Skip to content
My WebMD Sign In, Sign Up

Health & Parenting

Font Size

Depressed Adolescents Need Longer Stretches of Therapy

By
WebMD Health News

Jan. 13, 2000 (Washington) -- Adolescents with depression experienced recurrences of their symptoms after 2 years of intensive therapy, regardless of which of three common 'talking' therapies were used, according to a new study. The findings, which appear in the most recent issue of the Archives of General Psychiatry, show that therapy for depression needs to be ongoing and that family relationships must be addressed, one of the authors tells WebMD.

The study looked at the 2-year outcomes of 107 adolescents with major depression who were assigned to receive one of three types of therapy for 12-16 weeks: systemic behavioral family therapy, which focuses on changing family patterns of interacting; nondirective supportive therapy, which involves support without trying to change behavior and thought patterns; or cognitive behavioral therapy (CBT).

The latter "focuses on the relationship between feelings and behavior," David Brent, MD, a co-author of the study, tells WebMD, "and targets thinking patterns. People with depression may process information differently. They tend to focus on the negative. If you make people aware of those thinking patterns and try to correct them you can ameliorate [the depression]." Brent is a professor of child psychiatry at the University of Pittsburgh and is affiliated with the Western Psychiatric Institute and Clinic at Pittsburgh Medical Center.

The study builds on previously reported initial findings, which indicated that cognitive behavioral therapy was superior to family and supportive therapy in producing a faster rate of remission. Brent and his colleagues had hypothesized that the beneficial effect of cognitive behavioral therapy would last over a longer term, but that was not the case.

Based on these findings and others studies, "What I would say is that depression is a [long-term] disease, and it ought to be dealt with as a [long-term] disease," says Brent. Eighty percent of the adolescents in Brent's study recovered, 30% experienced a recurrence, regardless of therapy type, and 21% exhibited persistent depression during the 2-year follow-up period. This should prompt physicians to prepare parents and patients for the possibility of longer treatment stretches.

"You can't say for sure, but given that CBT worked better to begin with ... you probably need to have 4 to 6 monthly treatments to consolidate things. And you need to address the family difficulties head-on," Brent says.

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."

Today on WebMD

Girl holding up card with BMI written
Is your child at a healthy weight?
toddler climbing
What happens in your child’s second year.
 
father and son with laundry basket
Get your kids to help around the house.
boy frowning at brocolli
Tips for dealing with mealtime mayhem
 
mother and daughter talking
Tool
child brushing his teeth
Slideshow
 
Sipping hot tea
Slideshow
Young woman holding lip at dentists office
Video
 
Which Vaccines Do Adults Need
Article
rl with friends
fitSlideshow
 
tissue box
Quiz
Child with adhd
Slideshow