Effect of sertraline combined with psychological hotline-based Naikan therapy in the treatment of adolescents with depressive disorder

Abstract

Objective

This study examined the effect of sertraline combined with psychological hotline-based Naikan therapy (a structured form of self-reflection) in the treatment of adolescents with depressive disorder. Hotline-based Naikan therapy is where telephone operators who have been trained in this form of therapy help address psychological distress for callers through telephone counselling.

Methods

A randomized controlled trial was conducted involving 93 adolescent outpatients with depressive disorder, with 47 participants assigned to the combined group and 46 to the sertraline alone group. Adolescents in the combined group received treatment using sertraline at the same dose as those in the sertraline alone group. Depression and anxiety levels in both groups were evaluated using the Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) at baseline and after the 2nd, 4th and 12th week of treatment.

Results

There were no significant differences between the groups at baseline in terms of demographic or clinical characteristics. Participants in both the combined and sertraline groups reported no serious adverse reactions. By the end of the 12th week of treatment, significant between-group differences were found on the SDS and the SAS scores, favoring the combined treatment group (χ² = 6.68, P = 0.010 and χ² = 5.68, P = 0.017, respectively).

Conclusion

Sertraline combined with psychological hotline-based Naikan therapy is more effective in reducing depressive and anxiety symptoms in adolescents with depressive disorder than in those receiving sertraline alone.