OBJECTIVE Childhood-onset depression is associated with increased risk of recurrent depression and high morbidity extending into adolescence and adulthood. This multisite randomized controlled trial evaluated two active psychosocial treatments for childhood depression: family-focused treatment for childhood depression (FFT-CD) and individual supportive psychotherapy (IP). Aims were to describe effects through 52 weeks postrandomization on measures of depression, functioning, nondepressive symptoms, and harm events. METHODS Children meeting criteria for depressive disorders (N = 134) were randomly assigned to 15 sessions of FFT-CD or IP and evaluated at mid-treatment for depressive symptoms and fully at roughly 16 weeks (after acute treatment), 32 weeks, and 52 weeks/one year. See clinicaltrials.gov: NCT01159041. RESULTS Analyses using generalized linear mixed models confirmed the previously reported FFT-CD advantage on rates of acute depression response (≥50% Children's Depression Rating Scale reduction). Improvements in depression and other outcomes were most rapid during the acute treatment period, and leveled off between weeks 16 and 52, with a corresponding attenuation of observed group differences, although both groups showed improved depression and functioning over 52 weeks. Survival analyses indicated that most children recovered from their index depressive episodes by week 52: estimated 76% FFT-CD, 77% IP. However, by the week 52 assessment, one FFT-CD child and six IP children had suffered recurrent depressive episodes. Four children attempted suicide, all in the IP group. Other indicators of possible harm were relatively evenly distributed across groups. CONCLUSIONS Results indicate a quicker depression response in FFT-CD and hint at greater protection from recurrence and suicide attempts. However, outcomes were similar for both active treatments by week 52/one year. Although community care received after acute treatment may have influenced results, findings suggest the value of a more extended/chronic disease model that includes monitoring and guidance regarding optimal interventions when signs of depression-risk emerge.

中文翻译：

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与个体心理治疗相比，以家庭为中心的儿童抑郁症治疗的随机对照试验：一年的结果。

目的 儿童期抑郁症与复发性抑郁症的风险增加以及持续到青春期和成年期的高发病率有关。这项多中心随机对照试验评估了两种针对儿童抑郁症的积极心理社会治疗方法：针对儿童抑郁症的以家庭为中心的治疗 (FFT-CD) 和个人支持性心理治疗 (IP)。目的是描述随机化后 52 周对抑郁、功能、非抑郁症状和伤害事件的影响。方法 符合抑郁障碍标准的儿童 (N = 134) 被随机分配到 15 个疗程的 FFT-CD 或 IP 中，并在治疗中期评估抑郁症状，并在大约 16 周（急性治疗后）、32 周和 52周/一年。参见clinicaltrials.gov：NCT01159041。结果 使用广义线性混合模型的分析证实了先前报告的 FFT-CD 对急性抑郁反应率的优势（≥50% 儿童抑郁量表降低）。抑郁症和其他结局的改善在急性治疗期间最为迅速，并在第 16 周和第 52 周之间趋于平稳，观察到的组间差异相应减弱，尽管两组均在 52 周内表现出改善的抑郁症和功能。生存分析表明，大多数儿童在第 52 周从他们的指数抑郁发作中恢复过来：估计 76% FFT-CD，77% IP。然而，到第 52 周评估时，一名 FFT-CD 儿童和六名 IP 儿童反复出现抑郁发作。四个孩子企图自杀，都在 IP 组中。其他可能造成伤害的指标在各组中分布相对均匀。结论 结果表明 FFT-CD 中的抑郁反应更快，并暗示对复发和自杀企图的更大保护。然而，到第 52 周/一年，两种积极治疗的结果相似。尽管在急性治疗后接受的社区护理可能会影响结果，但研究结果表明更广泛/慢性疾病模型的价值，其中包括在出现抑郁风险迹象时对最佳干预措施进行监测和指导。