Table 2.
Primary and secondary outcomes
|
BPI |
CBT |
STPP |
STPP vs CBT |
CBT plus STPP vs BPI |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| n | Mean (SD) | n | Mean (SD) | n | Mean (SD) | Treatment effect (95% CI)* | p value† | Treatment effect (95% CI)* | p value† | ||
| Primary | |||||||||||
| MFQ | |||||||||||
| Baseline | 155 | 46·2 (10·6) | 154 | 46·2 (10·3) | 156 | 45·4 (10·8) | .. | .. | .. | .. | |
| 6 weeks | 99 | 36·5 (14·3) | 104 | 35·2 (11·3) | 107 | 34·9 (13·2) | .. | .. | .. | .. | |
| 12 weeks | 112 | 34·1 (14·4) | 106 | 31·6 (13·3) | 108 | 33·1 (14·2) | .. | .. | .. | .. | |
| 36 weeks | 105 | 30·5 (16·1) | 104 | 24·2 (15·1) | 109 | 26·6 (15·7) | 0·179 (−3·731 to 4·088) | 0·929 | −3·234 (−6·611 to 0·143) | 0·061 | |
| 52 weeks | 105 | 25·1 (16·2) | 111 | 25·0 (18·0) | 110 | 23·0 (15·9) | 0·307 (−3·161 to 3·774) | 0·862 | −2·806 (−5·790 to 0·177) | 0·065 | |
| 86 weeks | 116 | 23·6 (16·2) | 123 | 22·3 (15·7) | 114 | 21·8 (15·5) | 0·578 (−2·948 to 4·104) | 0·748 | −1·898 (−4·922 to 1·126) | 0·219 | |
| Secondary | |||||||||||
| RCMAS | |||||||||||
| Baseline | 155 | 41·1 (7·6) | 154 | 41·2 (6·4) | 155 | 40·5 (7·7) | .. | .. | .. | .. | |
| 6 weeks | 98 | 35·9 (10·6) | 103 | 37·1 (7·9) | 107 | 36·7 (10·0) | .. | .. | .. | .. | |
| 12 weeks | 110 | 34·2 (11·9) | 105 | 34·4 (11·4) | 108 | 34·3 (11·9) | .. | .. | .. | .. | |
| 36 weeks | 104 | 32 (13·3) | 102 | 27·0 (13·7) | 107 | 28·6 (13·3) | 0·855 (−2·530 to 4·239) | 0·621 | −3·832 (−6·781 to −0·884) | 0·011 | |
| 52 weeks | 100 | 27·2 (14·8) | 108 | 26·4 (14·9) | 104 | 25·5 (14·5) | 0·663 (−2·354 to 3·680) | 0·667 | −2·818 (−5·432 to −0·205) | 0·035 | |
| 86 weeks | 109 | 24·7 (14·7) | 115 | 24·8 (15·4) | 108 | 23·8 (14·6) | 0·254 (−2·980 to 3·489) | 0·878 | −0·663 (−3·460 to 2·134) | 0·642 | |
| LOI | |||||||||||
| Baseline | 155 | 10·0 (5·3) | 152 | 10·8 (5·4) | 154 | 9·2 (5·0) | .. | .. | .. | .. | |
| 6 weeks | 98 | 7·8 (5·4) | 102 | 7·6 (5·0) | 107 | 7·6 (5·0) | .. | .. | .. | .. | |
| 12 weeks | 111 | 6·6 (5·6) | 104 | 6·7 (5·2) | 107 | 7·3 (5·1) | .. | .. | .. | .. | |
| 36 weeks | 103 | 6·3 (5·4) | 101 | 4·8 (4·8) | 107 | 5·2 (4·9) | −0·816 (−1·972 to 0·341) | 0·167 | −1·249 (−2·258 to −0·240) | 0·015 | |
| 52 weeks | 99 | 5·6 (5·8) | 107 | 5·1 (5·5) | 102 | 4·9 (4·7) | −0·574 (−1·601 to 0·452) | 0·273 | −1·120 (−2·010 to −0·231) | 0·014 | |
| 86 weeks | 107 | 5·0 (5·4) | 115 | 4·9 (5·0) | 106 | 4·0 (4·6) | −0·062 (−1·091 to 0·967) | 0·906 | −0·847 (−1·736 to 0 ·042) | 0·062 | |
| HoNOSCA | |||||||||||
| Baseline | 148 | 18·9 (6·0) | 143 | 18·4 (6·0) | 144 | 18·2 (6·3) | .. | .. | .. | .. | |
| 6 weeks | 88 | 14·5 (6·5) | 91 | 14·1 (6·4) | 96 | 14·6 (6·9) | .. | .. | .. | .. | |
| 12 weeks | 101 | 14·3 (7·5) | 96 | 11·9 (6·8) | 94 | 12·9 (6·2) | .. | .. | .. | .. | |
| 36 weeks | 88 | 12 (8·7) | 81 | 9·7 (7·2) | 88 | 10·3 (7·6) | 0·617 (−1·499 to 2·733) | 0·567 | −1·410 (−3·221 to 0·401) | 0·127 | |
| 52 weeks | 88 | 9·5 (6·9) | 86 | 8·5 (7·3) | 83 | 8·6 (5·8) | 0·620 (−1·078 to 2·318) | 0·474 | −1·154 (−2·601 to 0·293) | 0·118 | |
| 86 weeks | 98 | 8·2 (6·2) | 92 | 7·3 (5·2) | 85 | 8·2 (7·2) | 0·626 (−0·814 to 2·066) | 0·394 | −0·611 (−1·819 to 0·598) | 0·322 | |
Linear mixed model estimates of the treatment effect at weeks 36, 52, and 86 post-randomisation. Data were missing for some participants. The model was based on data for 392 (84%) of 465 patients who provided one or more self-reported depression symptom scores over the 36, 52, or 86 week assessment points. The analysis used time since randomisation as a continuous variable, with therapist, participant and slope random effects, treatment, treatment by time interaction, and other prespecified baseline covariates (appendix). BPI=brief psychological intervention. CBT=cognitive behavioural therapy. STPP=short-term psychoanalytical psychotherapy. MFQ=Mood and Feelings Questionnaire. RCMAS=Revised Children's Manifest Anxiety Scale. LOI=Leyton Obsessional Inventory–adolescent version. HoNOSCA=Health of the Nation Outcome Scale for Children and Adolescents.
The marginal mean difference at a given timepoint, with negative effects indicating treatment benefit.
To control for two comparisons, we used a 2·5% significance level to maintain a 5% significance level for any measure and timepoint combination.