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Comparison of Cognitive-Behavioral Therapy, Sertraline, and Their Combination for Adolescent Depression

NCJ Number
216044
Journal
Journal of the American Academy of Child & Adolescent Psychiatry Volume: 45 Issue: 10 Dated: October 2006 Pages: 1151-1161
Author(s)
Glenn A. Melvin Ph.D.; Bruce J. Tonge M.D.; Neville J. King Ph.D.; David Heyne Ph.D.; Michael S. Gordon M.B.; Ester Klimkeit
Date Published
October 2006
Length
11 pages
Annotation
This study evaluated the effectiveness of cognitive-behavioral therapy (CBT) and antidepressant medication (sertraline) when used alone and in combination in the treatment of depressive disorders in adolescents.
Abstract
The three groups that received either CBT alone, sertraline alone, or CBT and sertraline in combination all showed statistically significant improvement on outcome measures (depressive diagnosis, Reynolds Adolescent Depression Scale, Revised Children's Manifest Anxiety Scale, and Suicidal Ideation Questionnaire); improvement was maintained during a 6-month followup. Combined CBT and sertraline did not produce greater positive effects than either treatment alone; however, compared with those who received sertraline alone, those who received CBT alone showed more progress for mild to moderate depression. This may have been due to the relatively low dose of sertraline used in the study. Taking into account study limitations, CBT and sertraline are equally recommended for the treatment of adolescents with depression. The study involved 73 adolescents (ages 12-18) with a primary diagnosis of DSM-IV major depressive disorder, dysthymic disorder or depressive disorder not otherwise specified. The adolescents were randomly assigned to one of the three treatment conditions. Measures of disorder symptoms were administered before and after treatment and at a 6-month followup. Depression diagnosis was the primary outcome measure; secondary measures were self-reports, other reports, and clinician ratings of global functioning. The study was conducted at three community-based clinics between July 2000 and December 2002. Data analyses used an intent-to-treat strategy in order to counter any overestimation of treatment outcomes. 4 tables, 2 figures, and 38 references