Clinical Trial Details
— Status: Terminated
Administrative data
| NCT number |
NCT01709526 |
| Other study ID # |
KUH5702803 |
| Secondary ID |
KUH5702803 |
| Status |
Terminated |
| Phase |
Phase 2/Phase 3
|
| First received |
June 29, 2011 |
| Last updated |
October 17, 2012 |
| Start date |
January 2009 |
| Est. completion date |
October 2012 |
Study information
| Verified date |
October 2012 |
| Source |
Kuopio University Hospital |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
Finland: Research Ethics Committee, Hospital District of Northern Savo |
| Study type |
Interventional
|
Clinical Trial Summary
The aims of this six month follow-up study are which treatment components will correlate or
which clinical treatments interventions contribute adolescent inpatients recovering in the
psychiatric treatment after discharge. Comparisons will be made between the 47 adolescents
aged 13 to 18 years, with major depression and conduct disorders, and between those with and
without suicide attempts by multivariate analyses. Are the adolescent psychiatric inpatients
recovered?
Description:
The whole prospective study sample consisted of 63 adolescents aged 13 to 18 years (40 girls
and 23 boys)referred for psychiatric treatment to the adolescent psychiatric inpatient unit
of Kuopio University Hospital, Finland. This study is part of the "Kliininen Laatuprojekti"-
Depression Project in Kuopio University Hospital. Researcher UH, Doctor of Philosophy, has
been the head of the study project. She has done this study by carrying, analysing, doing
articles and writing abstracts and keeping lectures and congress sessions in Finland and
aboard. In the same time she has done clinical work by caring adolescents in the hospital
ward and in the therapy settings. UH has been the first writer in the articles, one article
in national and three in international articles. This Doctoral dissertation has been
presented 17th November 2007, supervisor was professor, MD. Mauri Marttunen.
The prospective study set out to investigate gender differences, psychosocial and cognitive
functioning, self-image, and changes in these structured parameters, and the role of working
alliance. More girls than boys were admitted to inpatient care. Mood and conduct disorders
were the most common diagnoses. Girls more commonly had poor family relationships but more
peers than boys. Violent and destructive behaviour were more common among boys, and they
performed worse in tests assessing nonverbal cognitive performance and total immediate
recall memory than girls. Both girls and boys had an impaired IQ at entry. Major impairment
in functioning in several areas such as school, family relations, judgement and thinking was
found among both genders.
The psychosocial functioning and cognitive performance of inpatients improved during
treatment.
There were also improvements in intrapsychic constructs: in the psychological self-image,
especially body-image, and in relationships with family members, particularly among
emotionally-disturbed adolescents. Cognitive performance was significantly enhanced among
subjects both with a good and with a poor working alliance. According to multivariate
analyses, a better quality of working alliance and a greater number of therapy sessions were
associated with positive changes in cognitive performance and self-image.
When subjects with major depression and conduct disorder were compared, nonverbal cognitive
and general cognitive performance, body and self-image, and overall psychosocial functioning
improved in both groups of subjects during treatment. More positive changes in self-image
and family functioning were found among subjects with MDD.
Suicidal adolescents' treatment compliance and outcome were as good as those of non-suicidal
patients. Their psychosocial functioning, cognitive performance, and both the psychological
self and body-image improved during treatment. Positive changes in body-image associated
significantly with a higher probability of improvement in psychosocial functioning, while a
higher GAS score at entry was associated with a lower probability of functional improvement.
In clinical practice, attention needs to be paid to structured assessment of adolescent
psychiatric inpatients. This study suggests a need to combine at least regular individual
therapy, pharmacotherapy, family interventions, and a school program. Since a good working
alliance between the therapist and the adolescent patient seems to modify the treatment
outcome, particular attention to creating a good alliance with the patient and intensive
involvement of the parents in treatment are recommended. Prospective studies with a
sufficient follow-up after discharge and well-designed intervention studies among adolescent
inpatients are needed.
Now it is interested in how they are in recovery with the role of working alliance and
improvement in the psychosocial functioning after discharge?
