SYSTEMATIC REVIEW OF EFFICACY OF COGNITIVE-BEHAVIOR THERAPIES IN CHILDHOOD AND ADOLESCENT DEPRESSIVE DISORDER

Objective: To determine whether cognitive behaviour therapy is an effe ctive treatment for childhood and adolescent depressive disorder. Desi gn: Systematic review of six randomised trials comparing the efficacy of cognitive behaviour therapy with inactive interventions in subjects aged 8 to 19 years with depressive disorder. Main outcome measure: Re mission from depressive disorder. Results: The rate of remission from depressive disorder was higher in the therapy group (129/208; 62%) tha n in the comparison group (61/168; 36%). The pooled odds ratio was 3.2 (95% confidence interval 1.9 to 5.2), suggesting a significant benefi t of active treatment. Most studies, however, were based on relatively mild cases of depression and were of only moderate quality. Conclusio ns: Cognitive behaviour therapy may be of benefit for depressive disor der of moderate severity in children and adolescents. It cannot, howev er, yet be recommended for severe depression. Definitive large trials will be required to determine whether the results of this systematic r eview are reliable.