Brief CBT helps adolescents recover from depression

COGNITIVE BEHAVIORAL therapy (CBT) plays a big role in adolescents who are suffering from major depression, especially those who previously declined anti-depressants.

CBT is a form of psychotherapy that acknowledges that there may be behaviors that cannot be controlled through rational thought, since they emerge based on prior conditioning from the environment and other external and/or internal stimuli. CBT is described to be “problem-focused” (undertaken for specific problems) and “action-oriented” (therapist tries to assist the client in selecting specific strategies to help address those problems), or directive in its therapeutic approach.

In a study by Clarke G et al. published recently in Pediatrics, and reviewed by Christine M. Judge, MS and Louis M. Bell, MD, the rates of psychological hospitalization through year one were significantly lower among patients receiving CBT (0.9 percent versus 8.5 percent).

The study involved 212 adolescents age 12 to 18 years (68 percent female) who had previously declined antidepressants to treat major depression; and these adolescents were subjected to CBT intervention in a primary care setting.

Participants were randomized to CBT (two four-session modules) plus usual self-selected care (comprising of different chosen therapies, including antidepressants in some) or usual self-selected care alone.

Patients were followed up for two years, and the primary outcome was time to recovery (minimal to no symptoms and impairment for =eight weeks).

Results show that time to recovery was significantly shorter in the CBT group; the number needed to treat was six at 12 weeks post treatment, increasing to 10 at one to two years post-treatment.

Average time to response was 13.3 weeks in the CBT group versus 18.0 weeks in controls.

Among secondary outcomes, measures of symptoms, severity, functioning, and quality of life showed small to moderate improvements with CBT, but only through year one; other behavioral and psychosocial measures showed no improvements.

Louis M. Bell, MD, who commented on the study, said that recovery from major depression was significantly improved in the first year following these CBT therapy sessions.

“These findings make intuitive sense and appear to be valid given the rigor of the study, including its two-year follow-up period. Implementing such programs into routine pediatric care will help us better meet the needs of our adolescent patients diagnosed with depression,” said Dr. Bell. With a report

Vital Signs Issue 86 Vol. 4, April 1-30 2016