Integrated Treatment for Comorbid Depression and Obesity in Adolescents

青少年共病抑郁症和肥胖症的综合治疗

基本信息

批准号：
7995251
负责人：
ELISSA JELALIAN
金额：
$ 23.03万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-12-01 至 2012-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7995251
关键词：
Acute Address Adherence Adolescence Adolescent Adult Age Attention Audiotape Behavior Therapy Belief Blood Pressure Body Weight decreased Child Childhood Cholesterol Clinical Cognitive Therapy Combined Modality Therapy Comorbidity Confidence Intervals Control Groups Data Depressed mood Development Diet Habits Disease remission Eating Education Emotional disorder Exercise Feasibility Studies Feedback Female Gender Goals Grant Guidelines Health Individual Intervention Interview Length Literature Major Depressive Disorder Manuals Medical Mental Depression Nature Non-Insulin-Dependent Diabetes Mellitus Obesity Overweight Parents Participant Phase Physical activity Pilot Projects Prevalence Protocols documentation Public Health Randomized Recruitment Activity Refractory Research Research Personnel Risk Running Sampling School-Age Population Series Staging Techniques Teenagers Testing Training Training Programs Treatment Protocols United States Weight Work base depressive symptoms effective therapy experience falls follow-up intervention effect male meetings pilot trial programs psychosocial public health relevance satisfaction

项目摘要

DESCRIPTION (provided by applicant): Lifetime prevalence of major depression is estimated at 28% by age 18 (Lewinsohn et al., 1999), with higher cumulative rates in females (35%) than males (19%). Approximately 17% of children and adolescents in the United States are obese as defined by a BMI above the 95th percentile, with more than 30% falling between the 85th and 95th percentiles (Ogden et al., 2008). Overweight children and adolescents are at increased risk for type 2 diabetes (Pinhas-Hamiel et al., 1996) and overwhelming risk for adult obesity (Guo et al., 1994). There is a substantial percentage of adolescents who are both overweight and depressed with estimates from clinical samples averaging 25%. Treatment of teens with comorbid medical and psychiatric conditions such as overweight/obesity and depression has received little to no attention in the psychosocial treatment research literature. Due to the large number of adolescents who are both depressed and overweight, developing a behavioral treatment that addresses both problems simultaneously has important public health significance. The purpose of this proposal is to combine treatments for depression and overweight to address these co-occurring conditions in one intervention. The long-term objectives of this research are to develop efficient and effective treatments for co-occurring physical and emotional disorders. The research program will be divided into 3 major phases: a development phase (Stage 1a), a pilot study phase (Stage 1b), and a revision phase. During the development phase (Stage 1a), a treatment for overweight teens and CBT treatment for depressed teens will be adapted into one integrated protocol that addresses depression using CBT techniques, an exercise component, and advice regarding healthy eating. As part of this phase, we will adapt existing intervention manuals and therapist training materials, and gain some initial clinical experience with the intervention via an open trial with 6 teens. During the randomized pilot study phase (Stage 1b), the integrated intervention will be compared to a control group receiving CBT treatment for depression alone (N=40 in total). During the pilot phase, the feasibility and acceptability of administering the program will be assessed. In addition, we will compare change in depressed mood at end of treatment and 6 month follow-up periods across the two groups. During the revision phase, the intervention manual will be further developed and refined, based on experiences and observations made during the development and pilot study phases. PUBLIC HEALTH RELEVANCE: The cumulative prevalence of major depression in adolescence is estimated at almost 30%. Similarly, approximately 17% of children and adolescents are obese and another 30% at risk for overweight. This study addresses the co-occurrence of these two major public health issues in adolescence by developing an intervention that addresses both problems in an integrated protocol. The intervention protocol will integrate cognitive-behavioral treatment for depression with exercise plus education about healthy eating to achieve its goals.

描述（由申请人提供）：到18岁时，重度抑郁症的终生患病率为28％（Lewinsohn等，1999），女性的累积率（35％）高于男性（19％）。大约有17％的美国儿童和青少年肥胖，这是由第95％以上的BMI定义的，其中30％以上介于第85％和95％之间（Ogden等人，2008年）。超重的儿童和青少年患2型糖尿病的风险增加（Pinhas-Hamiel等，1996）和成人肥胖的压倒性风险（Guo等，1994）。在临床样本中估计为25％的估计，有很大一部分的青少年既超重又沮丧。在心理社会治疗研究文献中，使用合并症/肥胖症和抑郁症等合并症的青少年（例如超重/肥胖和抑郁症）几乎没有关注。由于众多沮丧且超重的青少年，开发一种同时解决这两个问题的行为待遇具有重要的公共卫生意义。该提案的目的是结合抑郁症和超重的治疗方法，以在一次干预措施中解决这些同时发生的疾病。这项研究的长期目标是为共同出现的身体和情绪障碍开发高效有效的治疗方法。研究计划将分为三个主要阶段：一个发展阶段（第1A阶段），试点研究阶段（第1B阶段）和修订阶段。在开发阶段（第1A阶段），对抑郁症青少年的超重青少年和CBT治疗的治疗方法将改编为一种综合方案，该方案使用CBT技术，运动成分以及有关健康饮食的建议来解决抑郁症。作为此阶段的一部分，我们将调整现有的干预手册和治疗师培训材料，并通过与6名青少年进行开放试验获得一些初步的临床经验。在随机试点研究阶段（第1B期），将综合干预与仅接受CBT治疗的对照组进行比较（总共n = 40）。在试点阶段，将评估管理该程序的可行性和可接受性。此外，我们将比较两组治疗结束时情绪抑郁症的变化和6个月的随访期。在修订阶段，根据开发和试点研究阶段的经验和观察，将进一步开发和完善干预手册。公共卫生相关性：青春期严重抑郁症的累积患病率估计为30％。同样，大约17％的儿童和青少年肥胖，另有30％的超重风险。这项研究通过开发一种解决综合协议中这两个问题的干预措施，解决了青春期这两个主要公共卫生问题的同时出现。干预方案将与运动以及有关健康饮食的教育以实现其目标的认知行为待遇。