BACKGROUND: There is great heterogeneity of clinical presentation and outcome in paediatric depression. AIMS: To identify which clinical and environmental risk factors at baseline and during treatment predicted major depression at 28-week follow-up in a sample of adolescents with depression. METHOD: One hundred and ninety-two British adolescents with unipolar major depression were enrolled in a randomised controlled trial (the Adolescent Depression Antidepressants and Psychotherapy Trial, ADAPT). Participants were treated for 28 weeks with routine psychosocial care and selective serotonin reuptake inhibitors (SSRIs), with half also receiving cognitive-behavioural therapy (CBT). Full clinical and demographic assessment was carried out at baseline and 28 weeks. RESULTS:Depression at 28 weeks was predicted by the additive effects of severity, obsessive-compulsive disorder and suicidal ideation at entry together with presence of at least one disappointing life event over the follow-up period. CONCLUSIONS: Clinicians should assess for severity, suicidality and comorbid obsessive-compulsive disorder at presentation and should monitor closely for subsequent life events during treatment.
RCT Entities:
BACKGROUND: There is great heterogeneity of clinical presentation and outcome in paediatric depression. AIMS: To identify which clinical and environmental risk factors at baseline and during treatment predicted major depression at 28-week follow-up in a sample of adolescents with depression. METHOD: One hundred and ninety-two British adolescents with unipolar major depression were enrolled in a randomised controlled trial (the Adolescent Depression Antidepressants and Psychotherapy Trial, ADAPT). Participants were treated for 28 weeks with routine psychosocial care and selective serotonin reuptake inhibitors (SSRIs), with half also receiving cognitive-behavioural therapy (CBT). Full clinical and demographic assessment was carried out at baseline and 28 weeks. RESULTS:Depression at 28 weeks was predicted by the additive effects of severity, obsessive-compulsive disorder and suicidal ideation at entry together with presence of at least one disappointing life event over the follow-up period. CONCLUSIONS: Clinicians should assess for severity, suicidality and comorbid obsessive-compulsive disorder at presentation and should monitor closely for subsequent life events during treatment.
Authors: Heather A MacPherson; Guillermo Perez Algorta; Amy N Mendenhall; Benjamin W Fields; Mary A Fristad Journal: J Clin Child Adolesc Psychol Date: 2013-06-24
Authors: Ian M Goodyer; Sonya Tsancheva; Sarah Byford; Bernadka Dubicka; Jonathan Hill; Raphael Kelvin; Shirley Reynolds; Christopher Roberts; Robert Senior; John Suckling; Paul Wilkinson; Mary Target; Peter Fonagy Journal: Trials Date: 2011-07-13 Impact factor: 2.279
Authors: Frederick Sundram; Susan J Hawken; Karolina Stasiak; Mathijs Fg Lucassen; Theresa Fleming; Matthew Shepherd; Andrea Greenwood; Raechel Osborne; Sally N Merry Journal: JMIR Ment Health Date: 2017-01-11
Authors: Matthew Owens; Joe Herbert; Peter B Jones; Barbara J Sahakian; Paul O Wilkinson; Valerie J Dunn; Timothy J Croudace; Ian M Goodyer Journal: Proc Natl Acad Sci U S A Date: 2014-02-18 Impact factor: 11.205
Authors: Cindy C Hagan; Julia Me Graham; Barry Widmer; Rosemary J Holt; Cinly Ooi; Adrienne O van Nieuwenhuizen; Peter Fonagy; Shirley Reynolds; Mary Target; Raphael Kelvin; Paul O Wilkinson; Edward T Bullmore; Belinda R Lennox; Barbara J Sahakian; Ian Goodyer; John Suckling Journal: BMC Psychiatry Date: 2013-10-05 Impact factor: 3.630