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Internet-delivered psychodynamic therapy versus cognitive behavioural therapy shows no difference for adolescent depression at 12-monthTwo online therapies offer similar support for teen depression

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Key Takeaway
Consider IPDT and ICBT for adolescent depression; no significant differences found at 12-month follow-up.

This randomized controlled trial evaluated adolescents aged 15–19 with major depressive disorder. The sample size consisted of 272 participants enrolled in the randomized study. The intervention involved internet-delivered psychodynamic therapy (IPDT) compared against internet-delivered cognitive behavioural therapy (ICBT) as the control.

The primary outcome measured depressive symptoms using the QIDS-A17-SR. Secondary outcomes included anxiety symptoms measured with the GAD-7, treatment costs, and healthcare use costs. Follow-up occurred at 12-month. Results indicated no significant group differences at the 12-month follow-up for depressive symptoms or anxiety symptoms. Treatment costs and healthcare use costs also showed no differences. Effect sizes, absolute numbers, and p-values were not reported in the results.

Safety data regarding adverse events, serious adverse events, discontinuations, and tolerability were not reported. A key limitation noted was that interpretation of health-care use data was restricted due to the COVID-19 pandemic taking place during the follow-up period. This restriction impacts the reliability of economic outcome data significantly for clinicians and researchers.

Practice relevance suggests ICBT and IPDT can be seen as viable alternatives for treating adolescent depression. However, the lack of reported statistical measures limits precise clinical interpretation. Clinicians should note the specific study design and population when considering application in their important practice settings carefully.

Researchers looked at two types of online therapy for teenagers with depression. Results showed no clear advantage for either method after one year, though data interpretation was limited. They compared internet-delivered psychodynamic therapy against internet-delivered cognitive behavioural therapy. The study included 272 adolescents aged 15 to 19 years old. This was a randomized controlled trial designed to see which method worked better. However, the pandemic during the follow-up period may affect how we interpret some results.

After twelve months, there were no significant differences between the two groups. Both treatments worked similarly for reducing depressive and anxiety symptoms. There were also no differences in treatment costs or healthcare use costs. This suggests both methods are equally effective for this age group.

One reason to be careful is that the COVID-19 pandemic happened during the follow-up period. This made it harder to interpret some health-care use data accurately. Safety information was not reported in this trial. Readers should understand that the pandemic may have changed how people used health services.

Readers should know that both options can be seen as viable alternatives for treating adolescent depression. It is important to talk to a doctor about the best choice for each person. Neither therapy was proven to be better than the other. Patients can choose based on their personal preference and availability.

What this means for you:
Two online therapies worked similarly for teen depression, but pandemic limits some cost data.

Study Details

Study typeRct
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
Adolescent depression poses a major public health concern with substantial clinical and societal implications. Both internet-delivered cognitive behavioural therapy (ICBT) and internet-delivered psychodynamic therapy (IPDT) have shown efficacy, but questions remain regarding long-term efficacy and cost-effectiveness. The present study presents a 12-month follow-up and cost-comparison from a randomized controlled trial (RCT) comparing ICBT and IPDT for adolescent depression. Participants were 272 adolescents aged 15–19 with a primary diagnosis of major depressive disorder. The primary outcome was depressive symptoms measured with the QIDS-A17-SR while the secondary outcome was anxiety symptoms measured with the GAD-7. Costs were assessed both by comparing costs of treatment and healthcare use 12-month post-treatment using the TIC-P. Results were stable at the 12-month follow up compared to treatment endpoint, for both depressive and anxiety symptoms. There were no significant group differences at the 12-month follow-up. There were no differences in treatment costs or in costs for healthcare use one-year post-treatment. This study suggests that treatment gains from IPDT and ICBT for adolescent depression remain stable during a 12-month follow-up period, with no differences between the treatments one-year post-treatment. Furthermore, it suggests comparable costs for the treatments. Interpretation of health-care use data was restricted due to the COVID-19 pandemic taking place during the follow-up period. This adds to the literature suggesting that ICBT and IPDT can be seen as viable alternatives for treating adolescent depression. More research into the long-term effects and cost-effectiveness is needed.
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