in terms of presently prescribed
      medication or for the need to initiate pharmacological treatment which will follow the
      evidence based medicine recommendations for pediatric psychopharmacology (Walkup et al.,
      2009). The child and adolescent psychiatrist will see each study participant weekly for
      monitoring of illness severity and medication management. Over the course of the 20 week
      treatment, the investigators will assess their diagnosis, global functioning, severity of
      depression, anxiety and suicidal ideation, and family factors. At each therapy session, the
      adolescents will be assessed for suicidal behavior by their clinician. They also will be seen
      every 4 weeks by an independent evaluator who will track their symptoms and functioning at
      weeks 4, 8, 12, 16, 20 or early termination and week 32 follow-up assessments. The open trial
      will allow us to determine the feasibility of recruiting depressed and suicidal youth. It
      also will allow us to determine the benefits of using IPT-A to treat depressed and suicidal
      youth.
    

Intervention name(s): IPT-A
Intervention type(s): Behavioral
Intervention description(s): Interpersonal Psychotherapy for adolescents (IPT-A) is a guideline based treatment with established efficacy as an intervention for adolescent depression
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Major Depressive Disorder (MDD); Dysthymia; Depressive Disorder Not Otherwise Specified (DDNOS)