Clinical outcome after short-term psychotherapy for adolescents with majordepressive disorder

Background: Cognitive behavioral therapy has been shown to be more efficaci ous than alternative psychosocial interventions for the acute treatment of adolescents with major depressive disorder. However, the long-term impact o f brief psychosocial interventions on the course of adolescent depression i s not well established. Methods: One hundred seven adolescents with major depressive disorder rando mly assigned to 12 to 16 weeks of cognitive behavioral therapy, systemic be havioral family therapy, or nondirective supportive therapy were evaluated for 2 years after the psychotherapy trial to document the subsequent course and predictors of major depressive disorder. Results: There were no long-term differential effects of the 3 psychotherap ies. Most participants (80%) recovered (median time, 8.2 months from baseli ne), and 30% had a recurrence (median time, 4.2 months from recovery). Twen ty-one percent were depressed during at least 80% of the follow-up period. Severity of depression (at baseline) and presence of self-reported parent-c hild conflict (at baseline and during the follow-up period) predicted lack of recovery, chronicity, and recurrence. Despite the similarity to clinical ly referred patients at baseline, patients recruited via advertisement were less likely to experience a recurrence. Conclusions: There were no significant differences in long-term outcome amo ng cognitive behavioral therapy, systematic behavioral family therapy, and nondirective supportive therapy. While most participants in this study even tually recovered, those with severe depression and self-perceived parent-ch ild conflict are at greater risk for chronic depression and recurrences.