Dialectical Behavior Therapy Decreases Depressive Symptoms among Adolescents in an Acute-Care Inpatient Unit

Abstract

Objective: Research has shown that dialectical behavior therapy (DBT) is an effective treatment modality to decrease suicidal ideation, incidents of nonsuicidal self-injurious behavior, and suicide attempts in an adolescent outpatient population. However, research on the impact of DBT on depressive and manic symptoms for adolescents and within an inpatient setting is limited. The purpose of this study is to examine whether DBT significantly decreases depressive and manic symptoms compared with treatment as usual (TAU) for inpatient adolescents. Method: We conducted a retrospective chart review for adolescents receiving inpatient DBT and for a historical control group on the same unit before DBT (i.e., TAU). Group differences for continuous outcomes were analyzed using analysis of covariance (ANCOVA), where discharge scores for Hamilton Depression Rating Scale (HAMD), Young Mania Rating Scale (YMRS), Clinical Global Impressions-Severity for Symptoms (CGI-S), and Dynamic Appraisal of Situational Aggression (DASA) were predicted by treatment condition (i.e., DBT and TAU) while co-varying for admission scores and using a t test for CGI-Improvement (CGI-I) in functioning, which was administered upon discharge. Results: Patients who received DBT had significantly lower HAMD scores, F(1, 409) = 5.272, p = 0.022, ηp2 = 0.013, and lower CGI-I scores, t(596) = 2.50, p = 0.00 upon discharge when controlling for admission scores, compared with patients who received TAU. ANCOVAs showed no significant differences on the YMRS, CGI-S, or DASA between the DBT and TAU groups. Conclusion: DBT on an acute-care inpatient unit for adolescents seems to significantly decrease depressive symptoms during a relatively short period of time compared with TAU. DBT may be an effective treatment modality to decrease depressive symptoms for acute-care inpatient units for adolescents.