Remission and recovery in the Treatment for Adolescents with Depression Study (TADS): acute and long-term outcomes.
OBJECTIVE
We examine remission rate probabilities, recovery rates, and residual symptoms across 36 weeks in the Treatment for Adolescents with Depression Study (TADS).


METHODS
The TADS, a multisite clinical trial, randomized 439 adolescents with major depressive disorder to 12 weeks of treatment with fluoxetine, cognitive-behavioral therapy, their combination, or pill placebo. The pill placebo group, treated openly after week 12, was not included in the subsequent analyses. Treatment differences in remission rates and probabilities of remission over time are compared. Recovery rates in remitters at weeks 12 (acute phase remitters) and 18 (continuation phase remitters) are summarized. We also examined whether residual symptoms at the end of 12 weeks of acute treatment predicted later remission.


RESULTS
At week 36, the estimated remission rates for intention-to-treat cases were as follows: combination, 60%; fluoxetine, 55%; cognitive-behavioral therapy, 64%; and overall, 60%. Paired comparisons reveal that, at week 24, all active treatments converge on remission outcomes. The recovery rate at week 36 was 65% for acute phase remitters and 71% for continuation phase remitters, with no significant between-treatment differences in recovery rates. Residual symptoms at the end of acute treatment predicted failure to achieve remission at weeks 18 and 36.


CONCLUSIONS
Most depressed adolescents in all three treatment modalities achieved remission at the end of 9 months of treatment.
Kennard
Betsy D
BD
5323 Harry Hines Blvd., University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-8589, USA. Beth.kennard@utsouthwestern.edu
Silva
Susan G
SG
Tonev
Simon
S
Rohde
Paul
P
Hughes
Jennifer L
JL
Vitiello
Benedetto
B
Kratochvil
Christopher J
CJ
Curry
John F
JF
Emslie
Graham J
GJ
Reinecke
Mark
M
March
John
J
D000293:Adolescent; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D012074:Remission Induction; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors