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Combined treatment with cognitive–behavioural therapy in adolescent depression: meta-analysis
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Background: The treatment of adolescent depression is controversial and studies of combined treatment (antidepressants and cognitive–behavioural therapy, CBT) have produced conflicting findings. Aims: To address the question of whether CBT confers additional benefit to antidepressant treatment in adolescents with unipolar depression for depressive symptoms, suicidality, impairment and global improvement. Method: Meta-analysis of randomised controlled trials (RCTs) of newer-generation antidepressants and CBT in adolescent depression. Results: There was no evidence of a statistically significant benefit of combined treatment over antidepressants for depressive symptoms, suicidality and global improvement after acute treatment or at follow-up. There was a statistically significant advantage of combined treatment for impairment in the short-term (at 12 weeks) only. There was some evidence of heterogeneity between studies. Conclusions: Adding CBT to antidepressants confers limited advantage for the treatment of an episode of depression in adolescents. The variation in sampling and methodology between studies, as well as the small number of trials, limits the generalisability of the findings and any conclusions that can be drawn. Future studies should examine predictors of response to treatment as well as clinical components that may affect outcome.
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“Dubicka et al. (2010) also reported that self-harm occurred in 19 of 569 (3.3%) young people with depression treated with antidepressants compared to 12 in 469 of those treated with a placebo (2.6%).”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Dubicka et al., 2010
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Dubicka et al. (2010) found the OR for antidepressant exposure was 1.70 (95% CI, 1.13–2.54).”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Dubicka et al., 2010
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Dubicka et al. (2010) found suicidal thoughts, which occurred in nine of 738 (1.2%) young people with depression treated with antidepressants compared to five in 634 of those treated with a placebo (2.6%).”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Dubicka et al., 2010
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The results indicated a significant association between the risk of youth suicidal thoughts and antidepressant use (OR:1.45).”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Dubicka et al., 2010
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The results represented a significant association between the risk of youth self-harm and antidepressant use, with an OR of 1.44 (Table 3).”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Dubicka et al., 2010
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Metadata
- Authors
- Dubicka, B., Elvins, R., Roberts, C., Chick, G., Wilkinson, P., & Goodyer, I. M.
- Affiliations
- University of Manchester (GB)
- Royal Manchester Children's Hospital (GB)
- University of Cambridge (GB)
- Corresponding author
- Dubicka, Bernadka
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2010-12
- Volume
- 197
- Issue
- 6
- Pages
- 433-440
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2152747725
- Cited by
- 116
- References
- 26
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 1 · 2022: 2 · 2021: 9 · 2020: 4 · 2019: 5 · 2018: 19 · 2017: 5 · 2016: 8 · 2015: 11 · 2014: 13 · 2013: 11 · 2012: 13
- FWCI
- 7.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Funders
- National Institute of Mental Health
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- adolescent depression, cognitive behavioral therapy, antidepressants, combination therapy, major depressive disorder, suicidality, functional disability, depressive symptoms, treatment response
- MeSH terms
- Adolescent, Child, Combined Modality Therapy, Depressive Disorder, Female, Humans, Male, Psychiatric Status Rating Scales, Suicide, Attempted, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Practice Guidelines as Topic, Suicidal Ideation
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