Mclean Hospital

Video: Predictors and Mechanisms of Symptom Change in Depression Treatment for Adolescents

Available with English captions.

Christian A. Webb, PhD, McLean Hospital – McLean Forum Lecture

Psychotherapies, including cognitive behavioral therapy (CBT), have been shown to be effective at improving depressive symptoms in adolescents.

However, the mechanisms through which depressed teens improve—and why many fail to sufficiently improve—remain largely unknown. A clearer understanding of the “active ingredients” of treatment and underlying mechanisms of symptom change may ultimately inform the development of more targeted—and ideally more effective and efficient—treatments for depressed youth.

In this presentation, Dr. Webb reviews research on the processes of symptom change in CBT for depressed adolescents. In addition, and relevant to the pursuit of personalized medicine in psychiatry, he discusses research aimed at identifying pre-treatment predictors of symptom improvement in psychotherapeutic and pharmacological treatments for depression.

Presentation highlights also include:

  • Review of several approaches used in psychotherapy research to investigate the processes that account for depressive symptom change
  • Explanation of how pre-treatment patient characteristics (e.g., clinical and demographic characteristics) can be used to predict treatment outcomes and inform treatment recommendations
  • Discussion of how smartphone-delivered surveys can be used to collect clinically useful information on the use of therapeutic skills and improvement in mood/symptoms

Greater knowledge of variables predicting better or worse treatment response prior to the start of treatment may have important clinical implications regarding which interventions are best suited for whom, thus informing treatment selection.

In current clinical practice, treatment selection for depressed youth (and adults) is largely based on trial-and-error and clinician/patient preference. Consistent with the goals of precision medicine, more recent research is aimed at developing actionable, algorithm-guided treatment recommendations to improve outcomes for depressed individuals.

February 25, 2021

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