Remission and Recovery in the Treatment for Adolescents With Depression Study (TADS): Acute and Long-Term Outcomes

• NCJ Number: 225787
• Journal: Journal of the American Academy of Child & Adolescent Psychiatry Volume: 48 Issue: 2 Dated: February 2009 Pages: 186-195
• Author(s): Betsy D. Kennard Psy.D.; Susan G. Silva Ph.D.; Simon Tonev Ph.D.; Paul Rohde Ph.D.; Jennifer L. Hughes B.A.; Benedetto Vitiello M.D.; Christopher J. Kratochvil M.D.; John F. Curry Ph.D.; Graham J. Emslie M.D.; Mark Reinecke Ph.D.; John March M.D., M.P.H.
• Date Published: February 2009
• Length: 10 pages
• Grant Number(s): N01 MH80008
• Sponsoring Agency: National Institute of Mental Health
• Corporate Author: Duke University Medical Ctr
• Publication Format: Article
• Publication Type: Program/Project Evaluation
• Language: English
• Country: United States of America

Annotation

This evaluation of the Treatment for Adolescents with Depression Study (TADS) examined remission rate probabilities, recovery rates, and residual symptoms across 36 weeks.

Abstract

The findings show that most depressed adolescents in all three treatment modalities (fluoxetine, cognitive-behavioral therapy, and a combination of the aforementioned treatments) achieved remission at the end of 9 months of treatment. For those treated with cognitive-behavioral therapy alone, 64 percent of the adolescents experienced remission of depressive symptoms; for those treated only with fluoxetine, 55 percent exhibited a remission of their depressive symptoms; and for those treated with both fluoxetine and cognitive-behavioral therapy, 60 percent showed a remission of depressive symptoms. Paired comparisons indicate that at week 24, all active treatments converged on remission outcomes. The recovery rate at 9 months was 65 percent for acute-phase remitters and 71 percent for continuation-phase remitters, with no significant between-treatment differences in recovery rates. Residual symptoms at the end of acute treatment predicted failure to achieve remission at weeks 18 and 36. Despite the early low remission rates, most depressed adolescents achieved remission after 9 months of treatment. Methods of achieving higher or more rapid remission rates are still needed. A better understanding of which remitted patients will fail to maintain their recovery and how to better assist them is also necessary. Clinicians should be especially attentive to the presence of residual symptoms that remain after initial treatment response. The TADs, which is a multisided clinical trial, randomized 439 adolescents with major depressive disorder to 12 weeks of treatment with fluoxetine, cognitive-behavioral therapy, a combination of these treatments, or pill placebo. The pill placebo group, which was treated openly after 12 weeks, was not included in the subsequent analyses. Treatment differences in remission rates and probabilities of remission over time were compared. 4 tables, 1 figure, and 41 references