A randomised controlled out-patient trial of cognitive-behavioural treatment for children and adolescents with depression: 9-month follow-up

Vostanis, Panos; Feehan, Catherine; Grattan, E; Bickerton, Wai‐Ling

doi:10.1016/0165-0327(96)00054-7

Cited by 123 publications

(60 citation statements)

References 39 publications

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“…These outpatient samples are likely to have higher means on the MFQ-C than would a sample of nonclinic, community youth. Thus, z scores for studies using the MFQ-C (Vostanis, Feehan, Grattan, & Bickerton, 1996a, 1996bWood, Harrington, & Moore, 1996) may be artificially lowered in comparison with studies using other depression symptom measures. However, removal of studies including the MFQ-C from benchmarking outcome analyses did not alter our conclusions.…”

Section: Benchmarking Proceduresmentioning

confidence: 99%

Community clinic treatment of depressed youth: Benchmarking usual care against CBT clinical trials.

Weersing¹,

Weisz²

2002

Journal of Consulting and Clinical Psychology

259

213

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This study used a benchmarking strategy to evaluate the effectiveness of community psychotherapy for depressed youth relative to evidence-based treatment in clinical trials. Symptom trajectories of depressed youth treated in community mental health centers (CMHCs) were compared with trajectories of youth treated with cognitive-behavioral therapy (CBT) in clinical trials. Overall, outcomes of CMHC youth more closely resembled those of control condition youth than youth treated with CBT. Within the CMHC sample, ethnic minority status and low therapy dose were related to worse outcomes. However, when outcomes for Caucasian youth and youth receiving longer term services were examined, the CMHC sample still performed more poorly than youth treated with CBT. The findings support the value of developing, testing, and exporting effective therapies for depressed youth to community clinic settings.To date, there have been more than 1,500 controlled investigations of the effects of psychotherapy for children and adolescents (Kazdin, 2000). Results of these studies, summarized in metaanalyses, have told a consistent tale: Psychotherapy for youth can produce beneficial effects, on the same order of magnitude as both adult psychotherapy and many medical interventions (Casey &

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Section: Benchmarking Proceduresmentioning

confidence: 99%

Community clinic treatment of depressed youth: Benchmarking usual care against CBT clinical trials.

Weersing¹,

Weisz²

2002

Journal of Consulting and Clinical Psychology

259

213

View full text Add to dashboard Cite

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“…All of these investigations are notable for their use of help-seeking samples, whether depressed adolescent outpatients or youths involved with the social service system. Vostanis and colleagues [35,43,44] compared brief CBT to supportive therapy in a sample of depressed teen outpatients and found no difference between the treatment groups in depression response (86% versus 75%). In this investigation, treatment not only was low dose (mean of six sessions) but also was offered over an extended time frame (1-5 months).…”

Section: Brief Cognitive Behavioral Therapymentioning

confidence: 99%

“…From the table, three clusters of manuals emerge: the Coping With Depression for Adolescents (CWD-A) program, the individual cognitive therapy Abbreviations: BDI, Beck Depression Inventory; CDI, Children's Depression Inventory; CES-D, Center for Epidemiological Studies Depression scale; CBT, cognitive behavioral therapy manual that has not been tested in more than one study; CWD-A, Coping with Depression for Adolescents; CWD-AP, Coping with Depression for Adolescents with additional parent sessions; FLX, fluoxetine; HMO, health maintenance organization; LS, life skills tutoring and case management group; MDD, major depressive disorder; NST, nondirective supportive therapy; NTX, no treatment; PLA, pill placebo; RLX, relaxation therapy; TAU, treatment as usual across a variety of service settings, may include counseling or antidepressant medication; WL, wait list. manual from the Brent clinical trial [23], and a set of similar brief CBT protocols tested in the United Kingdom [34][35][36]. All of these manuals have been used in diagnosed samples, and CWD-A has been adapted by numerous teams and applied in various settings and samples of adolescents.…”

Section: Review Of Major Empirical Findingsmentioning

confidence: 99%

Cognitive Behavioral Therapy for Depression in Youth

Weersing

Brent

2006

Child and Adolescent Psychiatric Clinics of North America

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“…As many as 50%-75% of children with major depression have recurrent episodes (1,3). Recurrence most often occurs within 6-12 months after remission (6)(7)(8). Thus, depression is a serious disorder requiring early intervention.…”

mentioning

confidence: 99%

Fluoxetine Versus Placebo in Preventing Relapse of Major Depression in Children and Adolescents

Emslie¹,

Kennard²,

Mayes³

et al. 2008

AJP

149

103

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Objective-The authors compared fluoxetine and placebo in continuation treatment to prevent relapse of major depressive disorder in children and adolescents.Method-After a detailed evaluation, children and adolescents 7-18 years of age with major depressive disorder were treated openly with fluoxetine. Those who had an adequate response after 12 weeks, as indicated by a Clinical Global Impression improvement score of 1 or 2 and a decrease of at least 50% in Children's Depression Rating Scale-Revised score, were randomly assigned to receive fluoxetine or placebo for an additional 6 months. The primary outcome measures were relapse and time to relapse. Relapse was defined as either a score of 40 or higher on the Children's Depression Rating Scale with a history of 2 weeks of clinical deterioration, or clinical deterioration as judged by the clinician. Additional analyses were conducted with relapse defined only as a score of 40 or higher on the Children's Depression Rating Scale.Results-Of 168 participants enrolled in acute fluoxetine treatment, 102 were randomly assigned to continuation treatment with fluoxetine (N=50) or placebo (N=52). Of these, 21 participants (42.0%) in the fluoxetine group relapsed, compared with 36 (69.2%) in the placebo group, a significant difference. Similarly, under the stricter definition of relapse, fewer participants in the fluoxetine group relapsed (N=11; 22.0%) than in the placebo group (N=25; 48.1%). Time to relapse was significantly shorter in the placebo group.Conclusions-Continuation treatment with fluoxetine was superior to placebo in preventing relapse and in increasing time to relapse in children and adolescents with major depression.Major depressive disorder is a serious disorder in the pediatric age group, with 2%-8% of children and adolescents afflicted (1,2). Youths with depression often have significant impairment in relationships, school, and work and are at increased risk for substance abuse, attempted and completed suicide, and depression in adulthood (1,3,4). Furthermore, it appears that early-onset major depression may be a more chronic and recurrent disorder than depression that begins in adulthood (1,5). As many as 50%-75% of children with major depression have recurrent episodes (1,3). Recurrence most often occurs within 6-12 months after remission (6)(7)(8). Thus, depression is a serious disorder requiring early intervention. Treatment for major depression may be divided into three phases: acute, continuation, and maintenance treatment. Acute treatment refers to initial treatment designed to achieve response (a significant reduction in depressive symptoms) and ultimately remission (minimal or no symptoms). The goal of treatment is remission, although most randomized controlled trials include response as the primary aim. Continuation treatment follows acute treatment with the goal of preventing relapse of symptoms from the treated episode and consolidating symptom improvement for a longer duration (recovery). Continuation treatment generally lasts 4-9 mon...

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A randomised controlled out-patient trial of cognitive-behavioural treatment for children and adolescents with depression: 9-month follow-up

Cited by 123 publications

References 39 publications

Community clinic treatment of depressed youth: Benchmarking usual care against CBT clinical trials.

Community clinic treatment of depressed youth: Benchmarking usual care against CBT clinical trials.

Cognitive Behavioral Therapy for Depression in Youth

Fluoxetine Versus Placebo in Preventing Relapse of Major Depression in Children and Adolescents

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