Rapid Response to Psychosocial Treatment for Adolescent Depression: A Two-Year Follow-up

doi:10.1097/00004583-199811000-00019

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 37, Issue 11, November 1998, Pages 1184-1190

https://doi.org/10.1097/00004583-199811000-00019 Get rights and content

ABSTRACT

Objective

To examine the differential course and treatment outcome of patients who participated in a randomized clinical trial, comparing cognitive, family, and supportive psychotherapies for adolescent major depressive disorder.

Method

In a sample of 100 depressed adolescents, remission, clinical recovery, recurrence, and functional improvement were examined at the end of acute treatment and at 1- and 2-year follow-up, according to their type of response to treatment. Rapid response was defined as a decline of 50° in the Beck Depression Inventory (BDI) score from pretreatment until the beginning of the second session of psychotherapy, intermediate as a decline of <50° 0but >0°. and initial nonresponse as a BDI score that stayed the same or increased.

Results

Rapid responders showed a better outcome at acute treatment, 1-year, and in some measures, 2-year follow-up. For those who had recurrences over time, rapid responders showed a longer period before recurrence. Subjects were most likely to respond rapidly, or not at all, in the supportive cell.

Conclusions

These findings suggest that milder forms of depression may benefit from initial supportive therapy or short trials of more specialized types of psychotherapy. The use of a placebo run-in period might help to “wash out” nonspecific responders.

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: This work was supported by NIMH grants MH-46500-06 (Adolescent Depression Treatment and Outcome, David A. Brent, M.D., principal investigator) and MH-55123 (Child and Adolescent Developmental Psychopathology Research Center for Early Onset Affective and Anxiety Disorders, David A. Brent, M.D., principal investigator).

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ARTICLESRapid Response to Psychosocial Treatment for Adolescent Depression: A Two-Year Follow-up

ABSTRACT

Objective

Method

Results

Conclusions

Clin Psychol Rev

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Behav Ther

J Am Acad Child Psychiatry

Neuropsychopharmacology

J Affect Disord

Prog Neuropsychopharmacol Biol Psychiatry

Functional Family Therapy

The measurement of pessimism: the Hopelessness Scale

J Consult Clin Psychol

A clinical psychotherapy trial for adolescent depression comparing cognitive, family, and supportive therapy

Arch Gen Psychiatry

The assessment of affective disorders in children and adolescents by semistructured interview: test-retest reliability of the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present Episode version

Arch Gen Psychiatry

Regression models and life tables

J R Stat Soc

A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression

Arch Gen Psychiatry

ARTICLES
Rapid Response to Psychosocial Treatment for Adolescent Depression: A Two-Year Follow-up