File(s) under permanent embargo
A comparison of cognitive-behavioral therapy, sertraline, and their combination for adolescent depression
journal contribution
posted on 2006-10-01, 00:00 authored by Glenn MelvinGlenn Melvin, B J Tonge, N J King, D Heyne, M S Gordon, E KlimkeitOBJECTIVE: To evaluate cognitive-behavioral therapy, antidepressant medication alone, and combined CBT and antidepressant medication in the treatment of depressive disorders in adolescents. METHOD: Seventy-three adolescents (ages 12-18 years) with a primary diagnosis of DSM-IV major depressive disorder, dysthymic disorder, or depressive disorder not otherwise specified were randomly allocated to one of three treatments. Treatment outcome measures were administered before and after acute treatment, and at a 6-month follow-up. Depression diagnosis was the primary outcome measure; secondary measures were self- and other report and clinician rating of global functioning. The trial was conducted at three community-based clinics between July 2000 and December 2002. Data analyses used an intent-to-treat strategy. RESULTS: Following acute treatment, all treatment groups demonstrated statistically significant improvement on outcome measures (depressive diagnosis, Reynolds Adolescent Depression Scale, Revised Children's Manifest Anxiety Scale, Suicidal Ideation Questionnaire), and improvement was maintained at follow-up. Combined cognitive-behavioral therapy and antidepressant medication was not found to be superior to either treatment alone. Compared with antidepressant medication alone, participants receiving cognitive-behavioral therapy alone demonstrated a superior acute treatment response (odds ratio = 6.86; 95% confidence interval 1.12-41.82). Although cognitive-behavioral therapy was found to be superior to antidepressant medication alone for the acute treatment of mild to moderate depression among youth, this may have stemmed from the relatively low dose of sertraline used. CONCLUSIONS: All treatments led to a reduction in depression, but the advantages of a combined approach were not evident. ©2006 by the American Academy of Child and Adolescent Psychiatry.
History
Journal
Journal of the American academy of child and adolescent psychiatryVolume
45Issue
10Pagination
1151 - 1161Publisher
ElsevierLocation
Amsterdam, The NetherlandsPublisher DOI
ISSN
0890-8567Language
engPublication classification
C1.1 Refereed article in a scholarly journalUsage metrics
Categories
No categories selectedKeywords
Social SciencesScience & TechnologyLife Sciences & BiomedicinePsychology, DevelopmentalPediatricsPsychiatryPsychologydepressioncognitive-behavioral therapysertralinePLACEBO-CONTROLLED TRIALFAMILY ASSESSMENT DEVICEMAJOR DEPRESSIONCLINICAL-TRIALRISK-FACTORSCHILDRENEFFICACYRELIABILITYFLUOXETINEVALIDITY
Licence
Exports
RefWorks
BibTeX
Ref. manager
Endnote
DataCite
NLM
DC