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Adolescents With Depression
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To the Editor: In their study, the TADS Team reported that the most effective treatment was fluoxetine in combination with CBT.1 Treatment with CBT alone was less effective than treatment with fluoxetine alone and not significantly more effective than treatment with pill placebo. The TADS Team was surprised by the 43% clinical response rate for CBT alone, which was lower than in some other studies,2-3 and posited that the lower response rate may have been due to greater severity, chronicity, and comorbidity in the TADS trial participants compared with previous trials.
In one of those earlier studies, we compared CBT with 2 other psychosocial treatments for mostly clinically referred, depressed adolescents.2 Greater severity was associated with a less robust response to CBT, and it indeed does appear that the TADS participants had more functional impairment and greater chronicity of depression. However, our rates of comorbidity were comPARAble (58.2% vs . . . [Full Text of this Article]
Jeffrey A. Bridge, PhD
bridgeja@upmc.edu
David A. Brent, MD
Western Psychiatric Institute and Clinic
Pittsburgh, Pa
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