This study compares three types of psychotherapy for adolescent major depression, cognitive-behavioral therapy (CBT), systemic behavioral family therapy (SBFT), and non-directive supportive therapy (NST). By the time of review, an estimated 110 patients will have been randomized to treatment. The protocol has specified 12-16 sessions over 12-16 weeks, two to four booster sessions over the next four months, and two years of follow-up after the end of acute treatment Siblings of the patients are also followed up two years. The goals of the renewal are to: . complete one- and two-year follow-up assessments on the patients and their siblings; . finalize all data analyses; . prepare manuscripts for publication.
The aims of the analyses are to assess: . the differential effects of the three treatments on depression, suicidality, and social competence at the end of acute treatment and over the course of follow-up; . the impact of age, hopelessness, and degree of family discord on the relative efficacy of CBT and SBFT; . the specificity of treatment effects; . the relative impact of SBFT vs. the two individual treatments in preventing the onset of depression in siblings of the adolescent depressed patients. . the predictors of remission and of recurrence of depression. This is the largest clinical trial of psychosocial treatments of adolescent major depression. The results of this study will be useful to clinicians and researchers with respect to design of psychosocial treatments, fit of treatment to patient characteristics, development of maintenance treatments to prevent recurrence of depression and development of interventions to prevention depression.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
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Child Psychopathology and Treatment Review Committee (CPT)
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University of Pittsburgh
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Dietz, Laura J; Marshal, Michael P; Burton, Chad M et al. (2014) Social problem solving among depressed adolescents is enhanced by structured psychotherapies. J Consult Clin Psychol 82:202-11
Bridge, Jeffrey A; Barbe, Remy P; Birmaher, Boris et al. (2005) Emergent suicidality in a clinical psychotherapy trial for adolescent depression. Am J Psychiatry 162:2173-5
Barbe, Remy P; Bridge, Jeffrey; Birmaher, Boris et al. (2004) Suicidality and its relationship to treatment outcome in depressed adolescents. Suicide Life Threat Behav 34:44-55
Gaynor, Scott T; Weersing, V Robin; Kolko, David J et al. (2003) The prevalence and impact of large sudden improvements during adolescent therapy for depression: a comparison across cognitive-behavioral, family, and supportive therapy. J Consult Clin Psychol 71:386-93
Brent, D A; Birmaher, B; Kolko, D et al. (2001) Subsyndromal depression in adolescents after a brief psychotherapy trial: course and outcome. J Affect Disord 63:51-8
Brent, D A (2001) Firearms and suicide. Ann N Y Acad Sci 932:225-39; discussion; 239-40
Stein, D; Brent, D A; Bridge, J et al. (2001) Predictors of parent-rated credibility in a clinical psychotherapy trial for adolescent depression. J Psychother Pract Res 10:1-7
Brent, D A (2001) Assessment and treatment of the youthful suicidal patient. Ann N Y Acad Sci 932:106-28; discussion 128-31
Brent, D A; Baugher, M; Birmaher, B et al. (2000) Compliance with recommendations to remove firearms in families participating in a clinical trial for adolescent depression. J Am Acad Child Adolesc Psychiatry 39:1220-6
Birmaher, B; Brent, D A; Kolko, D et al. (2000) Clinical outcome after short-term psychotherapy for adolescents with major depressive disorder. Arch Gen Psychiatry 57:29-36

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