Improving Mood with Psychoanalytic and Cognitive Therapies (IMPACT)

  • Research Project Team

    • Professor Peter Fonagy,
    • Dr Rob Senior,
    • Professor Mary Target,
    • Dr Nick Midgley,
    • Professor Ian Goodyer,
    • Sally Parkinson


    • University of Cambridge,
    • University of Manchester,
    • University College London


  • Background

    In the UK, 1 in 10 young people referred to Child and Adolescent Mental Health Services (CAMHS) receives a diagnosis of depression. There are strong links between adolescent depression and recurrent depressive episodes and suicidality in later life.

    This highlights the need to identify psychological treatments that have long-term benefits in reducing the risk of relapse in later life.

    In 2005, the NICE guidelines highlighted the need for a randomised controlled trial (RCT) to assess the efficacy of Cognitive Behavioural Therapy (CBT) and psychodynamic psychotherapy in the treatment of adolescent depression.

    The IMPACT trial was set up in response to NICE recommendations, and is the largest clinical trial of psychological therapies for adolescent depression ever to have taken place in Europe.

  • Aims

    • To assess the effectiveness of three therapeutic interventions in the treatment and relapse prevention of adolescent depression.

    • To estimate the overall health, social and educational costs of the interventions based on research findings, and build ground for future adolescent depression treatment recommendations.

    • To explore whether, or how, cortisol levels and genes might influence individual responses to treatment.
  • Methodology

    The study is a pragmatic randomised controlled trial, which reflects how these services are provided, and used, in real NHS settings by the adolescent population.

    470 participants aged 11-17 years with moderate/severe depression have been recruited from CAMHS within NHS Trusts across three regions in the UK: North London, East Anglia and the North West.

    Participants are randomly allocated to one of the three interventions: Cognitive Behavioural Therapy (CBT), Short Term Psychoanalytic Psychotherapy (STPP) and Specialist Clinical Care (SCC). Outcome assessments take place with participants at 6, 12, 36, 52 and 86 weeks after starting treatment.

  • Results

    We will have completed all follow-up assessments with IMPACT participants by December 2014, and the results will be published in 2015.