Psychodiagnostic assessment may be useful as a treatment for children with mood disorders, alleviating some distress for patients and their families during the wait for more intensive treatment, reports a recent study from the USA. The benefit of these assessments, however, appears less effective if mood disorder is comorbid with ADHD, disruptive behaviour disorder [DBD] or anxiety disorder.
This was an open-label study of psychodiagnostic screening assessment as a treatment before randomisation to clinical trials, to assess whether mood symptoms improve after assessment, identify predictors of improvement and determine if improvement between screening assessment and randomisation affect treatment response.
A total of 95 children aged 7–14 with mood disorders completed screening assessments (including Clinical Global Impressions–Improvement [CGI-I], Children’s Depression Rating Scale–Revised [CDRS‑R] and Young Mania Rating Scale [YMRS]), and were randomised into a 12-week trial of omega-3, Individual-Family Psychoeducational Psychotherapy (PEP), their combination or placebo. Comorbid diagnoses (ADHD, DBD and anxiety disorder) were examined.
Between screening and randomisation nearly half the sample (48.4%) experienced at least some improvement (CGI-I ≤ 3), with 35.8% minimally improved (CGI-I = 3), and 12.6% much improved (CGI‑I < 3). On average, symptom severity signiﬁcantly improved pre-randomisation on both the CDRS-R and YMRS (both p<0.001) rating scales.
These data suggest that psychodiagnostic screening assessment was most helpful for children with less severe clinical presentations, including those without comorbid ADHD, and that less intensive interventions may beneﬁt children with mild to moderate mood symptoms. These findings may have signiﬁcant public health implications due to the risk associated with delaying treatment.
Young AS, Meers MR, Vesco AT, et al. Predicting therapeutic effects of psychodiagnostic assessment among children and adolescents participating in randomized controlled trials. J Clin Child Adolesc Psychol 2016; Epub ahead of print.