title: Impact of comorbidity on a cognitive-behavioral group treatment for adolescent depression.
abstract: OBJECTIVE
  Examine hypotheses concerning the negative impact of lifetime psychiatric comorbidity on participation in, and benefit from, a cognitive-behavioral group treatment for depression in adolescents (e.g., greater severity at intake, less recovery and more recurrence, less participation in treatment).
  
  
  METHODS
  Across two previous studies conducted between 1986 and 1993, 151 depressed adolescents (aged 14-18) were randomly assigned to one of three treatment conditions (two active treatments and a waitlist control) and followed for 24 months posttreatment. Forty percent of participants had one or more lifetime comorbid diagnoses at intake.
  
  
  RESULTS
  Comorbid anxiety disorders were associated with higher depression measure scores at intake and greater decrease in depression scores by posttreatment. Overall lifetime comorbidity was unrelated to diagnostic recovery, but lifetime substance abuse/dependence was associated with slower time to recovery. Participants with attention-deficit and disruptive behavior disorders were more likely to experience depression recurrence posttreatment. Associations between comorbidity and participation or therapy process measures were nonsignificant.
  
  
  CONCLUSIONS
  Although some outcomes were worse for some comorbid diagnoses, the reassuring overall conclusion is that the presence of psychiatric comorbidity is generally not a contraindication for the use of structured group cognitive-behavioral interventions for depressed adolescents.
authors: Oregon Research Institute, Eugene, 97403-1983, USA. paulr@ori.org
authors: P
authors: P
authors: Rohde
authors: G N
authors: GN
authors: Clarke
authors: P M
authors: PM
authors: Lewinsohn
authors: J R
authors: JR
authors: Seeley
authors: N K
authors: NK
authors: Kaufman
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D009922:Oregon / Q000453:epidemiology; D016016:Proportional Hazards Models