Document Type

Article

Journal Title

Journal of the American Academy of Child and Adolescent Psychiatry

Publication Date

2-2009

Volume

48

Abstract

OBJECTIVE: We examine remission rate probabilities, recovery rates, and residual symptoms across 36 weeks in the Treatment for Adolescents with Depression Study (TADS).

METHOD: The TADS, a multisite clinical trial, randomized 439 adolescents with major depressive disorder to 12 weeks of treatment with fluoxetine, cognitive-behavioral therapy, their combination, or pill placebo. The pill placebo group, treated openly after week 12, was not included in the subsequent analyses. Treatment differences in remission rates and probabilities of remission over time are compared. Recovery rates in remitters at weeks 12 (acute phase remitters) and 18 (continuation phase remitters) are summarized. We also examined whether residual symptoms at the end of 12 weeks of acute treatment predicted later remission.

RESULTS: At week 36, the estimated remission rates for intention-to-treat cases were as follows: combination, 60%; fluoxetine, 55%; cognitive-behavioral therapy, 64%; and overall, 60%. Paired comparisons reveal that, at week 24, all active treatments converge on remission outcomes. The recovery rate at week 36 was 65% for acute phase remitters and 71% for continuation phase remitters, with no significant between-treatment differences in recovery rates. Residual symptoms at the end of acute treatment predicted failure to achieve remission at weeks 18 and 36.

CONCLUSIONS: Most depressed adolescents in all three treatment modalities achieved remission at the end of 9 months of treatment.

MeSH Headings

Adolescent, Cognitive Therapy, Combined Modality Therapy, Depressive Disorder, Major, Female, Fluoxetine, Humans, Male, Remission Induction, Serotonin Uptake Inhibitors, Treatment Outcome

ISSN

1527-5418

Comments

NOTICE: this is the author’s version of a work that was accepted for publication in Journal of the American Academy of Child and Adolescent Psychiatry. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of the American Academy of Child and Adolescent Psychiatry, [48, 2, (2009)] DOI#10.1097/CHI.0b013e31819176f9

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