title: Impersistence of depression in youth: Implications for drug study design.
abstract: Food and Drug Administration data show that most anti-depressant studies in youth do not show drug effect. The few positive studies used rigorous diagnostic screening procedures, suggesting major depressive disorder (MDD) may not be a persistent condition in a subgroup of youth. To investigate persistence of MDD, we serially assessed a cohort of inpatients admitted to the hospital with a clinical diagnosis of MDD. Assessments included a structured diagnostic interview, the Diagnostic Interview for Children and Adolescents-Revised (DICA-R), and measures of depressive symptomatology. Of 66 subjects (40 girls; mean age, 14.4 +/- 2.2 years), 34 (51.5%) met DICA-R criteria for MDD at the initial postadmission assessment. Of these, only 8 (23.5%) met DICA-R criteria for MDD at any subsequent assessment. Similar reductions were found on other ratings of depression. In conclusion, MDD did not persist in this sample. The findings suggest a multigated assessment procedure should be employed before randomization in antidepressant clinical trials.
authors.affiliation: Department of Psychiatry, Drexel University College of Medicine and Philadelphia Health & Education Corporation, Philadelphia, Pennsylvania, USA.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Malone
authors.forename: David S
authors.initials: DS
authors.lastname: Bennett
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Delaney
authors.forename: Muniya S
authors.initials: MS
authors.lastname: Choudhury
authors.forename: James F
authors.initials: JF
authors.lastname: Luebbert
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Cater
mesh_terms: D000293:Adolescent; D002648:Child; D002986:Clinical Trials as Topic / Q000379:methods*; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D012107:Research Design; D013997:Time Factors