Open Door Review

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! S))&40%_!;>_!"62*7#0Y2_!Q>_!F4:)%&_!Q>_!OB3$7M2_!F>_!H$<<_!i>_!I0_!>!>!>!L)*2D4_!/>![+,--^>!;91%)Y$*D!9))&! Z$(#!1647#)2*2<4($7!2*&!7)D*$($Y0!(#0%21$06![;@/=8"^?!2!1%2D92($7!0::07($Y0*066!6B10%$)%$(4!(%$2!"%$2<6_!-+_!-d.>!! ! @$&D<04_!a>_!8%0D00*_!Q>_!HBD#06_!8>_!5B6($*_!@>![+,-+^>!/647#)2*2<4($7!1647#)(#0%214!26!2!(%02(90*(!:)%! &01%066$)*!$*!2&)<0670*(6>!8#$<&!2*&!=&)<0670*(!/647#$2(%$7!8<$*$76!):!a)%(#!=90%$72_!++_!gdEb+>!! ! H0*()*_!;>!2*&!@$&D<04_!a>![+,-+^!s=!12(#!$*!(#0!Z))&6t?!=!6(B&4!):!7#$<&!1647#)(#0%21$6(6Ä!12%($7$12($)*!$*! 2!<2%D0!%2*&)9$60&!7)*(%)<<0&!(%$2!8)B*60<<$*D!2*&!/647#)(#0%214!50602%7#_!-+_!+,]E-P>! ! @$&D<04_!a>_!=*62<&)_!L>!2*&!"2%D0(_!@>![+,-]^>!"#0!902*$*D:B!/647#)(#0%214_!.-[-^_!-+bE-Pd>! W(*&,!>-001(3! IMPACT is a randomised controlled relapse prevention trial aiming to assess and compare the effectiveness of three therapeutic interventions in the treatment and relapse prevention of adolescent depression: Cognitive Behavioural Therapy (CBT), Short Term Psychoanalytic Psychotherapy (STPP) and Specialist Clinical Care (SCC). The trial is a collaboration between the University of Cambridge, UCL and the University of Manchester. The study aims to recruit 540 participants in total aged between 11 and 17 with moderate/severe depression. Recruitment is from Child and Adolescent Health Services (CAMHS) within National Health Service (NHS) Trusts across three major regions in the UK: North London, East Anglia and Manchester and the Wirral. All participants are randomly allocated to one of the three interventions and after their first therapy session, are reassessed at 6, 12, 36, 52 and 86 weeks. The study is based on an ‘intent to treat’ design and is a pragmatic trial to reflect how these services are provided, and used, in real NHS settings by the adolescent population. An additional aim of the trial is to explore whether, or how, cortisol levels and genes might influence individual responses to treatment; this is being conducted via lab-analysis of saliva samples collected from consenting participants at baseline and at their 36-week follow up assessments. Furthermore, the study intends to estimate the overall health, social and educational costs of the interventions based on research findings, and build ground for future adolescent depression treatment recommendations. IMPACT also contains two further voluntary sub-branches: MR-IMPACT, which involves using magnetic resonance imaging to explore brain function and intervention effects amongst depressed adolescents, and IMPACT-ME, a qualitative study exploring young people’s experiences of overcoming depression, as well as their expectations and experiences of treatment in the IMPACT trial. G$#.1/.\!!

Professor Peter Fonagy, Professor Mary Target, Dr Nick Midgley – all Anna Freud Centre, and Research Department of Clinical, Educational and Health Psychology, UCL.

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