Depression Often Recurs in Teens
November 8, 2010
Depression is a relatively common malady among teenagers; roughly five percent of adolescents experience an episode of major depressive disorder, which can impair their functioning and raise their risk of suicide and adult depression.
But which treatments for adolescent depression are most effective, and which are best at preventing a recurrence? To find out, researchers at Duke University and other institutions followed-up on 196 teens who had participated in the Treatment for Adolescents with Depression Study (TADS).
The 86 male and 110 female teenagers from the TADS study were randomly assigned to one of four treatment groups: an antidepressant (fluoxetine hydrochloride, marketed as Prozac®), cognitive behavioral therapy (CBT), a combination of the two, or a placebo. Those in the placebo group were offered their choice of treatment after completing the 12-week study period.
Five years later, the follow-up study found that the vast majority of the teens (over 96%) had recovered from their episode of depression. The most effective treatment was determined to be the combination of fluoxetine and therapy. However, almost half of the participants experienced a recurrence of major depression, regardless of which treatment was used in the original TADS study.
The most significant predictor of recurrence was gender: 57% of the females in the group had another episode of major depression, compared to just 33% of the males. The study's authors noted that this finding indicates "the importance of understanding and reducing the vulnerabilities of female adolescents to recurrent episodes."
Female teens may be more likely to have a recurrence of depression for a variety of reasons. The authors hypothesized that female adolescents may be at risk for a second depression if they feel that they cannot personally make any impact, which affects the desire to set or reach goals, or if they have a tendency toward unproductive, repetitive thoughts that focus on their negative experiences, personal weaknesses, or bad feelings.
Additional measures to delay recurrence of depression, according to the authors of the study, should include monitoring for symptoms of depression, managing antidepressant medication and "booster sessions" of cognitive behavioral therapy.