Evidence Base Update of Psychosocial Treatments for Child and Adolescent Depression

Abstract

Depression in youth is prevalent and disabling and tends to presage a chronic and recurrent course of illness and impairment in adulthood. Clinical trial research in youth depression has a 30 year history, and evidence-based treatment reviews appeared in 1998 and 2008. The current review of 42 randomized controlled trials (RCTs) updates these reviews to include RCTs published between 2008 and 2014 (N = 14) and re-evaluates previously reviewed literature. Given the growing maturity of the field, this review utilized a stringent set of methodological criteria for trial inclusion, most notable for excluding trials based in sub-clinical samples of youth that had been included in previous reviews (N = 12) and including well-designed RCTs with null and negative findings (N = 8). Findings from the current review suggest that evidence for child treatments is notably weaker than for adolescent interventions, with no child treatments achieving well-established status and the evidentiary basis of treatments downgraded from previous reports. Cognitive behavioral therapy (CBT) for clinically depressed children appears to be possibly efficacious, with mixed findings across trials. For depressed adolescents, both CBT and Interpersonal Psychotherapy (IPT) are well-established interventions, with evidence of efficacy in multiple trials by independent investigative teams. This positive conclusion is tempered by the small size of the IPT literature (N = 6) and concern that CBT effects may be attenuated in clinically complicated samples and when compared against active control conditions. In conclusion, data on predictors, moderators, and mediators are examined and priorities for future research discussed.

Prevention of Depression in At-Risk Adolescents: Predictors and Moderators of Acute Effects

“…37 In contrast, studies of the treatment of adolescent depression have shown that, across intervention conditions, poorer outcomes are predicted for older youths with more severe indicators of depression, higher levels of comorbid problems, and greater levels of environmental adversity. 38 Studies of moderators of treatment response have been sparse but have found that maternal depression, interpersonal trauma, family conflict, and substance use appear to negatively moderate CB treatment effects. 39 Effects for anxiety and negative cognitions, such as hopelessness, have been mixed, with enhanced effects of CB relative to control in some studies and diminished outcomes for CB found in other investigations.…”

Psychosocial Treatments Targeting Anxiety and Depression in Adolescents and Adults on the Autism Spectrum: Review of the Latest Research and Recommended Future Directions

“…First onset is often during adolescence and it is associated with significant impairment in global life domains [15]. Among adolescents in the general population, CBT and interpersonal therapy (IPT) have been deemed “well-established” evidence-based treatments for depression with medium effect size response rates, as well as “probably efficacious” for children [16]. …”

Child labor and severe functioning difficulties and disability in Mexican children and adolescents 5-17 years of age

“…24 Research has yet to clarify the relationships between anxiety or depression and child labor; some authors theorize that child labor creates stress or trauma during childhood, which could lead to mental disorders at that time and later in life. 25 Systematic reviews show that improvements in depression and anxiety prevention programs (schoolbased or not) 26 as well as cognitive behavioral therapy and interpersonal psychotherapy 27 can be efficacious at reducing these important health problems. Either of these options (prevention programs or treatment) have the potential to reduce the possible contribution of these mental health issues on higher levels of child labor or of educational lag as well as their impact in adulthood.…”