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A Clinical Psychotherapy Trial for Adolescent Depression Comparing Cognitive, Family, and Supportive Therapy
Abstract
BACKGROUND: Previous studies in nonclinical samples have shown psychosocial treatments to be efficacious in the treatment of adolescent depression, but few psychotherapy treatment studies have been conducted in clinically referred, depressed adolescents. METHODS: One hundred seven adolescent patients with DSM-III-R major depressive disorder (MDD) were randomly assigned to 1 of 3 treatments: individual cognitive behavior therapy, systemic behavior family therapy (SBFT), or individual nondirective supportive therapy (NST). Treatments were 12 to 16 sessions provided in as many weeks. Intent-to-treat analyses were conducted using all follow-up data. RESULTS: Of the 107 patients enrolled in the study, 78 (72.9%) completed the study, 4 (3.7%) never initiated treatment, 10 (9.3%) had exclusionary criteria that were undetected at entry, 8 (7.5%) dropped out, and 7 (6.5%) were removed for clinical reasons. Cognitive behavior therapy showed a lower rate of MDD at the end of treatment compared with NST (17.1% vs 42.4%; P = .02), and resulted in a higher rate of remission (64.7%, defined as absence of MDD and at least 3 consecutive Beck Depression Inventory scores < 9) than SBFT (37.9%; P = .03) or NST (39.4%; p = .04). Cognitive behavior therapy resulted in more rapid relief in interviewer-rated (vs both treatments, P = .03) and self-reported depression (vs SBFT, P = .02). All 3 treatments showed significant and similar reductions in suicidality and functional impairment. Parents' views of the credibility of cognitive behavior therapy improved compared with parents' views of both SBFT (P = .01) and NST (P = .05). CONCLUSIONS: Cognitive behavior therapy is more efficacious than SBFT or NST for adolescent MDD in clinical settings, resulting in more rapid and complete treatment response.
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“Trials comparing CBT to either family therapy or supportive psychotherapy show that it is better at both improving mood and achieving remission.9”
From Computerised cognitive behaviour therapy for depression in adolescents: Study protocol for a feasibility randomised controlled trial (2014) · cites this paper as [9]
In the citing paper
“Other bias | High risk | Authors state that an ITT analysis was carried out on all 107 participants in the Brent 1997 publication, however in the Renaud 1998 publication it states that analysis was carried out on 100 randomised participants (see ITT analysis de- tails above)”
From Interventions for preventing relapse and recurrence of a depressive disorder in children and adolescents (2012) · cites this paper as Brent 1997 publication
In the citing paper
“Random sequence genera- tion (selection bias) | Low risk |”
From Interventions for preventing relapse and recurrence of a depressive disorder in children and adolescents (2012) · cites this paper as Brent 1997 publication
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Empirically supported psychological interventions: Controversies and evidence
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“…one psychotherapy trial that included suicidal, depressed adolescents, whereas cognitive behavioral therapy was superior to family therapy and supportive therapy with regard to resolution of depressive symptomatology, there were no group differences with regard to suicidality (Brent et al., 1997).”
ResultSelf-citationYouth Suicide Risk and Preventive Interventions: A Review of the Past 10 Years
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Metadata
- Authors
- Brent, D. A.
- Corresponding author
- Brent, David A.
- ORCID
- Brent, David A.
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 1997-09-01
- Volume
- 54
- Issue
- 9
- Pages
- 877
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W1993925129
- Cited by
- 753
- References
- 58
- Citations by year
- 2025: 4 · 2024: 12 · 2023: 12 · 2022: 12 · 2021: 24 · 2020: 12 · 2019: 9 · 2018: 17 · 2017: 11 · 2016: 16 · 2015: 32 · 2014: 31 · 2013: 22 · 2012: 35
- FWCI
- 35.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01mh046500-07)
- National Institute of Mental Health (MH 46500)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- adolescent depression, major depressive disorder, cognitive behavioral therapy, supportive therapy, family therapy, treatment efficacy, remission, suicidality, functional disability, parental attitudes
- MeSH terms
- Adolescent, Age Factors, Attitude to Health, Depressive Disorder, Family Therapy, Female, Humans, Male, Person-Centered Psychotherapy, Parents, Patient Dropouts, Social Class, Suicide, Comorbidity, Cognitive Behavioral Therapy, Treatment Outcome
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