Adolescent Interpersonal Counseling in Primary Care

NCT ID: NCT06390462

Last Updated: 2025-08-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

9000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-03-25

Study Completion Date

2039-12-31

Brief Summary

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The demand for prevention and treatment of adolescent depression has rapidly increased over years. A national project to improve treatment of adolescent depression in primary care has taken place in Finland starting 2020.

The goal of this prospective observational cohort study is to describe pathways to mental health services in adolescents with depressive symptoms. The main questions it aims to answer are:

* Do young people reporting depressive symptoms have equal access to treatment?
* How is it best to recognize those adolescents who will benefit from IPC-A?

Adolescents who participate in the study will

* complete a survey on protective and risk factors of depression three times over 6 months
* report possible depressive symptoms every two weeks over 6 months
* report whether they needed and received help, motivation for treatment, and benefits and harms from treatment

We will also collect

* information from one of caretakers with two surveys within 6 month- intervals on their view on adolescent's need for support, strengths and risks, and benefits and harms from treatment where applicable
* where applicable, from the professional who provided support after the intervention on their training and competence, as well as content of and response to treatment
* register data to estimate overall provision and cost of social welfare and health care services one year preceding the study and over 2 to 10 years after the observation period

Researchers will compare an intervention that is new in Finland, adolescent interpersonal counseling (IPC-A), to other treatments of depression, to see if it is equal to or better than other treatments of depression.

Detailed Description

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Background: Implementation of evidence-based interventions is one of the proposed responses to increased demand for prevention and treatment of adolescent depression. A national implementation of adolescent interpersonal counseling (IPC-A) has taken place in Finland starting 2020. While the efficacy of interpersonal psychotherapy (IPT-A) as an intervention to treat depression of adolescents is well established, the effectiveness and cost-effectiveness of the shorter adaptation, IPC-A, remains open. Investigators present a protocol for an evaluation of pathways to mental health services of depressed adolescents and a prospective, observational community-based cohort study to estimate the effectiveness and cost-effectiveness of IPC-A, as compared to adolescents with sustained depression with treatment as usual or no treatment.

Methods: The cohort will include grade 7 to 9 adolescents (13-16-year-olds) in selected Finnish schools, excluding adolescents with preceding treatment of depression. A universal prospective evaluation of adolescents in a 6-month follow-up will provide information on the proportion of adolescents a) with sustained depression over the follow-up period (Patient Health Questionnaire 9 items, PHQ-9 ≥ 10) in two measurements over 6 months), b) with a self-reported need for support due to depressive symptoms, and c) with a therapeutic intervention. The investigators will describe the treatment received (number of sessions, therapeutic content) based on reports from adolescents, caretakers, and therapists, as well as electronic patient records. The primary outcome measure will be the proportion of adolescents who will receive specialized psychiatric services by 12 months after baseline. Secondary outcome measures comparing three groups as defined at 6 months (IPC-A, treatment as usual (TAU), or no treatment group). They will include proportion of adolescents who received any support by 12 months after baseline, and longitudinal changes in PHQ-9-A scores by 12 months. Cost-effectiveness will be evaluated using survey data at 12 months, and an economic evaluation using register data and information on service use 12 months before and 2 and 10 years after baseline. Collection of survey data is expected to start in March 2024 and is set to finish in May 2025.

Discussion: The study will describe need for, pathways to, and content of social and health services for depressed adolescents. Benefits and harms of treatment and the national implementation will be observed. The results can improve detection and equal access to care, and inform decision-makers about the best practices for prevention, including utility of the implementation of IPC-A.

Conditions

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Depressive Symptoms Mild to Moderate in Severity Major Depressive Disorder

Study Design

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Observational Model Type

ECOLOGIC_OR_COMMUNITY

Study Time Perspective

PROSPECTIVE

Study Groups

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Adolescents with sustained depression

PHQ-9-A ≥ 10 at least twice in a 6 months follow-up

Interpersonal counseling

Intervention Type BEHAVIORAL

A structured psychotherapeutic intervention to prevent depression or treat mild to moderate depression. IPC-A is a brief, individual-based intervention (3-8 sessions). The focus is on interpersonal relations as a factor of resilience in depressive symptoms. IPC-A is a shorter form of IPT-A, developed by prof. Myrna Weissman and team.

Treatment as usual

Intervention Type BEHAVIORAL

Any other behavioral or medical support or depression indicated by depressive symptoms or depression. This is based on adolescent, caretaker and professional's report.

No support, intervention or other treatment

Intervention Type OTHER

The group will comprise those adolescents who report sustained depression but do not seek or receive support over 6 months of follow-up based on adolescent and caretaker's report

Interventions

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Interpersonal counseling

A structured psychotherapeutic intervention to prevent depression or treat mild to moderate depression. IPC-A is a brief, individual-based intervention (3-8 sessions). The focus is on interpersonal relations as a factor of resilience in depressive symptoms. IPC-A is a shorter form of IPT-A, developed by prof. Myrna Weissman and team.

Intervention Type BEHAVIORAL

Treatment as usual

Any other behavioral or medical support or depression indicated by depressive symptoms or depression. This is based on adolescent, caretaker and professional's report.

Intervention Type BEHAVIORAL

No support, intervention or other treatment

The group will comprise those adolescents who report sustained depression but do not seek or receive support over 6 months of follow-up based on adolescent and caretaker's report

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* we will include all adolescents attending grades 7 to 9 in selected schools with on informed consent

Exclusion Criteria

* psychiatric care within the past 12 months or receiving a psychosocial intervention (psychotherapy, IPC-A, any other therapy of support) during the 12 months before baseline,
* an inability to reliably understand the Finnish, Plain Finnish, Swedish, or English versions of the survey, or
* an adolescents' or caretakers' report of a need for exclusion, such as another medical condition - including a mental disorder - requiring acute current treatment or support.
Minimum Eligible Age

13 Years

Maximum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Strategic Research Council of Finland

UNKNOWN

Sponsor Role collaborator

University of Helsinki

OTHER

Sponsor Role collaborator

University of Eastern Finland

OTHER

Sponsor Role collaborator

Tampere University

OTHER

Sponsor Role collaborator

Finnish Institute for Health and Welfare

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Outi Linnaranta, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Finnish Institute for Health and Welfare

Locations

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The wellbeing services county of Kanta-Häme

Hämeenlinna, , Finland

Site Status RECRUITING

Finnish Institute for Health and Welfare

Helsinki, , Finland

Site Status RECRUITING

The wellbeing services county of Central Finland

Jyväskylä, , Finland

Site Status RECRUITING

The wellbeing services county of North Ostrobothnia

Oulu, , Finland

Site Status RECRUITING

Countries

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Finland

Central Contacts

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Outi Linnaranta, MD, PhD

Role: CONTACT

+358504327128

Jasmin Kaljadin, MSc

Role: CONTACT

+358295247728

Facility Contacts

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Jasmin Kaljadin, MSc

Role: primary

Outi Linnaranta, MD, PhD

Role: primary

+358504327128

Jasmin Kaljadin, MSc

Role: backup

Tiia-Reeta Kukko, MSc

Role: primary

Jasmin Kaljadin

Role: backup

Ulla Heikkilä, MSc

Role: primary

Jasmin Kaljadin, MSc

Role: backup

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Related Links

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https://stnimagine.fi/tyopaketti-4-vaikuttavuusseuranta/

Description in Finnish and in English about the study, participant informed consent (adolescent, caretaker, professional)

Other Identifiers

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1271/6.02.03/2024

Identifier Type: -

Identifier Source: org_study_id

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