Acute Time to Response in the Treatment for Adolescents With Depression Study (TADS)

• NCJ Number: 216591
• Journal: Journal of the American Academy of Child & Adolescent Psychiatry Volume: 45 Issue: 12 Dated: December 2006 Pages: 1412-1418
• Author(s): Christopher Kratochvil M.D.; Susan Silva Ph.D.; Graham Emslie M.D.; Steve McNulty M.S.; John Walkup M.D.; John Curry Ph.D.; Mark Reinecke Ph.D.; Benedetto Vitiello M.D.; Paul Rhode Ph.D.; Nora Feeny Ph.D.; Charles Casat M.D.; Sanjeev Pathak M.D.; Elizabeth Weller M.D.; Diane May M.A.; Taryn Mayes M.S.; Michele Robins Ph.D.; John March M.D.
• Date Published: December 2006
• Length: 7 pages
• Contract Number(s): RFP-NIH-NIMH 98-DS-0008
• Sponsoring Agency: National Institute of Mental Health
• Corporate Author: The TADS Team
• Publication Format: Article
• Publication Type: Program/Project Evaluation
• Language: English
• Country: United States of America
• Note: For other articles in this series, see NCJ-216589-90 and NCJ-216592-95.

Annotation

This study examined the time to response for both pharmacotherapy and psychotherapy for adolescents with major depressive disorder (MDD) who were enrolled in the Treatment for Adolescents With Depression Study (TADS); TADS randomly assigned 439 youths (ages 12 to 17) to treatment with either fluoxetine (FLX), cognitive-behavioral therapy (CBT), their combination (COMB), or pill placebo (PBO).

Abstract

Findings indicate that FLX and COMB accelerated treatment response compared with PBO, and COMB accelerated response relative to CBT alone. Based on pharmacotherapist scores on the Clinical Global Impression-Improvement Scale (CGI-I), COMB and FLX showed faster onset of benefit than PBO on both the time to response and time to stable response, and COMB was faster than FLX in achieving stable response. The probability of sustained early response was approximately three times greater for COMB than PBO, two times greater for FLX than PBO, and 1.5 times greater for COMB than FLX. On the psychotherapist CGI-I scores, both first response and stable response occurred faster in COMB than CBT, with a probability of sustained early response approximately three times greater for COMB than CBT. Response was defined as "very much improved" or "much improved" on the CGI-I. Survival analyses, as determined by Cox proportional hazards models, and Kaplan-Meier curves were conducted to assess time to first response and time to stable response. Direct comparisons between pharmacotherapy and CBT were not made because of differences in visit schedules. 2 tables, 2 figures, and 16 references