{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T11:15:06Z","timestamp":1767870906326,"version":"3.49.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether individual, adapted Meaning-Centered Psychotherapy (IMCP), delivered alongside protocolized fluoxetine, improves depressive symptoms and related outcomes in adolescents with moderate-to-severe depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 168 adolescents with DSM-5-TR depressive disorder and Patient Health Questionnaire\u20139 modified for Adolescents (PHQ-A) \u226510, all receiving protocolized fluoxetine, participants were randomized to IMCP+TAU or TAU; the IMCP group completed seven weekly 60-minute sessions. The primary outcome was PHQ-A; secondary outcomes were the Zung Self-Rating Anxiety Scale (SAS), Clinical Global Impressions - Severity and - Improvement (CGI-S\/CGI-I), Children\u2019s Global Assessment Scale (CGAS), Rosenberg Self-Esteem Scale (RSES), and Meaning in Life Questionnaire - Presence and Search subscales (MLQ-Presence\/Search). Serious adverse events (SAEs) and adverse events (AEs) were recorded throughout the 12-week study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across 12 weeks, the IMCP group showed earlier and larger reductions in depressive symptoms (PHQ-A) than TAU, with advantages evident by week 4 and maintained at weeks 8 and 12; severity distributions shifted more toward milder categories in IMCP. Anxiety (SAS) declined in both groups, with greater improvement in IMCP. Clinician ratings reflected the same pattern: IMCP achieved lower illness severity (CGI-S) and better early improvement (CGI-I), and greater functional gains (CGAS) throughout follow-up. Self-esteem (RSES) rose more in IMCP. Meaning in life-Presence (MLQ-Presence) increased more with IMCP, while Search (MLQ-Search) changed minimally and similarly across groups. Neither group experienced SAEs, and AE frequencies were low and did not differ meaningfully between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adjunctive IMCP with standardized fluoxetine produced greater 12-week improvements than TAU in symptoms, clinician ratings, functioning, self-esteem, and felt meaning, supporting IMCP as a feasible and effective adjunct.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1748005","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T06:37:36Z","timestamp":1767854256000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adjunctive individual meaning-centered psychotherapy plus protocolized fluoxetine for moderate-to-severe adolescent depression"],"prefix":"10.3389","volume":"16","author":[{"given":"Li-Li","family":"Sheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1186\/s12884-025-07703-z","article-title":"The relationship between social support and maternal attachment of adolescent mothers and postpartum depression in Turkey","volume":"25","author":"Bulduk","year":"2025","journal-title":"BMC Pregnancy Childbirth"},{"key":"B2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s40479-025-00302-6","article-title":"Personality traits or emotional dysregulation: a multiple mediation analyses of adolescent depression","volume":"12","author":"Aune","year":"2025","journal-title":"Borderline Pers Disord Emot Dysregul"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e92496","DOI":"10.7759\/cureus.92496","article-title":"Transcranial magnetic stimulation in obsessive-compulsive disorder and adolescent depression: A systematic review of efficacy, safety, and predictors of treatment response","volume":"17","author":"Babu Bodapati","year":"2025","journal-title":"Cureus"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.4094\/chnr.2018.24.3.263","article-title":"Systematic review of meaning-centered interventions for adolescents","volume":"24","author":"Lim","year":"2018","journal-title":"Child Health Nurs Res"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2024.03.005","article-title":"Meaning-centered psychotherapy versus cognitive behavioral therapy for cancer survivors: A randomized controlled trial\u2606","volume":"55","author":"Marco","year":"2024","journal-title":"Behav Ther"},{"key":"B6","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1007\/s00520-024-09039-4","article-title":"Does enhanced meaning after meaning-centered group psychotherapy mediate a reduction in depressive symptoms in cancer survivors? 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