BACKGROUND AND OBJECTIVE: Health care providers have few alternatives for youth depression other than antidepressants. We examined whether brief cognitive behavioral therapy (CBT) is a viable alternative in primary care. METHODS: A total of 212 adolescents aged 12 to 18 with major depression who had recently declined or quickly discontinued new antidepressant treatment were randomized toself-selected treatment as usual (TAU) control condition or TAU plus brief individual CBT. Blinded evaluators followed youth for 2 years. The primary outcome was time to major depression diagnostic recovery. RESULTS:CBT was superior to the control condition on the primary outcome of time to diagnostic recovery from major depression, with number needed to treat from 4 to 10 across follow-up. A similar CBT advantage was found for time to depression diagnosis response, with number needed to treat of 5 to 50 across time points. We observed a significant advantage for CBT on many secondary outcomes over the first year of follow-up but not the second year. Cohen's d effect sizes for significant continuous measures ranged from 0.28 to 0.44, in the small to medium effect range. Most TAU health care services did not differ across conditions, except for psychiatric hospitalizations, which occurred at a significantly higher rate in the control condition through the first year of follow-up. CONCLUSIONS: Observed results were consistent with recent meta-analyses of CBT for youth depression. The initial year of CBT superiority imparted an important clinical benefit and may reduce the risk of future recurrent depression episodes.
RCT Entities:
BACKGROUND AND OBJECTIVE: Health care providers have few alternatives for youth depression other than antidepressants. We examined whether brief cognitive behavioral therapy (CBT) is a viable alternative in primary care. METHODS: A total of 212 adolescents aged 12 to 18 with major depression who had recently declined or quickly discontinued new antidepressant treatment were randomized to self-selected treatment as usual (TAU) control condition or TAU plus brief individual CBT. Blinded evaluators followed youth for 2 years. The primary outcome was time to major depression diagnostic recovery. RESULTS: CBT was superior to the control condition on the primary outcome of time to diagnostic recovery from major depression, with number needed to treat from 4 to 10 across follow-up. A similar CBT advantage was found for time to depression diagnosis response, with number needed to treat of 5 to 50 across time points. We observed a significant advantage for CBT on many secondary outcomes over the first year of follow-up but not the second year. Cohen's d effect sizes for significant continuous measures ranged from 0.28 to 0.44, in the small to medium effect range. Most TAU health care services did not differ across conditions, except for psychiatric hospitalizations, which occurred at a significantly higher rate in the control condition through the first year of follow-up. CONCLUSIONS: Observed results were consistent with recent meta-analyses of CBT for youth depression. The initial year of CBT superiority imparted an important clinical benefit and may reduce the risk of future recurrent depression episodes.
Authors: Gregory Clarke; Lynn Debar; Frances Lynch; James Powell; John Gale; Elizabeth O'Connor; Evette Ludman; Terry Bush; Elizabeth H B Lin; Michael Von Korff; Stephanie Hertert Journal: J Am Acad Child Adolesc Psychiatry Date: 2005-09 Impact factor: 8.829
Authors: John March; Susan Silva; Stephen Petrycki; John Curry; Karen Wells; John Fairbank; Barbara Burns; Marisa Domino; Steven McNulty; Benedetto Vitiello; Joanne Severe Journal: JAMA Date: 2004-08-18 Impact factor: 56.272
Authors: Christopher J Kratochvil; Diane E May; Susan G Silva; Vishal Madaan; Susan E Puumala; John F Curry; John Walkup; Hayden Kepley; Benedetto Vitiello; John S March Journal: J Child Adolesc Psychopharmacol Date: 2009-10 Impact factor: 2.576
Authors: John F Dickerson; David H Feeny; Gregory N Clarke; Alex L MacMillan; Frances L Lynch Journal: Qual Life Res Date: 2017-11-17 Impact factor: 4.147
Authors: John F Dickerson; Frances L Lynch; Michael C Leo; Lynn L DeBar; John Pearson; Gregory N Clarke Journal: Pediatrics Date: 2018-01-19 Impact factor: 7.124
Authors: Christine Y Lu; Robert B Penfold; Jamie Wallace; Caitlin Lupton; Anne M Libby; Stephen B Soumerai Journal: Psychiatr Res Clin Pract Date: 2020-10-07
Authors: Javier Méndez; Óscar Sánchez-Hernández; Judy Garber; José P Espada; Mireia Orgilés Journal: Int J Environ Res Public Health Date: 2021-04-26 Impact factor: 3.390
Authors: Andrea Monsour; Emma J Mew; Sagar Patel; Alyssandra Chee-A-Tow; Leena Saeed; Lucia Santos; Darren B Courtney; Priya N Watson; Suneeta Monga; Peter Szatmari; Martin Offringa; Nancy J Butcher Journal: BMC Med Res Methodol Date: 2020-05-25 Impact factor: 4.615