Group cognitive-behavioral treatment for depressed adolescent offspring of depressed parents in a health maintenance organization.
OBJECTIVE
A randomized, controlled effectiveness trial of group cognitive-behavioral therapy (CBT) for depressed adolescent offspring of depressed parents in a health maintenance organization (HMO) was conducted.


METHODS
Potential adult cases were found by reviewing antidepressant medication prescriptions, mental health appointments, and medical charts. Introductory study letters signed by each parent's treating physician were mailed to the appropriate adults. Eligible offspring aged 13 to 18 who met current DSM-III-R criteria for major depression and/or dysthymia were randomly assigned to either usual HMO care (n = 47) or usual care plus a 16-session group CBT program (n = 41). Assessments were conducted at baseline, after treatment, and at 12- and 24-month follow-up.


RESULTS
Using intent-to-treat analyses, the authors were unable to detect any significant advantage of the CBT program over usual care, either for depression diagnoses, continuous depression measures, nonaffective measures, or functioning outcomes.


CONCLUSIONS
Group CBT does not appear to be incrementally beneficial for depressed offspring of depressed parents who are receiving other mental health care. However, given that many other studies have found positive effects of CBT for youth depression, this single study should not be viewed as evidence that CBT is ineffective overall.
Clarke
Gregory N
GN
Kaiser Permanente Center for Health Research, Portland, OR 97227-1098, USA.
Hornbrook
Mark
M
Lynch
Frances
F
Polen
Michael
M
Gale
John
J
O'Connor
Elizabeth
E
Seeley
John R
JR
Debar
Lynn
L
D000293:Adolescent; D000328:Adult; D016241:Child of Impaired Parents / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005500:Follow-Up Studies; D006279:Health Maintenance Organizations; D006801:Humans; D010290:Parents / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index