Treatment of Depression in Children and Adolescents: A Systematic Review

Project Summary Title and Description

Title: Treatment of Depression in Children and Adolescents: A Systematic Review
Description: The purpose of the review is to examine the efficacy and comparative effectiveness of both benefits and harms of commonly used types of nonpharmacological and pharmacological treatments of child and adolescent depressive disorders.
Attribution: N/A
Authors of Report: N/A
Methodology description: We conducted a systematic review to evaluate the efficacy, comparative effectiveness, and moderators of benefits and harms of available nonpharmacological and pharmacological treatments for children and adolescent a confirmed diagnosis of a depressive disorder (DD)—major depressive disorder (MDD), persistent depressive disorder (PDD, previously termed dysthymia) or DD not otherwise specified (DD NOS). We searched five databases and other sources for evidence available from inception to May 29, 2019, dually screened the results, and analyzed eligible studies.
PROSPERO: CRD42018112150
DOI: https://doi.org/10.23970/AHRQEPCCER224
Notes: Data for this project were entered retrospectively by uploading data from Word. Titles of each evidence table are listed in the Appendix. https://pubmed.ncbi.nlm.nih.gov/32298061/
Funding Source: AHRQ

Key Questions

1. KQ 1a. In adolescents and children, what are the benefits and harms of nonpharmacological interventions for DDs (MDD, PDD/dysthymic disorders, or DD NOS)?

2. KQ 1b. How do these benefits and harms vary by subpopulation (e.g., patient characteristics, parent/caregiver characteristics, disorder characteristics, history of previous treatment, comorbid condition, exposure to a traumatic life event)?

3. KQ 2a. In adolescents and children, what are the benefits and harms of pharmacological interventions for DDs (MDD, PDD/dysthymic disorders, or DD NOS)?

4. KQ 2b. How do the benefits and harms vary by subpopulation (e.g., patient characteristics, disorder characteristics, history of previous treatment, comorbid condition, exposure to a traumatic life event)?

5. KQ 3a. In adolescents and children, what are the benefits and harms of combination interventions for DDs (MDD, PDD/dysthymic disorders, or DD NOS)?

6. KQ 3b. How do the benefits and harms vary by subpopulation (e.g., patient characteristics, disorder characteristics, history of previous treatment, comorbid condition, exposure to a traumatic life event)?

7. KQ 4a. In adolescents and children, what are the benefits and harms of collaborative care interventions for DDs (MDD, PDD/dysthymic disorders, or DD NOS)?

8. KQ 4b. How do the benefits and harms vary by subpopulation (e.g., patient characteristics, disorder characteristics, history of previous treatment, comorbid condition, exposure to a traumatic life event)?

9. KQ 5a. In adolescents and children, what are the comparative benefits and harms of treatments (pharmacological, nonpharmacological, combined, collaborative care interventions) for DDs (MDD, or PDD/dysthymic disorders, or DD NOS)?

10. KQ 5b. How do these benefits and harms vary by subpopulation (e.g., patient characteristics, disorder characteristics, history of previous treatment, comorbid condition, exposure to a traumatic life event)?

Associated Extraction Forms

Type
Standard

Associated Studies (each link opens a new tab)

Title	Authors	Year
A randomized clinical trial comparing family-focused treatment and individual supportive therapy for depression in childhood and early adolescence		2017
Cognitive-behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial		2017
Study 329 continuation phase: safety and efficacy of paroxetine and imipramine in extended treatment of adolescent major depression		2016
Cognitive behavioral therapy in primary care for youth declining antidepressants: a randomized trial		2016
Evaluation of a spirituality informed e-mental health tool as an intervention for major depressive disorder in adolescents and young adults - a randomized controlled pilot trial		2015
Family-based interpersonal psychotherapy for depressed preadolescents: examining efficacy and potential treatment mechanisms		2015
A double-blind, placebo-controlled study of selegiline transdermal system in depressed adolescents		2014
Sequential treatment with fluoxetine and relapse--prevention CBT to improve outcomes in pediatric depression		2014
Concurrent treatment for adolescent and parent depressed mood and suicidality: feasibility, acceptability, and preliminary findings		2015
A double-blind efficacy and safety study of duloxetine fixed doses in children and adolescents with major depressive disorder
A double-blind efficacy and safety study of duloxetine flexible dosing in children and adolescents with major depressive disorder		2014
Social problem solving among depressed adolescents is enhanced by structured psychotherapies		2014
Cognitive behavioral therapy for depressed adolescents exposed to interpersonal trauma: an initial effectiveness trial		2014
Escitalopram in the treatment of adolescent depression: a randomized, double-blind, placebo-controlled extension trial		2013
Moderators of fluoxetine treatment response for children and adolescents with comorbid depression and substance use disorders		2012
A novel early intervention for preschool depression: findings from a pilot randomized controlled trial		2012
Predictors of spontaneous and systematically assessed suicidal adverse events in the treatment of SSRI-resistant depression in adolescents (TORDIA) study		2009
Treatment of selective serotonin reuptake inhibitor-resistant depression in adolescents: predictors and moderators of treatment response		2009
Cognitive-behavioral therapy to prevent relapse in pediatric responders to pharmacotherapy for major depressive disorder		2008
Family-based interpersonal psychotherapy for depressed preadolescents: an open-treatment trial		2008
Switching to another SSRI or to venlafaxine with or without cognitive behavioral therapy for adolescents with SSRI-resistant depression: the TORDIA randomized controlled trial		2008
Childhood depression: a place for psychotherapy. An outcome study comparing individual psychodynamic psychotherapy and family therapy		2007
Treatment for Adolescents with Depression Study (TADS): safety results
Predictors and moderators of acute outcome in the Treatment for Adolescents with Depression Study (TADS)
Functioning and quality of life in the Treatment for Adolescents with Depression Study (TADS)
Acute time to response in the Treatment for Adolescents with Depression Study (TADS)
Remission and residual symptoms after short-term treatment in the Treatment of Adolescents with Depression Study (TADS)		2006
A comparison of cognitive-behavioral therapy, sertraline, and their combination for adolescent depression		2006
Omega-3 treatment of childhood depression: a controlled, double-blind pilot study		2006
Paroxetine treatment in children and adolescents with major depressive disorder: a randomized, multicenter, double-blind, placebo-controlled trial		2006
Fluoxetine 40-60 mg versus fluoxetine 20 mg in the treatment of children and adolescents with a less-than-complete response to nine-week treatment with fluoxetine 10-20 mg: a pilot study
An international, multicenter, placebo-controlled trial of paroxetine in adolescents with major depressive disorder		2006
A double-blind, randomized, placebo-controlled trial of escitalopram in the treatment of pediatric depression		2006
A randomized effectiveness trial of brief cognitive-behavioral therapy for depressed adolescents receiving antidepressant medication		2005
Fluoxetine treatment for prevention of relapse of depression in children and adolescents: a double-blind, placebo-controlled study		2004
Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial		2004
A randomized, placebo-controlled trial of citalopram for the treatment of major depression in children and adolescents		2004
An efficacy/effectiveness study of cognitive-behavioral treatment for adolescents with comorbid major depression and conduct disorder		2004
Suicidality and its relationship to treatment outcome in depressed adolescents		2004
Lifetime history of sexual abuse, clinical presentation, and outcome in a clinical trial for adolescent depression		2004
Fluoxetine for acute treatment of depression in children and adolescents: a placebo-controlled, randomized clinical trial
Attachment-based family therapy for depressed adolescents: a treatment development study		2002
Group cognitive-behavioral treatment for depressed adolescent offspring of depressed parents in a health maintenance organization		2002
Efficacy of paroxetine in the treatment of adolescent major depression: a randomized, controlled trial		2001
Imipramine compliance in adolescents
The efficacy of cognitive-behavioral and interpersonal treatments for depression in Puerto Rican adolescents		1999
Efficacy of interpersonal psychotherapy for depressed adolescents		1999
Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions		1999
Predictors of treatment efficacy in a clinical trial of three psychosocial treatments for adolescent depression		1998
Adolescent depression: controlled desipramine treatment and atypical features		1998
A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression		1997
A clinical psychotherapy trial for adolescent depression comparing cognitive, family, and supportive therapy		1997
Venlafaxine in the treatment of children and adolescents with major depression		1997
A randomized, controlled trial of amitriptyline in the acute treatment of adolescent major depression		1996
Response of depressed adolescents to cognitive-behavioral treatment: do differences in initial severity clarify the comparison of treatments?		1994
Pharmacokinetically designed double-blind placebo-controlled study of nortriptyline in 6- to 12-year-olds with major depressive disorder		1992
Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial		2017
Treatment response in depressed adolescents with and without co-morbid attention-deficit/hyperactivity disorder in the Treatment for Adolescents with Depression Study		2009
The effects of cognitive-behavioural therapy on mood-related ruminative response style in depressed adolescents		2008
A phase 3, double-blind, randomized, placebo-controlled study of vilazodone in adolescents with major depressive disorder		2018
Predictors and moderators of relapse in children and adolescents with major depressive disorder		2018
Desvenlafaxine versus placebo in a fluoxetine-referenced study of children and adolescents with major depressive disorder		2018
The short-term safety and efficacy of fluoxetine in depressed adolescents with alcohol and cannabis use disorders: a pilot randomized placebo-controlled trial		2009
Depressed Adolescents Treated with Exercise (DATE): a pilot randomized controlled trial to test feasibility and establish preliminary effect sizes		2013
Combined cognitive behavioral therapy and bupropion for the treatment of problematic on-line game play in adolescents with major depressive disorder		2012
Clinical and psychosocial predictors of suicide attempts and nonsuicidal self-injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT)		2011
Cognitive-behavioral therapy plus healthy lifestyle enhancement for depressed, overweight/obese adolescents: results of a pilot trial		2016
Cognitive behavioral therapy for childhood depression: a comparison of face-to-face and interactive televideo settings		2004
A randomized, double-blind, placebo-controlled evaluation of the safety and efficacy of citalopram in children and adolescents with depression		2001
A double-blind, multicentre placebo controlled study of paroxetine in adolescents with unipolar major depression		1998
Desvenlafaxine versus placebo in the treatment of children and adolescents with major depressive disorder		2018
Depressed youth: treatment outcome and changes in family functioning in individual and family therapy		2012
Innovations in practice: a pilot study of interpersonal psychotherapy for depressed adolescents and their parents		2016
Feasibility of Attachment Based Family Therapy for depressed clinic-referred Norwegian adolescents		2013
Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence		2015
Double-blind, placebo-controlled study of nortriptyline in depressed children using a fixed plasma level design		1989
A double-blind, placebo-controlled trial of sertraline in depressed adolescent alcoholics: a pilot study		2000
Treating a broader range of depressed adolescents with combined therapy		2018
Estimating patient-specific treatment advantages in the 'Treatment for Adolescents with Depression Study'		2019
Pilot randomized controlled trial of Omega-3 and individual-family psychoeducational psychotherapy for children and adolescents with depression		2019
Prognostic implications for adolescents with depression who drop out of psychological treatment during a randomized controlled trial		2019
Predicting dropout in adolescents receiving therapy for depression		2018
A randomized controlled trial of the impact of a family-based adolescent depression intervention on both youth and parent mental health outcomes		2018
Depression in childhood: one year outcomes of family versus individual treatment		57
Impact of childhood trauma on treatment outcome in the Treatment for Adolescents with Depression Study (TADS)		2010
Escitalopram in the treatment of adolescent depression: a randomized placebo-controlled multisite trial		2009
Fluoxetine versus placebo in preventing relapse of major depression in children and adolescents		2008
Imipramine plus cognitive-behavioral therapy in the treatment of school refusal		2000
Predicting time to recovery among depressed adolescents treated in two psychosocial group interventions		2006
Attachment-based family therapy for depressed adolescents: programmatic treatment development		2003
A multi_family group intervention for adolescent depression: the BEST MOOD program		2017
Predictors of treatment response in anxious-depressed adolescents with school refusal		2003

Downloadable Data Content

Files: XLSX Project Data