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Short-term treatments may not affect longer term recovery or recurrence among adolescents with a major depressive episode

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Question

Question

Do adolescents who have responded to short-term treatments or who receive the most effective short-term treatment for major depression have better longer term outcomes?

Patients

196 adolescents who took part in the Treatment for Adolescents with Depression Study (TADS) took part in this follow-up study called the Survey of Outcomes Following Treatment for Adolescent Depression (SOFTAD). The TADS included 439 adolescents with a primary diagnosis of major depressive disorder.

Setting

12 academic sites in the USA; 2000–2008.

Intervention

Short-term treatment with fluoxetine hydrochloride, cognitive-behavioural therapy (CBT), fluoxetine plus CBT or placebo. After 12 weeks of treatment, the placebo group was stopped, and placebo partial responders, non-responders or responders who relapsed were offered their TADS treatment of choice. The other groups continued to be compared across an additional 6-week continuation period and an 18-week maintenance period. After the TADS study, participants could receive any treatment. During SOFTAD, 42.3% and 44.9% participants received psychotherapy and antidepressant medication, respectively; these treatments did not differ between the different TADS groups (p<0.05).

Outcomes

Recovery (defined as absence of clinically significant major depressive disorder symptoms on the Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime Version (K-SADS-PL) interview for at least 8 weeks); …

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