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    Depressed Adolescents Need Longer Stretches of Therapy

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    John Sargent, MD, dean of the Karl Menninger School of Psychiatry and Mental Health Sciences in Topeka, Kan., had high praise for the study.

    "What I am getting from the study are several things: that there are degrees of severity of depression in teen-agers; that it is often a chronic condition, that in teen-agers who are depressed, [most] recover with treatment, which is good; [and] that CBT leads more to recover initially but not over time. The degree of family conflict, degree of hopelessness, degree of functional difference ... those variables have a lot more to do with how the teen-ager does over time."

    Sargent goes on to point out, that in terms of length of therapy offered, the initial research "did exactly what most insurance companies provide [for], and what they found is that it works for half the people. And that is pretty awful." Sargent, who is also the director of education and research at the Menninger Clinic, was not involved in any of the research.

    The next research project for Brent and colleagues is to study the various options for treatment of depression in adolescents who fail to respond to the ever more common use of antidepressants.

    The study was supported by grants from the National Institutes of Mental Health.

    Vital Information:

    • One-fifth of adolescents who are treated for major depression with 'talking' therapy remain depressed after 2 years, regardless of the type of therapy used.
    • Initial research showed that cognitive behavioral therapy worked better than either systemic behavioral family therapy or nondirective supportive therapy, but the new research shows that the effect is not sustained.
    • Researchers interpret the findings to imply that depression should be seen as a long-term disease.
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