Review: Psychotherapy for adolescents with depression: initial but no sustainable benefits
S. N Merry
Evid Based Ment Health 2008
11: 49.
web only references 11/2/49
Subgroup analyses of specific types of psychotherapy models showed significant post-treatment benefit of PT over control for BT (RR response: 6.76, 95% CI 1.45 to 31.40; p=0.01), IPT (RR response: 1.68, 95% CI 1.08 to 2.63; p=0.02), and CBT (RR response: 1.38, 95% CI 1.14 to 1.66; p=0.0009). At 1–6 month follow-up and 6–12 month follow-ups, there were no differences in response between different models of PT and control conditions. Subgroup analyses by control condition revealed significant post-treatment benefit of PT over attention-placebo (RR response: 1.48, 95% CI 1.12 to 1.96; p=0.006). This benefit was not evident at 1–6 month or 6–12 month follow-ups. There was a significant post-treatment benefit of PT over waiting list control (RR response: 2.00, 95% CI 1.34 to 2.98; p=0.0006), and also at 1–6 months (RR response: 1.98, 95% CI 1.27 to 3.07). There was no difference in response between PT (combined with TAU) and TAU alone, or PT and no treatment at any time point. PT improved post-treatment response in adolescents (RR response: 1.35, 95% CI 1.10 to 1.66; p=0.004), but not among children (6–12 years). PT improved response regardless of depression severity (mild to moderate or moderate to severe).
However, the analyses did not correct for the multiple subgroup analyses. This may have led to false-positive conclusions.
Most of the trials examined adolescents aged 12–18 years (81%), and were in people with mild to moderate depression (79%); 64% of participants were female. Follow-up ranged from between 1–6 months (14 studies) and 6–12 months (8 studies). Trials varied in methodological quality and diagnostic criteria used for diagnosing depression. Heterogeneity between studies was significant (p=0.04) and publication bias was significant (p<0.001).
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