High rate of non-eligibility: methodological factors impacting on recruitment for a multicentre, double-blind study of paediatric patients with major depressive disorder.
BACKGROUND
This report describes difficulties encountered when attempting to recruit children and adolescents with major depression for a recent international double-blind, placebo-controlled trial (www.clinicaltrials.gov Nr. NCT00849901).


METHODS
Over a 14-month period, children and adolescents with depressive symptoms were pre-screened for their eligibility for inclusion.


RESULTS
85 patients (age 7-17 years) were considered. Of these, only one was enrolled. The main reasons for non-eligibility were: failure to meet the baseline severity criterion on the primary outcome scale (clinical global impression-severity; 32.1% of the patients); requirement for immediate hospitalisation (15.4%); or the presence of an exclusionary comorbid psychiatric disorder (19.1%).


CONCLUSIONS
The recruitment of paediatric patients with major depression was primarily limited by various inclusion and exclusion criteria. Slow recruitment of small patient samples may impact strongly on the representativeness and generalisability of research findings, and thus on analyses in evidence-based medicine and on the development and recommendations of treatment guidelines. This may impact in turn on the feasibility of the clinical development and registration process of new compounds in paediatric psychopharmacology and beyond.
Department of Child and Adolescent Psychiatry and Psychotherapy, Research Unit for Paediatric Psychopharmacology, Central Institute of Mental Health, Mannheim, Germany. Lucia.Bliznak@zi-mannheim.de
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Dittmann
D000293:Adolescent; D002648:Child; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic / Q000379:methods*; D009483:Neuropsychological Tests; D010349:Patient Compliance; D018579:Patient Selection; D012107:Research Design; D013406:Suicide, Attempted; D016896:Treatment Outcome