Treatment for teenage depression appears to be effective for the vast majority of patients, however, in nearly half of all cases the condition comes back, especially among female patients, researchers from Duke University report in an article published in Archives of General Psychiatry.

Approximately 5.9% of teenage girls and 4.6% of males of the same age are affected with major depressive disorder, the authors explain.

The researchers wrote:

It is associated with functional impairment, risk of suicide and risk of adult depression. Thus, it is important to investigate not only the efficacy of adolescent major depressive disorder treatments but also whether they reduce the risk of subsequent negative outcomes, especially depression recurrence.

John Curry, Ph.D., and team studied 86 male and 110 female adolescents who took part in the TADS (Treatment for Adolescents with Depression Study). They were randomly chosen to one of four-short-term treatments:

  • Fluoxetine hydrochloride (Prozac) treatment
  • CBT (cognitive behavioral therapy)
  • A combination of Prozac with CBT
  • A placebo (dummy drug)

The researchers followed up on them for five years.

96.4% of them recovered from their initial depression episode during the five-year follow-up period, and 88.3% got better within 24 months.

Even though the two-year recovery period was not linked to any specific type of treatment, those who responded to the 12-week treatment session had a higher chance of recovering during the first 24 months.

46.6% of all the participants had a depression recurrence.

The researchers wrote:

Contrary to our hypotheses, neither full response to short-term treatment nor treatment with a combination of fluoxetine and cognitive behavioral therapy reduced the risk of recurrence. However, short-term treatment non-responders were more likely to experience recurrence than full and partial responders. Females were significantly more likely to have a recurrence than males.

61.9% of participants who also suffered from an anxiety disorder experienced depression recurrence.

The scientists also found that those with depression recurrence had higher scores on suicidal thoughts and behavior scales.

They wrote:

Our results reinforce the importance of modifying a short-term treatment that leads to partial response or non-response because these were associated with less likelihood of recovery in two years,” the authors write. “The finding that recurrence rates increased significantly from two to three years after baseline suggests that recurrence prevention efforts, such as symptom or medication monitoring or cognitive behavioral therapy booster sessions may be of value beyond the [18-week] maintenance period included in TADS.

Female sex was the most robust predictor of recurrence, indicating the importance of understanding and reducing the vulnerabilities of female adolescents to recurrent episodes.

“Recovery and Recurrence Following Treatment for Adolescent Major Depression”
John Curry, PhD; Susan Silva, PhD; Paul Rohde, PhD; Golda Ginsburg, PhD; Christopher Kratochvil, MD; Anne Simons, PhD; Jerry Kirchner, BS; Diane May, MA, MSN; Betsy Kennard, PsyD; Taryn Mayes, MS; Norah Feeny, PhD; Anne Marie Albano, PhD; Sarah Lavanier, PsyD; Mark Reinecke, PhD; Rachel Jacobs, PhD; Emily Becker-Weidman, PhD; Elizabeth Weller, MD{dagger}; Graham Emslie, MD; John Walkup, MD; Elizabeth Kastelic, MD; Barbara Burns, PhD; Karen Wells, PhD; John March, MD, MPH
Arch Gen Psychiatry. Published online November 1, 2010. doi:10.1001/archgenpsychiatry.2010.150

Written by Christian Nordqvist