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Improving outcome of paediatric depression with cognitive–behavioural therapy (CBT) after initial improvement on antidepressant medication
  1. Benedetto Vitiello
  1. National Institute of Mental Health, Bethesda, Maryland, USA; bvitiell@mail.nih.gov

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ABSTRACT FROM: Kennard BD, Emslie GJ, Mayes TL, et al. Sequential treatment with fluoxetine and relapse-prevention CBT to improve outcomes in pediatric depression. Am J Psychiatry 2014;171:1083–90.

What is already known on this topic

Major depression is a common cause of disability in youth due to its high prevalence, frequently incomplete resolution, and tendency to recur.1 Psychosocial and pharmacological interventions are effective as acute treatments, but little information had been available to clinicians on how to best consolidate initial improvement and prevent relapse.

Methods of the study

This randomised trial tested whether adding cognitive–behavioural therapy (CBT) to antidepressant medication after initial symptomatic improvement helps with reaching remission and decreasing relapse. Two hundred youths, aged 8–17, with major depression were first treated with fluoxetine. After 6 weeks, 144 had improved and were randomised to either adding CBT or continuing only on medication for 6 months. CBT consisted of a total of 8–11 visits, included a family component, and was delivered by non-physician psychotherapists according to a manual. There were two primary outcomes: (1) …

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