Remission and residual symptoms after short-term treatment in the Treatment of Adolescents with Depression Study (TADS)

Betsy Kennard, Susan Silva, Benedetto Vitiello, John Curry, Christopher Kratochvil, Anne Simons, Jennifer Hughes, Norah Feeny, Elizabeth Weller, Michael Sweeney, Mark Reinecke, Sanjeev Pathak, Golda Ginsburg, Graham Emslie, John March

Research output: Contribution to journalArticle

160 Citations (Scopus)

Abstract

OBJECTIVE: To ascertain remission rates in depressed youth participating in the Treatment for Adolescents With Depression Study (TADS), a multisite clinical trial that randomized 439 adolescents with major depressive disorder (MDD) to a 12-week treatment of fluoxetine (FLX), cognitive-behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO). METHOD: Using an end-of-treatment Children's Depression Rating Scale-Revised (CDRS-R) total score of 28 or below as the criterion for remission, rates of remission were examined with logistic regression, controlling for site. Loss of MDD diagnosis and residual symptoms in responders (defined as Clinical Global Impressions-Improvement (CGI-I) score of 1 (very much improved) or 2 (much improved) were also examined across treatment groups. RESULTS: After 12 weeks of treatment, 102 (23%) of 439 youths had reached remission. The remission rate was significantly higher in the COMB group (37%) relative to the other treatment groups (FLX, 23%; CBT, 16%; PBO, 17%), with odds ratios of 2.1 for COMB versus FLX, 3.3 for COMB versus CBT, and 3.0 for COMB versus PBO. In addition, 71% of subjects across treatment groups no longer met criteria for MDD at the end of acute treatment. Fifty percent of the youths who responded by CGI-I criteria continued to have residual symptoms, such as sleep or mood disturbances, fatigue, and poor concentration. CONCLUSIONS: The combination of FLX and CBT was superior to both monotherapy and PBO in terms of remission rates, but overall rates of remission remain low and residual symptoms are common at the end of 12 weeks of treatment. Copyright 2006

Original languageEnglish (US)
Pages (from-to)1404-1411
Number of pages8
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume45
Issue number12
DOIs
StatePublished - Dec 2006

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Depression
Fluoxetine
Cognitive Therapy
Major Depressive Disorder
Placebos
Therapeutics
Fatigue
Sleep
Randomized Controlled Trials
Logistic Models
Odds Ratio

Keywords

  • Depression
  • Remission
  • Residual symptoms
  • Treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Developmental and Educational Psychology

Cite this

Remission and residual symptoms after short-term treatment in the Treatment of Adolescents with Depression Study (TADS). / Kennard, Betsy; Silva, Susan; Vitiello, Benedetto; Curry, John; Kratochvil, Christopher; Simons, Anne; Hughes, Jennifer; Feeny, Norah; Weller, Elizabeth; Sweeney, Michael; Reinecke, Mark; Pathak, Sanjeev; Ginsburg, Golda; Emslie, Graham; March, John.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 45, No. 12, 12.2006, p. 1404-1411.

Research output: Contribution to journalArticle

Kennard, B, Silva, S, Vitiello, B, Curry, J, Kratochvil, C, Simons, A, Hughes, J, Feeny, N, Weller, E, Sweeney, M, Reinecke, M, Pathak, S, Ginsburg, G, Emslie, G & March, J 2006, 'Remission and residual symptoms after short-term treatment in the Treatment of Adolescents with Depression Study (TADS)', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 45, no. 12, pp. 1404-1411. https://doi.org/10.1097/01.chi.0000242228.75516.21
Kennard, Betsy ; Silva, Susan ; Vitiello, Benedetto ; Curry, John ; Kratochvil, Christopher ; Simons, Anne ; Hughes, Jennifer ; Feeny, Norah ; Weller, Elizabeth ; Sweeney, Michael ; Reinecke, Mark ; Pathak, Sanjeev ; Ginsburg, Golda ; Emslie, Graham ; March, John. / Remission and residual symptoms after short-term treatment in the Treatment of Adolescents with Depression Study (TADS). In: Journal of the American Academy of Child and Adolescent Psychiatry. 2006 ; Vol. 45, No. 12. pp. 1404-1411.
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AU - Kennard, Betsy

AU - Silva, Susan

AU - Vitiello, Benedetto

AU - Curry, John

AU - Kratochvil, Christopher

AU - Simons, Anne

AU - Hughes, Jennifer

AU - Feeny, Norah

AU - Weller, Elizabeth

AU - Sweeney, Michael

AU - Reinecke, Mark

AU - Pathak, Sanjeev

AU - Ginsburg, Golda

AU - Emslie, Graham

AU - March, John

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N2 - OBJECTIVE: To ascertain remission rates in depressed youth participating in the Treatment for Adolescents With Depression Study (TADS), a multisite clinical trial that randomized 439 adolescents with major depressive disorder (MDD) to a 12-week treatment of fluoxetine (FLX), cognitive-behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO). METHOD: Using an end-of-treatment Children's Depression Rating Scale-Revised (CDRS-R) total score of 28 or below as the criterion for remission, rates of remission were examined with logistic regression, controlling for site. Loss of MDD diagnosis and residual symptoms in responders (defined as Clinical Global Impressions-Improvement (CGI-I) score of 1 (very much improved) or 2 (much improved) were also examined across treatment groups. RESULTS: After 12 weeks of treatment, 102 (23%) of 439 youths had reached remission. The remission rate was significantly higher in the COMB group (37%) relative to the other treatment groups (FLX, 23%; CBT, 16%; PBO, 17%), with odds ratios of 2.1 for COMB versus FLX, 3.3 for COMB versus CBT, and 3.0 for COMB versus PBO. In addition, 71% of subjects across treatment groups no longer met criteria for MDD at the end of acute treatment. Fifty percent of the youths who responded by CGI-I criteria continued to have residual symptoms, such as sleep or mood disturbances, fatigue, and poor concentration. CONCLUSIONS: The combination of FLX and CBT was superior to both monotherapy and PBO in terms of remission rates, but overall rates of remission remain low and residual symptoms are common at the end of 12 weeks of treatment. Copyright 2006

AB - OBJECTIVE: To ascertain remission rates in depressed youth participating in the Treatment for Adolescents With Depression Study (TADS), a multisite clinical trial that randomized 439 adolescents with major depressive disorder (MDD) to a 12-week treatment of fluoxetine (FLX), cognitive-behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO). METHOD: Using an end-of-treatment Children's Depression Rating Scale-Revised (CDRS-R) total score of 28 or below as the criterion for remission, rates of remission were examined with logistic regression, controlling for site. Loss of MDD diagnosis and residual symptoms in responders (defined as Clinical Global Impressions-Improvement (CGI-I) score of 1 (very much improved) or 2 (much improved) were also examined across treatment groups. RESULTS: After 12 weeks of treatment, 102 (23%) of 439 youths had reached remission. The remission rate was significantly higher in the COMB group (37%) relative to the other treatment groups (FLX, 23%; CBT, 16%; PBO, 17%), with odds ratios of 2.1 for COMB versus FLX, 3.3 for COMB versus CBT, and 3.0 for COMB versus PBO. In addition, 71% of subjects across treatment groups no longer met criteria for MDD at the end of acute treatment. Fifty percent of the youths who responded by CGI-I criteria continued to have residual symptoms, such as sleep or mood disturbances, fatigue, and poor concentration. CONCLUSIONS: The combination of FLX and CBT was superior to both monotherapy and PBO in terms of remission rates, but overall rates of remission remain low and residual symptoms are common at the end of 12 weeks of treatment. Copyright 2006

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