RAPID RESPONSE TO PSYCHOSOCIAL TREATMENT FOR ADOLESCENT DEPRESSION - A 2-YEAR FOLLOW-UP

Objective: To examine the differential course and treatment outcome of patients who participated in a randomized clinical trial, comparing c ognitive, family, and supportive psychotherapies for adolescent major depressive disorder. Method: In a sample of 100 depressed adolescents, remission, clinical recovery, recurrence, and functional improvement were examined at the end of acute treatment and at 1- and 2-year follo w-up, according to their type of response to treatment. Rapid response was defined as a decline of greater than or equal to 50% in the Beck Depression Inventory (BDI) score from pretreatment until the beginning of the second session of psychotherapy, intermediate as a decline of <50% but >0%, and initial nonresponse as a BDI score that stayed the s ame or increased. Results: Rapid responders showed a better outcome at acute treatment, 1-year, and in some measures, e-year follow-up. For those who had recurrences over time, rapid responders showed a longer period before recurrence. Subjects were most likely to respond rapidly , or not at all, in the supportive cell. Conclusions: These findings s uggest that milder forms of depression may benefit from initial suppor tive therapy or short trials of more specialized types of psychotherap y. The use of a placebo run-in period might help to ''wash out'' nonsp ecific responders.