title: Compliance with recommendations to remove firearms in families participating in a clinical trial for adolescent depression.
abstract: OBJECTIVE
  To assess the rate and correlates of compliance with clinicians' recommendations to remove firearms from the homes of depressed adolescents participating in a clinical trial.
  
  
  METHODS
  The parents of 106 adolescents with major depression who participated in a randomized psychotherapy clinical trial were asked systematically about firearms in the home. Those who answered affirmatively were given information about the suicide risk conveyed by guns in the home and urged to remove them. The rates of gun removal and acquisition were assessed at the end of the treatment and over the subsequent 2-year naturalistic follow-up.
  
  
  RESULTS
  Of those who had guns at intake, 26.9% reported removing them by the end of the acute trial. Retention was associated with urban origin, marital dissatisfaction, and paternal psychopathology. Of those who did not have guns at intake, 17.1% reported acquiring them over 2-year follow-up. Living in a 2-parent household and marital dissatisfaction were associated with gun acquisition.
  
  
  CONCLUSIONS
  Families of depressed adolescents may frequently be noncompliant with recommendations to remove guns from the home despite compliance with other aspects of treatment. More efficacious interventions to reduce access to guns in the homes of at-risk youths are needed.
authors.affiliation: Division of Child and Adolescent Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA. brentda@msx.upmc.edu
authors.forename: D A
authors.initials: DA
authors.lastname: Brent
authors.forename: M
authors.initials: M
authors.lastname: Baugher
authors.forename: B
authors.initials: B
authors.lastname: Birmaher
authors.forename: D J
authors.initials: DJ
authors.lastname: Kolko
authors.forename: J
authors.initials: J
authors.lastname: Bridge
mesh_terms: D000293:Adolescent; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D005389:Firearms; D006801:Humans; D008297:Male; D010290:Parents / Q000193:education / Q000523:psychology; D010349:Patient Compliance; D011613:Psychotherapy; D012449:Safety; D013405:Suicide / Q000523:psychology; D014948:Wounds, Gunshot / Q000517:prevention & control* / Q000523:psychology; D000092864:Suicide Prevention