Depressive Symptoms and Clinical Status During the Treatment of Adolescent Suicide Attempters (TASA) Study |
| |
| Authors: | Benedetto Vitiello David A Brent Laurence L Greenhill Graham Emslie Karen Wells John T Walkup Barbara Stanley Oscar Bukstein Betsy D Kennard Scott Compton Barbara Coffey Mary F Cwik Kelly Posner Ann Wagner John S March Mark Riddle Tina Goldstein John Curry Lisa Capasso Taryn Mayes Jamie Zelazny |
| |
| Institution: | 1. Department of Psychiatry, Harvard Medical School, Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA;2. Department of Psychology, Harvard University, Cambridge, MA, USA;1. Research School of Psychology, Australian National University, Canberra, Australia;2. Institute of Psychiatry, Psychology & Neuroscience, King''s College London, London, United Kingdom;3. Discipline of Psychology, Faculty of Health, University of Canberra, Canberra, Australia;4. Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Charles Perkins Centre, University of Sydney, Sydney, Australia;1. King''s College London, Psychological Medicine, Institute of Psychiatry, United Kingdom;2. South London and Maudsley NHS Foundation Trust, Department of Psychological Medicine, King''s College Hospital, United Kingdom;3. King''s College London, Health Service and Population Research Department, Institute of Psychiatry, United Kingdom;1. Geha Mental Health Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;2. Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, USA;3. Centre for Suicide Research, University of Oxford, Oxford, UK;4. National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden;5. Unit for Suicide Research, Ghent University, Ghent, Belgium;6. National Suicide Research Foundation, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland;7. Department of Medicine and Health Science, University of Molise, Via De Santis Campobasso and National Institute for Health, Migration and Poverty, Roma, Italy;8. National Institute of Mental Health, Klecany, Czech Republic;9. Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eotvos Lorand University, Budapest, Hungary;10. Institute of Behavioral Sciences, Semmelweis University Budapest, Budapest, Hungary;11. Université de Lorraine, Pôle de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy-Laxou, Nancy-Laxou, France;12. Department of Psychiatry, University of Oviedo, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM Oviedo, Spain;13. Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel;14. Department of Clinical Psychology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania;15. Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany;p. Psychiatry Department, Sheba Health Center and Sackler School of Medicine, Tel Aviv University, Tel Avis, Israel;1. Behavioral Pharmacology Research Unit, Department of Psychiatry, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA;2. University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA;3. HSR and D Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2800 Plymouth Road, Building 16, Floor 2, Ann Arbor, MI, 48109, USA;4. University of Michigan Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, MI, 48109, USA;5. Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd Bldg 10-G080, Ann Arbor, MI, 48109-2800, USA |
| |
| Abstract: | ObjectiveTo examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide.MethodAdolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depressive disorder (96.0% had major depressive disorder), and a Children's Depression Rating Scale-Revised (CDRS-R) score of 36 or higher, entered a 6-month treatment with antidepressant medication, cognitive-behavioral therapy focused on suicide prevention, or their combination (Comb), at five academic sites. Treatment assignment could be either random or chosen by study participants. Intent-to-treat, mixed effects regression models of depression and other relevant ratings were estimated. Improvement and remission rates were computed with the last observation carried forward.ResultsMost patients (n = 104 or 84%) chose treatment assignment, and overall, three fourths (n = 93) received Comb. In Comb, CDRS-R declined from a baseline adjusted mean of 49.6 (SD 12.3) to 38.3 (8.0) at week 12 and to 27.0 (10.1) at week 24 (p < .0001), with a Clinical Global Impression -defined improvement rate of 58.0% at week 12 and 72.2% at week 24 and a remission (CDRS-R ≤28) rate of 32.5% at week 12 and 50.0% at week 24. The CDRS-R and the Scale for Suicidal Ideation scores were correlated at baseline (r= 0.43, p < .0001) and declined in parallel.ConclusionsWhen vigorously treated with a combination of medication and psychotherapy, adolescents with depression who have recently attempted suicide show rates of improvement and remission of depression that seem comparable to those observed in nonsuicidal adolescents with depression. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
