title: The prevalence and impact of large sudden improvements during adolescent therapy for depression: a comparison across cognitive-behavioral, family, and supportive therapy.
abstract: This study assessed the treatment specificity and impact on outcome of large, abrupt symptomatic improvements occurring prior to and during cognitive-behavioral, family, and supportive therapy. Eighty-seven depressed adolescents receiving at least 8 therapy sessions were included. Abrupt large decreases in depressive symptoms were identified by changes in weekly Beck Depression Inventory scores. Overall, 28% experienced a pretreatment gain and 39% a sudden within-treatment gain. Both types of gains were associated with superior outcome on self-report and interviewer ratings of depression. Among those participants failing to experience a pretreatment or sudden within-treatment gain, cognitive-behavioral therapy produced the superior outcomes. These findings suggest pretreatment and sudden within-treatment gains are important therapeutic events worthy of further investigation.
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA. scott.gaynor@wmich.edu
authors.forename: Scott T
authors.initials: ST
authors.lastname: Gaynor
authors.forename: V Robin
authors.initials: VR
authors.lastname: Weersing
authors.forename: David J
authors.initials: DJ
authors.lastname: Kolko
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: Jungeun
authors.initials: J
authors.lastname: Heo
authors.forename: David A
authors.initials: DA
authors.lastname: Brent
mesh_terms: D000293:Adolescent; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D005196:Family Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015995:Prevalence; D012944:Social Support