Remission and Residual Symptoms After Short-Term Treatment in the Treatment of Adolescents With Depression Study (TADS)

• NCJ Number: 216590
• Journal: Journal of the American Academy of Child & Adolescent Psychiatry Volume: 45 Issue: 12 Dated: December 2006 Pages: 1404-1411
• Author(s): Betsy Kennard Psy.D; Susan Silva Ph.D.; Benedetto Vitiello M.D.; John Curry Ph.D.; Christopher Kratochvil M.D.; Anne Simons Ph.D.; Jennifer Hughes B.A.; Norah Feeny Ph.D.; Elizabeth Weller M.D.; Michael Sweeny Ph.D.; Mark Reinecke Ph.D.; Sanjeev Pathak M.D.; Golda Ginsburg Ph.D.; Graham Emslie M.D.; John March M.D.
• Date Published: December 2006
• Length: 8 pages
• Contract Number(s): RFP-NIH-NIMH 98-DS-0008
• Sponsoring Agency: National Institute of Mental Health
• Corporate Author: The TADS Team
• Publication Format: Article
• Publication Type: Program/Project Evaluation
• Language: English
• Country: United States of America
• Note: For other articles in this series, see NCJ-216589 and NCJ-216591-95.

Annotation

This article reports on remission rates in adolescents with major depressive disorder (MDD) who are participating in the Treatment for Adolescents With Depression Study (TADS), which involves random assignments of 439 adolescents with MDD to 12-weeks of treatment with either fluoxetine (FLX), cognitive-behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO).

Abstract

In achieving remission, the combination of FLX and CBT was superior to treatment with either alone and PBO; however, overall remission rates were low and residual symptoms were common at the end of 12 weeks of treatment. At the end of 12 weeks, 102 (23 percent) of the 439 youths had shown remission of MDD symptoms. The remission rate was significantly higher in the COMB group (37 percent compared to the other treatment groups (FLX, 23 percent; CBT, 16 percent; and PBO, 17 percent). In addition, 71 percent of the patients across treatment groups no longer met criteria for MDD at the end of acute treatment. Fifty percent of those who demonstrated remission continued to have residual symptoms at the end of 12 weeks, such as sleep or mood disturbance, fatigue, and poor concentration. The criterion for remission was a total score of 28 or below on the children's Depression Rating Scale-Revised. Rates of remission were examined with logistic regression. Loss of MDD diagnosis and residual symptoms in patients (defined as Clinical Global Impressions-Improvement) were also examined across treatment groups. 3 tables, 1 figure, and 40 references