title: The bi-directional relationship between parent-child conflict and treatment outcome in treatment-resistant adolescent depression.
abstract: OBJECTIVE
  To examine the bidirectional relationship between parent-child discord and treatment outcome for adolescent treatment-resistant depression.
  
  
  METHODS
  Depressed youth who had not responded to an adequate course of a selective serotonin reuptake inhibitor (SSRI) were randomized to either a switch to another SSRI or venlafaxine, with or without the addition of cognitive behavior therapy (CBT) in the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) study. The Conflict Behavior Questionnaire was used to assess adolescent (CBQ-A) and parent-reported (CBQ-P) parent-child discord. The impact of remission on parent-child conflict, and the differential impact of medication and CBT on the CBQ-A and CBQ-P, were assessed using generalized linear models.
  
  
  RESULTS
  Although there were no differential treatment effects on parent or adolescent-report of conflict, remission was associated with improvement in the CBQ-P. In general, intake family conflict did not predict remission, except in the sub-group of participants whose parents reported clinically significant parent-child conflict at intake, for whom high levels of parent-reported conflict predicted a lower likelihood of remission. Conflict also did not moderate treatment response.
  
  
  CONCLUSIONS
  Remission of depression may be sufficient to reduce parent-reported parent-child conflict. However, higher parent-reported conflict, in the clinically significant range, predicts a lower likelihood of remission from depression. Clinical trial registration information-Treatment of SSRI-Resistant Depression in Adolescents (TORDIA); http://clinicaltrials.gov/; NCT00018902.
authors.affiliation: University of Texas at Houston Medical School, USA.
authors.forename: Manivel
authors.initials: M
authors.lastname: Rengasamy
authors.forename: Brandon M
authors.initials: BM
authors.lastname: Mansoor
authors.forename: Robert
authors.initials: R
authors.lastname: Hilton
authors.forename: Giovanna
authors.initials: G
authors.lastname: Porta
authors.forename: Jiayan
authors.initials: J
authors.lastname: He
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Emslie
authors.forename: Taryn
authors.initials: T
authors.lastname: Mayes
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Clarke
authors.forename: Karen Dineen
authors.initials: KD
authors.lastname: Wagner
authors.forename: Martin B
authors.initials: MB
authors.lastname: Keller
authors.forename: Neal D
authors.initials: ND
authors.lastname: Ryan
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: Wael
authors.initials: W
authors.lastname: Shamseddeen
authors.forename: Joan Rosenbaum
authors.initials: JR
authors.lastname: Asarnow
authors.forename: David A
authors.initials: DA
authors.lastname: Brent
mesh_terms: D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003220:Conflict, Psychological; D003511:Cyclohexanols / Q000008:administration & dosage / Q000494:pharmacology*; D061218:Depressive Disorder, Treatment-Resistant; D005260:Female; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
chemical_list: D003511:Cyclohexanols; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride