Rapid Response to Psychosocial Treatment for Adolescent Depression: A Two-Year Follow-up

RENAUD, JOHANNE; BRENT, DAVID A.; BAUGHER, MARIANNE; BIRMAHER, BORIS; KOLKO, DAVID J.; BRIDGE, JEEFREY

doi:10.1097/00004583-199811000-00019

Cited by 139Psychotherapy Techniques and ApplicationsTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Rapid Response to Psychosocial Treatment for Adolescent Depression: A Two-Year Follow-up

RENAUD, JOHANNE, BRENT, DAVID A., BAUGHER, MARIANNE, BIRMAHER, BORIS, KOLKO, DAVID J., BRIDGE, JEEFREY·1998·Journal of the American Academy of Child & Adolescent Psychiatry

DOI 10.1097/00004583-199811000-00019

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Abstract

Objective To examine the differential course and treatment outcome of patients who participated in a randomized clinical trial, comparing cognitive, family, and supportive psychotherapies for adolescent major depressive disorder.Method In a sample of 100 depressed adolescents, remission, clinical recovery, recurrence, and functional improvement were examined at the end of acute treatment and at 1- and 2-year follow-up, according to their type of response to treatment. Rapid response was defined as a decline of > or = 50% in the Beck Depression Inventory (BDI) score from pretreatment until the beginning of the second session of psychotherapy, intermediate as a decline of < 50% but > 0%, and initial nonresponse as a BDI score that stayed the same or increased.Results Rapid responders showed a better outcome at acute treatment, 1-year, and in some measures, 2-year follow-up. For those who had recurrences over time, rapid responders showed a longer period before recurrence. Subjects were most likely to respond rapidly, or not at all, in the supportive cell.Conclusions These findings suggest that milder forms of depression may benefit from initial supportive therapy or short trials of more specialized types of psychotherapy. The use of a placebo run-in period might help to "wash out" nonspecific responders.

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Similar rapid gains are observed in CBT for post-traumatic stress disorder, adolescent depression, binge eating, and irritable bowel syndrome.
“Similar gains are observed in CBT for post-traumatic stress disorder (PTSD; 53 percent of clients), adolescent depression, binge eating (62 percent of clients), and irritable bowel syndrome (30 percent of clients) [41,42,43,44].”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [42]
Sudden improvements for 40 to 60% of clients following brief interventions and initial therapy sessions are a well-observed effect in the cognitive behavioural therapies.
“For example, sudden improvements for 40 to 60% of clients following brief interventions and initial therapy sessions are a well-observed effect in the cognitive behavioural therapies [41,42,43,44].”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [42]
Improvements in openness to experience, awareness, and particularly stress and valued action are broadly congruent with the existing literature on brief interventions and improvements early in therapy.
“Improvements in openness to experience, awareness, and particularly stress and valued action are broadly congruent with the existing literature on brief interventions and improvements early in therapy.”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [42]
In Renaud 1998, follow-up analyses were split by responder status rather than treatment group.
“One and two-year follow-up analysis of remission and relapse-recurrence of depressive episode was split by whether participants were 'rapid responders', 'intermediate responders' or 'initial non-responders', rather than by treatment group assignment.”
From Interventions for preventing relapse and recurrence of a depressive disorder in children and adolescents (2012) · cites this paper as Renaud 1998
An associated publication of Renaud 1998 presented overall relapse-recurrence rates but did not split by initial treatment group.
“An associated publication also presented data on overall relapse-recurrence rates but, again, did not split this analysis by participants' initial acute treatment group assignment.”
From Interventions for preventing relapse and recurrence of a depressive disorder in children and adolescents (2012) · cites this paper as Renaud 1998

Five trials used a design with acute treatment then long-term follow-up or continuation/maintenance, with entry not based on response/remission.
“The second type of design was executed by five trials; participants underwent acute treatment of a depressive episode, then entered either controlled or naturalistic long-term follow-up, or a continuation or maintenance phase (or both), with measures of relapse-recurrence collected at follow-up. Entry into the follow-up, continuation and/or maintenance phase was not based on response or remission”
From Interventions for preventing relapse and recurrence of a depressive disorder in children and adolescents (2012) · cites this paper as Renaud 1998
Two trials (Emslie 1998; Renaud 1998) conducted naturalistic follow-up without re-randomisation.
“Within this design, two trials conducted a naturalistic follow-up of relapse in participants who had responded to acute treatment and did not re-randomise participants to a separate relapse prevention treatment at any point (Emslie 1998; Renaud 1998).”
From Interventions for preventing relapse and recurrence of a depressive disorder in children and adolescents (2012) · cites this paper as Renaud 1998
In Renaud 1998, the ITT analysis was at low risk of bias.
“Incomplete outcome data (attrition bias) ITT analysis | Low risk |”
From Interventions for preventing relapse and recurrence of a depressive disorder in children and adolescents (2012) · cites this paper as Renaud 1998 publication
In Renaud 1998, other bias was at high risk of bias.
“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 Renaud 1998 publication

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Authors: RENAUD, J., BRENT, D. A., BAUGHER, M., BIRMAHER, B., KOLKO, D. J., & BRIDGE, J.
Affiliations: University of Pittsburgh Medical Center (US)
Corresponding author: BRENT, DAVID A.
ORCID: RENAUD, JOHANNE
BRENT, DAVID A.
BIRMAHER, BORIS
KOLKO, DAVID J.
Venue: Journal of the American Academy of Child & Adolescent Psychiatry
Publisher: Elsevier BV
Published: 1998-11
Volume: 37
Issue: 11
Pages: 1184-1190
ISSN: 0890-8567 (ISSN-L)
DOI: 10.1097/00004583-199811000-00019
OpenAlex: W2003186388
Cited by: 139
References: 46
Citations by year: 2026: 1 · 2025: 1 · 2024: 6 · 2023: 3 · 2022: 7 · 2021: 4 · 2020: 2 · 2019: 5 · 2018: 7 · 2017: 5 · 2016: 5 · 2015: 6 · 2014: 6 · 2013: 9 · 2012: 5
FWCI: 4.00
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01mh046500-07)
National Institute of Mental Health (P30MH055123, MH 55123, MH-46500-06)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: adolescent depression, major depressive disorder, treatment outcomes, cognitive therapy, family therapy, supportive therapy, depression recurrence, remission, long-term follow-up
MeSH terms: Adolescent, Depression, Female, Follow-Up Studies, Humans, Male, Psychotherapy, Severity of Illness Index, Statistics as Topic, Time Factors, Treatment Outcome

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Rapid Response to Psychosocial Treatment for Adolescent Depression: A Two-Year Follow-up

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