Assessment of Transcultural Psychotherapy in Child Major Depressive Disorder

Inclusion Criteria:

• Be a child aged or an adolescent aged 6-20 years-old (this may be a declaratory ageat the time of the consultation or based on a document for a residence request if noother identity documents are available)

• Be a first or second-generation migrant (born abroad or born from at least oneparent who is born abroad)

• Have a psychological and/or psychiatric follow-up by a first-line care

• Have been referred for transcultural psychotherapy by their first line care to treatdepression resistant to standard management.

• Present a depression according to the clinician who proposes the transculturaltreatment (first line therapist), based on usual as well as cultural symptomscriteria of the below list:

• Sadness

• Diminish interest or pleasure in most of the usual activities

• Insomnia or hypersomnia

• Psychomotor agitation

• Asthenia, loss of energy

• Feeling of worthlessness or excessive guilt

• Recurrent throughs of death

• School problems (school failure, drop in grades, aggressivity with adult,school refusal...)

• Mutism, and selective mutism

• Runaways

• Aggressivity

• Impulsivity

• Violence and delinquency

• Conflicts with parents and adults from the community

• Exclusion from family

• Somatic pains

• Massive separation anxiety

• Regressive symptoms - loosing of an already acquired function such as speech,walk, stay alone for a sufficient time in relation to age, manage stress oranxiety for reasonable situations...

• Denial of medical care for a chronic disease with no evident reasons

• Cultural designation such as possessed by a spirit, being a child witch, orother cultural designations

• State of trance The list is not exhaustive, and some other symptoms may beaccepted if the first line clinician as well as the referent agree. Thepatients will be well characterized after inclusion.

• Present a score >= 4 on the iCGI - Severity at inclusion.

• Present transcultural issues confirmed by the referent (usual procedure of indirectpre-selection based on the presentation of the situation by referring physician)

• Have an informed consent signed by both parents/ one parent / tutor / adult patient (cf. 14.1 paragraph)

Exclusion Criteria:

• Patient or family has previously had transcultural psychotherapy

• Patient presents an acute psychiatric disorder which hinders the realization of thetranscultural therapy - for example, excited delirium with great psychicdisorganization, or high suicidal risk patients. These situations will be excludedduring the screening time based on the first line therapist evaluation

• Patient presents an acute somatic disease which may hinder the well organization ofthe therapy

• Patient addressed for a legal expertise

• Child's/Adolescent's refusal

• Pregnant or breastfeeding (for women for young women of childbearing age)

• Participation in another interventional study

• Patient under guardianship or curatorship