Predictors and Moderators of Acute Outcome in the Treatment for Adolescents With Depression Study (TADS)

• NCJ Number: 216593
• Journal: Journal of the American Academy of Child & Adolescent Psychiatry Volume: 45 Issue: 12 Dated: December 2006 Pages: 1427-1439
• Author(s): John Curry Ph.D.; Paul Rohde Ph.D.; Anne Simons Ph.D.; Susan Silva Ph.D.; Benedetto Vitiello M.D.; Christopher Kratochvil M.D.; Mark Reinecke Ph.D.; Norah Feeny Ph.D.; Karen Wells Ph.D.; Sanjeev Pathak M.D.; Elizabeth Weller M.D.; David Rosenberg M.D.; Betsy Kennard Psy.D; Michele Robins Ph.D.; Golda Ginsburg Ph.D.; John March M.D.
• Date Published: December 2006
• Length: 13 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-216589-92 and NCJ-216594-95.

Annotation

This study identified predictors and moderators of response to 12 weeks of treatment for 439 adolescents with major depressive disorder (MDD) who participated in the Treatment for Adolescents With Depression Study (TADS); the adolescents were randomly assigned to treatment with either fluoxetine (FLX), cognitive-behavioral therapy (CBT), both fluoxetine and CBT (COMB), or clinical management with pill placebo (PBO).

Abstract

Adolescents who were younger than 16 years old, less chronically depressed, higher functioning, less hopeless, with less suicidal ideation, fewer melancholic features or comorbid diagnoses, and greater expectations for improvement were more likely to benefit from the treatment. Three variables moderated the effect of assigned treatment: annual family income, severity of depression, and severity of cognitive distortions. At low and middle levels of family income (less than $75,000 annually), COMB and FLX were equally effective, and both were more effective than CBT or PBO, which did not differ significantly from each other. At high levels of family income ($75,000 and above annually), the three active treatments were not significantly different from one another. At lower levels of initial severity of depression, COMB produced better results than either FLX or CBT. At higher levels of severity, COMB had no advantage over FLX. Both conditions led to better treatment results than CBT or PBO. Patients with lower initial cognitive distortions responded equally well to COMB and FLX, and both of these treatments produced better results than CBT or PBO. The outcome measure was a week-12 predicted score obtained from the Children's Depression Rating Scale-Revised (CDRS-R). For each candidate moderator or predictor, a general linear model was conducted to examine main and interactive effects of treatment and the variable on the CDRS-R. 5 tables, 1 figure, and 41 references