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A Randomized Effectiveness Trial of Brief Cognitive-Behavioral Therapy for Depressed Adolescents Receiving Antidepressant Medication

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Title: A Randomized Effectiveness Trial of Brief Cognitive-Behavioral Therapy for Depressed Adolescents Receiving Antidepressant Medication
Language: English
Authors: Clarke, Gregory, DeBar, Lynn, Lynch, Frances, Powell, James, Gale, John, O'Connor, Elizabeth, Ludman, Evette, Bush, Terry, Lin, Elizabeth H. B., Von Korff, Michael, Hertert, Stephanie
Source: Journal of the American Academy of Child and Adolescent Psychiatry. Sep 2005 44(9):888-888.
Availability: Lippincott Williams & Wilkins, P.O. Box 1620, Hagerstown, MD 21741. Tel: 800-638-3030 (Toll Free); Fax: 301-223-2400.
Peer Reviewed: Y
Page Count: 11
Publication Date: 2005
Document Type: Journal Articles
Reports - Research
Descriptors: Measures (Individuals), Psychiatry, Adolescents, Cognitive Restructuring, Depression (Psychology), Drug Therapy, Behavior Modification, Outcomes of Treatment
Geographic Terms: Oregon
ISSN: 0890-8567
Abstract: Objective: To test a collaborative-care, cognitive-behavioral therapy (CBT) program adjunctive to selective serotonin reuptake inhibitor (SSRI) treatment in HMO pediatric primary care. Method: A randomized effectiveness trial comparing a treatment-as-usual (TAU) control condition consisting primarily of SSRI medication delivered outside the experimental protocol (n = 75) versus TAU SSRI plus brief CBT (n = 77). Participants were identified by a recent dispense of SSRI medication followed by telephone screening. Adolescents with a diagnosis of major depressive disorder (n = 152) were enrolled. The CBT program employed cognitive restructuring and/or behavioral activation training. Therapists consulted with prescribing pediatricians to improve medication adherence. Results: Through 1-year follow-up, the authors found CBT advantages on the Short Form-12 Mental Component Scale (p = .04), reductions in TAU outpatient visits (p = .02), and days' supply of all medications (p = .01). No effects were detected for major depressive disorder episodes; a nonsignificant trend favoring CBT was detected on the Center for Epidemiology Depression Scale (p = .07). Conclusions: The authors detected a weak CBT effect, possibly rendered less significant by the small sample and likely attenuated by the unexpected reduction in SSRI pharmacotherapy in the CBT condition. Small, incremental improvements over monotherapy, such as observed in this study, most likely represent the new norm in adolescent depression treatment research.
Abstractor: Author
Number of References: 52
Entry Date: 2006
Accession Number: EJ727998
Database: ERIC
FullText Text:
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  Data: A Randomized Effectiveness Trial of Brief Cognitive-Behavioral Therapy for Depressed Adolescents Receiving Antidepressant Medication
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  Data: <searchLink fieldCode="AR" term="%22Clarke%2C+Gregory%22">Clarke, Gregory</searchLink><br /><searchLink fieldCode="AR" term="%22DeBar%2C+Lynn%22">DeBar, Lynn</searchLink><br /><searchLink fieldCode="AR" term="%22Lynch%2C+Frances%22">Lynch, Frances</searchLink><br /><searchLink fieldCode="AR" term="%22Powell%2C+James%22">Powell, James</searchLink><br /><searchLink fieldCode="AR" term="%22Gale%2C+John%22">Gale, John</searchLink><br /><searchLink fieldCode="AR" term="%22O'Connor%2C+Elizabeth%22">O'Connor, Elizabeth</searchLink><br /><searchLink fieldCode="AR" term="%22Ludman%2C+Evette%22">Ludman, Evette</searchLink><br /><searchLink fieldCode="AR" term="%22Bush%2C+Terry%22">Bush, Terry</searchLink><br /><searchLink fieldCode="AR" term="%22Lin%2C+Elizabeth+H%2E+B%2E%22">Lin, Elizabeth H. B.</searchLink><br /><searchLink fieldCode="AR" term="%22Von+Korff%2C+Michael%22">Von Korff, Michael</searchLink><br /><searchLink fieldCode="AR" term="%22Hertert%2C+Stephanie%22">Hertert, Stephanie</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+the+American+Academy+of+Child+and+Adolescent+Psychiatry%22"><i>Journal of the American Academy of Child and Adolescent Psychiatry</i></searchLink>. Sep 2005 44(9):888-888.
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  Data: Lippincott Williams & Wilkins, P.O. Box 1620, Hagerstown, MD 21741. Tel: 800-638-3030 (Toll Free); Fax: 301-223-2400.
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  Data: Objective: To test a collaborative-care, cognitive-behavioral therapy (CBT) program adjunctive to selective serotonin reuptake inhibitor (SSRI) treatment in HMO pediatric primary care. Method: A randomized effectiveness trial comparing a treatment-as-usual (TAU) control condition consisting primarily of SSRI medication delivered outside the experimental protocol (n = 75) versus TAU SSRI plus brief CBT (n = 77). Participants were identified by a recent dispense of SSRI medication followed by telephone screening. Adolescents with a diagnosis of major depressive disorder (n = 152) were enrolled. The CBT program employed cognitive restructuring and/or behavioral activation training. Therapists consulted with prescribing pediatricians to improve medication adherence. Results: Through 1-year follow-up, the authors found CBT advantages on the Short Form-12 Mental Component Scale (p = .04), reductions in TAU outpatient visits (p = .02), and days' supply of all medications (p = .01). No effects were detected for major depressive disorder episodes; a nonsignificant trend favoring CBT was detected on the Center for Epidemiology Depression Scale (p = .07). Conclusions: The authors detected a weak CBT effect, possibly rendered less significant by the small sample and likely attenuated by the unexpected reduction in SSRI pharmacotherapy in the CBT condition. Small, incremental improvements over monotherapy, such as observed in this study, most likely represent the new norm in adolescent depression treatment research.
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      – Text: English
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        PageCount: 11
        StartPage: 888
    Subjects:
      – SubjectFull: Measures (Individuals)
        Type: general
      – SubjectFull: Psychiatry
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      – SubjectFull: Adolescents
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      – SubjectFull: Cognitive Restructuring
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      – SubjectFull: Depression (Psychology)
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      – SubjectFull: Drug Therapy
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      – SubjectFull: Oregon
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      – TitleFull: A Randomized Effectiveness Trial of Brief Cognitive-Behavioral Therapy for Depressed Adolescents Receiving Antidepressant Medication
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