defined the treatements are a bit vague in the articles, so I'll have
to dig up the JAMA article.
larry
http://www.cbc.ca/stories/print/2004/08/17/teens_depress040817
Drug, talk therapy combo top treatment for depressed teens: study
Last Updated Tue, 17 Aug 2004 17:51:45
TORONTO - Combining an antidepressant with psychotherapy is one of the
best treatments for teenagers with severe depression, according to a
new study.
Depression requires careful assessment and monitoring.
The study compared treatments for depression for those aged 12 to 17.
"What we wanted to know was, if you stack these treatments up
head-to-head how do they do relative to a placebo?" said Dr. John
March of Duke University in Durham, N.C.
Between spring 2000 and summer 2003, March and his colleagues studied
439 patients who received either:
* The antidepressant drug fluoxetine, or Prozac.
* Psychotherapy with a trained therapist.
* A combination of the drug and psychotherapy.
* A placebo.
The psychotherapy treatment is known as cognitive behavioral therapy
or CBT. In CBT, a therapist tries to break the patient's destructive
mental patterns by reinforcing positive thoughts and behaviours.
The results of the 12-week study were:
* Of those treated by a therapist using CBT alone, 43 per cent
showed improvement, compared to 35 per cent in the placebo group.
* Of those who took Prozac alone, 61 per cent improved.
* Among those who received both treatments, 71 per cent responded
positively.
Experts were surprised by the findings, since previous studies in
adults showed little difference between antidepressant drugs and
psychotherapy.
Both Canada and the U.S. have put labels on some antidepressants
called selective serotonin reuptake inhibitors, or SSRIs, warning
doctors to monitor teens for an increased risk of suicidal thoughts or
harmful behaviour, especially during the early stages of treatment.
In March's study, the risk of suicide declined in all patients who
received treatment. Those who got both the SSRI and psychotherapy had
the lowest risk.
Dr. Nili Benazon, a psychologist at the Centre for Addiction and
Mental Health in Toronto, said the findings may prompt her to change
the way she manages teens with depression.
"Our best bet for a positive outcome is going to be combine the
cognitive behavior therapy with an antidepressant," said Benazon.
The study appears in Wednesday's issue of the Journal of the American
Medical Association.
Written by CBC News Online staff
Copyright � 2004 Canadian Broadcasting Corporation - All Rights Reserved
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