Outcome of Adolescent Depression: 6 Months After Treatment

Objective: To evaluate the demographic and clinical factors that predicted depression in adolescents at 6 months after treatment. Method: A total of 130 adolescents (aged 12 to 18 years) who had been clinically referred for treatment with a DSM-IV major depressive disorder, dysthymic disorder or minor depression were treated with either CBT, sertraline, their combination or supportive psychotherapy, in two randomized clinical trials using the same assessment instruments. Assessments in both studies were conducted at initial assessment, three months later at the conclusion of treatment, and at 6-month follow up. The data of these two trials were pooled. The primary outcome measures were the presence of a depressive disorder and the Reynolds Adolescent Depression Scale (RADS) score at 6-month follow up. Results: At baseline, only the Self Efficacy Questionnaire for Depressed Adolescents (SEQ-DA) predicted depression at 6-month follow up. Individual measures following 3 months of acute treatment that predicted depression at 6-month follow up were SEQ-DA, RADS, Revised Children's Manifest Anxiety Scale-total score, Global Assessment of Function, adolescent-rated Family Assessment Device General Functioning Subscale and adolescent-rated Visual Analogue Scores of mood states. Conclusion: Clinical variables as reported by the adolescent and identified by the clinician at baseline assessment and following 3 months of treatment predicted depression at 6-month follow up. No demographic variables were predictive of depression at 6-month follow up.

[1]  I. Goodyer,et al.  Treated depression in adolescents: predictors of outcome at 28 weeks. , 2009, The British journal of psychiatry : the journal of mental science.

[2]  B. Tonge,et al.  A comparison of cognitive-behavioral therapy, sertraline, and their combination for adolescent depression. , 2006, Journal of the American Academy of Child and Adolescent Psychiatry.

[3]  I. Goodyer,et al.  Longitudinal investigation into childhood-and adolescence-onset depression: Psychiatric outcome in early adulthood , 2006, British Journal of Psychiatry.

[4]  B. Tonge,et al.  The Self-Efficacy Questionnaire for Depression in Adolescents (SEQ-DA) , 2005, European Child & Adolescent Psychiatry.

[5]  G. Parker Critique of the Guidelines for the Treatment of Depression: Flaws in the Construction , 2004 .

[6]  G. Parker Critique of the guidelines for the treatment of depression: flaws in the construction. , 2004, The Australian and New Zealand journal of psychiatry.

[7]  A. Nierenberg Predictors of response to antidepressants general principles and clinical implications. , 2003, The Psychiatric clinics of North America.

[8]  A. Sandler Depressive spectrum disorders in high-risk adolescents: Episode duration and predictors of time to recovery , 2002 .

[9]  David Brent,et al.  Course and outcome of child and adolescent major depressive disorder. , 2002, Child and adolescent psychiatric clinics of North America.

[10]  J. Garber,et al.  Depressive spectrum disorders in high-risk adolescents: episode duration and predictors of time to recovery. , 2002, Journal of the American Academy of Child and Adolescent Psychiatry.

[11]  A. Tamplin,et al.  Family functioning in adolescents at high and low risk for major depressive disorder , 2001, European Child & Adolescent Psychiatry.

[12]  B. Birmaher,et al.  Subsyndromal depression in adolescents after a brief psychotherapy trial: course and outcome. , 2001, Journal of affective disorders.

[13]  P. Lewinsohn,et al.  Clinical implications of "subthreshold" depressive symptoms. , 2000, Journal of abnormal psychology.

[14]  S Iyengar,et al.  Clinical outcome after short-term psychotherapy for adolescents with major depressive disorder. , 2000, Archives of general psychiatry.

[15]  P. Ambrosini Historical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). , 2000, Journal of the American Academy of Child and Adolescent Psychiatry.

[16]  David J. A. Dozois,et al.  A psychometric evaluation of the Beck Depression inventory-II , 1998 .

[17]  I. Goodyer,et al.  Family functioning and parent general health in families of adolescents with major depressive disorder. , 1998, Journal of affective disorders.

[18]  C. Gatsonis,et al.  First-episode major depressive and dysthymic disorder in childhood: clinical and sociodemographic factors in recovery. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[19]  A. Rush,et al.  Recurrence of major depressive disorder in hospitalized children and adolescents. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[20]  C. Reynolds,et al.  What I Think and Feel: A Revised Measure of Children's Manifest Anxiety , 1997, Journal of abnormal child psychology.

[21]  A. Fronek,et al.  Principles and Clinical Applications , 1997 .

[22]  W. Bickerton,et al.  A randomised controlled out-patient trial of cognitive-behavioural treatment for children and adolescents with depression: 9-month follow-up. , 1996, Journal of affective disorders.

[23]  P. Szatmari,et al.  Predicting the one-year course of adolescent major depression. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[24]  R. Dahl,et al.  Unipolar depression in adolescents: clinical outcome in adulthood. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[25]  P. Lewinsohn,et al.  Major depression in community adolescents: age at onset, episode duration, and time to recurrence. , 1994, Journal of the American Academy of Child and Adolescent Psychiatry.

[26]  I. Gotlib,et al.  Adolescent psychopathology: II. Psychosocial risk factors for depression. , 1994, Journal of abnormal psychology.

[27]  I. Gotlib,et al.  Adolescent psychopathology: II. Psychosocial risk factors for depression. , 1994, Journal of abnormal psychology.

[28]  K. Myers,et al.  Depression in young people: initial presentation and clinical course. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[29]  P. Lewinsohn,et al.  Cognitive-behavioral group treatment of adolescent depression: Prediction of outcome , 1992 .

[30]  P. Lewinsohn,et al.  Comorbidity of unipolar depression: II. Comorbidity with other mental disorders in adolescents and adults. , 1991, Journal of abnormal psychology.

[31]  D. Offord,et al.  Ontario Child Health Study: reliability and validity of the general functioning subscale of the McMaster Family Assessment Device. , 1988, Family process.

[32]  H. Rogers,et al.  Preliminary Validation of the Abbreviated Spanier Dyadic Adjustment Scale: Some Psychometric Data Regarding a Screening Test of Marital Adjustment , 1984 .

[33]  M. Kovács,et al.  Depressive disorders in childhood. II. A longitudinal study of the risk for a subsequent major depression. , 1984, Archives of general psychiatry.

[34]  C. Sharpley,et al.  A Psychometric Evaluation of the Spanier Dyadic Adjustment Scale , 1982 .

[35]  D. Palermo,et al.  The children's form of the manifest anxiety scale. , 1956, Child development.