The Treatment for Adolescents With Depression Study (TADS): outcomes over 1 year of naturalistic follow-up.
OBJECTIVE
The Treatment for Adolescents With Depression Study (TADS) evaluates the effectiveness of fluoxetine, cognitive-behavioral therapy (CBT), and their combination in adolescents with major depressive disorder. The authors report effectiveness outcomes across a 1-year naturalistic follow-up period.


METHODS
The randomized, controlled trial was conducted in 13 academic and community sites in the United States. Stages I, II, and III consisted of 12, 6, and 18 weeks of acute, consolidation, and continuation treatment, respectively. Following discontinuation of TADS treatments at the end of stage III, stage IV consisted of 1 year of naturalistic follow-up. The participants were 327 subjects between the ages of 12 and 17 with a primary DSM-IV diagnosis of major depressive disorder. No TADS treatment was provided during the follow-up period; treatment was available in the community. The primary dependent measures, rated by an independent evaluator blind to treatment status, were the total score on the Children's Depression Rating Scale-Revised and the rate of response, defined as a rating of much or very much improved on the Clinical Global Impressions improvement measure.


RESULTS
Sixty-six percent of the eligible subjects participated in at least one stage IV assessment. The benefits seen at the end of active treatment (week 36) persisted during follow-up on all measures of depression and suicidality.


CONCLUSIONS
In contrast to earlier reports on short-term treatments, in which worsening after treatment is the rule, the longer treatment in the TADS was associated with persistent benefits over 1 year of naturalistic follow-up.
Department of Psychiatry and Behavioral Sciences and the Duke Clinical Research Institute at Duke University Medical Center, Durham, NC 27705, USA. john.march@duke.edu
March
John
J
Silva
Susan
S
Curry
John
J
Wells
Karen
K
Fairbank
John
J
Burns
Barbara
B
Domino
Marisa
M
Vitiello
Benedetto
B
Severe
Joanne
J
Riedal
Karyn
K
Goldman
Marguerita
M
Feeny
Norah
N
Findling
Robert
R
Stull
Sheridan
S
Baab
Susan
S
Weller
Elizabeth B
EB
Robbins
Michele
M
Weller
Ronald A
RA
Jessani
Naushad
N
Waslick
Bruce
B
Sweeney
Michael
M
Dublin
Randi
R
Walkup
John
J
Ginsburg
Golda
G
Kastelic
Elizabeth
E
Koo
Hyung
H
Kratochvil
Christopher
C
May
Diane
D
LaGrone
Randy
R
Vaughan
Brigette
B
Albano
Anne Marie
AM
Hirsch
Glenn S
GS
Podniesinki
Elizabeth
E
Chu
Angela
A
Reincecke
Mark
M
Leventhal
Bennett
B
Rogers
Gregory
G
Jacobs
Rachel
R
Pathak
Sanjeev
S
Wells
Jennifer
J
Lavanier
Sarah A
SA
Danielyan
Arman
A
Rohde
Paul
P
Simons
Anne
A
Grimm
James
J
Frank
Stephanie
S
Emslie
Graham
G
Kennard
Beth
B
Hughes
Carroll
C
Mayes
Taryn L
TL
Rosenberg
David
D
Benazon
Nili
N
Butkus
Michael
M
Bartoi
Marla
M
D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States
D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors