Teens with depression show most improvement when medication and therapy combined
Teenagers suffering from depression improved more with a combination of an antidepressant and cognitive-behavior therapy than they did when treated with either separately, a multicenter study published today in the Journal of the American Medical Association shows.
Results of a national, yearlong government-funded study in which UT Southwestern Medical Center at Dallas researchers participated also showed that depressed teens treated only with cognitive-behavior therapy did little better than teens given placebos. Cognitive-behavior therapy is a form of psychotherapy that emphasizes the role of thinking in creating subsequent feelings and behaviors.
The study, designated the Treatment for Adolescents with Depression Study (TADS), is the first to directly compare psychotherapy and medication treatment for teenagers, said Dr. Graham Emslie, professor of psychiatry and director of UT Southwesterns child and adolescent psychiatry division.
Conducted at 13 academic and community centers around the country, the study examined the effectiveness of four treatments for adolescents with major depressive disorder: treatment with fluoxetine whose brand name is Prozac; treatment with cognitive-behavior therapy only; treatment with a combination of the two; and use of a placebo. The study included 439 patients ages 12 through 17.
"For moderate to severely depressed adolescents, a combination of medication and cognitive-behavior therapy is the most effective treatment," said Dr. Emslie, who holds the Charles E. and Sarah M. Seay Chair in Child Psychiatry. "In this particular age group, treating with therapy alone is not an effective alternative.
"Recent controversies over using antidepressants in adolescents bring up the issue of assessing risk versus benefit. If there were non-medication therapies that worked as well as antidepressants for adolescents, then there would be plausible treatment alternatives. This study shows that not to be the case."
Study results showed a 71 percent improvement in teens receiving Prozac and therapy together, as compared with a 60 percent improvement rate in subjects given Prozac only, 43 percent for those in therapy only and 35 percent who took placebos. Results were measured by standardized guidelines used to evaluate symptoms of depression.
"As physicians, we need to be careful about monitoring medications in teens," Dr. Emslie said. "People should be concerned about using medications appropriately. But they also should realize that antidepressants are an important part of treatment for depression in adolescents."
Major depressive disorder affects 5 percent of American teens. Depression also contributes significantly to teen suicides and suicidal behavior, with suicide the third leading cause of death in adolescents. More than half-million teens attempt suicide each year, with 2,000 – almost half suffering from major depression – dying. Depression in teens also is a major risk for depressive disorder, suicide and long-term psychosocial impairment in adulthood.
There were no suicides in the TADS study. The number of suicide attempts was too small to analyze statistically, and there was little difference in the number of attempted suicides in each of the four groups examined, Dr. Emslie said.
Donna Steph Hansard | EurekAlert!
The most recent press releases about innovation >>>
Die letzten 5 Focus-News des innovations-reports im Überblick:
New technique promises tunable laser devices
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems Holding GmbH about commercial use of a multi-well tissue plate for automated and reliable tissue engineering & drug testing.
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems...
HZI researchers pave the way for new agents that render hospital pathogens mute
Pathogenic bacteria are becoming resistant to common antibiotics to an ever increasing degree. One of the most difficult germs is Pseudomonas aeruginosa, a...