title: Effective components of TORDIA cognitive-behavioral therapy for adolescent depression: preliminary findings.
abstract: In this report, we conducted a secondary analysis of the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) study to explore the impact of specific cognitive-behavioral therapy (CBT) treatment components on outcome. In TORDIA, 334 youths (ages 12 to 18 years) with major depressive disorder who had failed to respond to an adequate course of selective serotonin reuptake inhibitor (SSRI) medication were randomized to a medication switch (either to an alternative SSRI or venlafaxine) with or without 12 weeks of adjunctive CBT. Participants who had more than 9 CBT sessions were 2.5 times more likely to have adequate treatment response than those who had 9 or fewer sessions. CBT participants who received problem-solving and social skills treatment components, controlling for number of sessions and other confounding variables, were 2.3 and 2.6 times, respectively, more likely to have a positive response. These preliminary findings underscore the importance of receiving an adequate number of sessions to attain an adequate clinical response. Finally, social skills and problem solving may be active elements in CBT for adolescent depression and should be considered in treatment by those working with seriously depressed youths.
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-8589, USA. Beth.Kennard@UTSouthwestern.edu
authors.forename: Betsy D
authors.initials: BD
authors.lastname: Kennard
authors.forename: Greg N
authors.initials: GN
authors.lastname: Clarke
authors.forename: V Robin
authors.initials: VR
authors.lastname: Weersing
authors.forename: Joan Rosenbaum
authors.initials: JR
authors.lastname: Asarnow
authors.forename: Wael
authors.initials: W
authors.lastname: Shamseddeen
authors.forename: Giovanna
authors.initials: G
authors.lastname: Porta
authors.forename: Michele
authors.initials: M
authors.lastname: Berk
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hughes
authors.forename: Anthony
authors.initials: A
authors.lastname: Spirito
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Emslie
authors.forename: Martin B
authors.initials: MB
authors.lastname: Keller
authors.forename: Karen D
authors.initials: KD
authors.lastname: Wagner
authors.forename: David A
authors.initials: DA
authors.lastname: Brent
mesh_terms: D000293:Adolescent; D000339:Affect; D016009:Chi-Square Distribution; D002648:Child; D015928:Cognitive Behavioral Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004644:Emotions; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011340:Problem Solving; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012919:Social Behavior; D016896:Treatment Outcome
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors