Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-18T04:46:42.800Z Has data issue: false hasContentIssue false
  • English
  • Français

Is cognitive behavioural therapy an effective complement to antidepressants in adolescents? A meta-analysis

Published online by Cambridge University Press:  24 June 2014

Raffaella Calati ,
Laura Pedrini ,
Sara Alighieri ,
Mariela Ivana Alvarez ,
Lorenzo Desideri ,
Daniele Durante ,
Federica Favero ,
Luisa Iero ,
Giulia Magnani  and
Valentina Pericoli
...Show all authors
Raffaella Calati
Affiliation:
Institute of Psychiatry, University of Bologna, Bologna, Italy
Laura Pedrini
Affiliation:
IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
Sara Alighieri
Affiliation:
N.P.E.E., Rimini AUSL, Rimini, Italy
Mariela Ivana Alvarez
Affiliation:
Children and Adolescent Psychiatry Unit, Reggio Emilia AUSL, Reggio Emilia, Italy
Lorenzo Desideri
Affiliation:
Department of Mental Health, Children and Adolescent Psychiatry Unit, AUSL Bologna, Bologna, Italy
Daniele Durante
Affiliation:
N.P.E.E., Parma AUSL, Parma, Italy
Federica Favero
Affiliation:
Children and Adolescent Psychiatry Unit, Modena AUSL, Sassuolo, Italy
Luisa Iero
Affiliation:
Child Neurology and Psychiatry Unit, Department of Neurological Sciences, University of Bologna, Bologna, Italy
Giulia Magnani
Affiliation:
Department of Mental Health, Children and Adolescent Psychiatry Unit, AUSL Bologna, Bologna, Italy Department of Mental Health, Children and Adolescent Psychiatry Unit, Imola AUSL, Imola, Italy
Valentina Pericoli
Affiliation:
Children and Adolescent Psychiatry Unit, Ravenna AUSL, Ravenna, Italy
Alexia Polmonari
Affiliation:
Children and Adolescent Psychiatry Unit, Ferrara AUSL, Ferrara, Italy
Roberta Raggini
Affiliation:
Children and Adolescent Psychiatry Unit, AUSL Forlì, Forlì, Italy
Elena Raimondi
Affiliation:
Department of Mental Health, Children and Adolescent Psychiatry Unit, AUSL Bologna, Bologna, Italy
Valentina Riboni
Affiliation:
Children and Adolescent Psychiatry Unit, Piacenza AUSL, Piacenza, Italy
Maria Cristina Scaduto
Affiliation:
Child Neurology and Psychiatry Unit, Department of Neurological Sciences, University of Bologna, Bologna, Italy
Alessandro Serretti*
Affiliation:
Institute of Psychiatry, University of Bologna, Bologna, Italy
Giovanni De Girolamo
Affiliation:
IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
*
Alessandro Serretti, MD, PhD, Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy. Tel: +39 051 6584233; Fax: +39 051 521030; E-mail: alessandro.serretti@unibo.it
Get access Rights & Permissions [Opens in a new window]

Abstract

Calati R, Pedrini L, Alighieri S, Alvarez MI, Desideri L, Durante D, Favero F, Iero L, Magnani G, Pericoli V, Polmonari A, Raggini R, Raimondi E, Riboni V, Scaduto MC, Serretti A, De Girolamo G. Is cognitive behavioural therapy an effective complement to antidepressants in adolescents? A meta-analysis.

Objective: Evidence on effectiveness of combined treatments versus antidepressants alone in adolescents consists on a few studies in both major depressive and anxiety disorders. A meta-analysis of randomised 12-week follow-up studies in which antidepressant treatment was compared to combined treatment consisting of the same antidepressant with cognitive behavioural therapy has been performed.

Methods: Data were entered into the Cochrane Collaboration Review Manager software and were analysed within a random effect framework. A quality assessment has been performed through Jadad Scale.

Results: Higher global functioning at the Children's Global Assessment Scale was found in the combined treatment group (p < 0.0001) as well as higher improvement at the Clinical Global Impressions Improvement Scale (p = 0.04). No benefit of combined treatment was found on depressive symptomatology at the Children's Depression Rating Scale – Revised.

Conclusion: Combined treatment seems to be more effective than antidepressant alone on global functioning and general improvement in adolescents with major depressive and anxiety disorders.

Keywords

affective disorderantidepressantsanxietydepressionpsychotherapy
Type
Review Article
Information
Acta Neuropsychiatrica , Volume 23 , Issue 6 , December 2011 , pp. 263 - 271
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Michael, KD, Crowley, SL.How effective are treatments for child and adolescent depression? A meta-analytic review. Clin Psychol Rev 2002;22:247–269.CrossRefGoogle ScholarPubMed
2.Papanikolaou, K, Richardson, C, Pehlivanidis, A, Papadopoulou-Daifoti, Z.Efficacy of antidepressants in child and adolescent depression: a meta-analytic study. J Neural Transm 2006;113:399–415.CrossRefGoogle ScholarPubMed
3.Reinblatt, SP, Riddle, MA.The pharmacological management of childhood anxiety disorders: a review. Psychopharmacology 2007;191:67–86.CrossRefGoogle ScholarPubMed
4.Tsapakis, EM, Soldani, F, Tondo, L, Baldessarini, RJ.Efficacy of antidepressants in juvenile depression: meta-analysis. Br J Psychiatry 2008;193:10–17.CrossRefGoogle ScholarPubMed
5.Masi, G, Liboni, F, Brovedani, P.Pharmacotherapy of major depressive disorder in adolescents. Expert Opin Pharmacother 2010;11:375–386.CrossRefGoogle ScholarPubMed
6.Gentile, S.Antidepressant use in children and adolescents diagnosed with major depressive disorder: what can we learn from published data? Rev Recent Clin Trials 2010;5:63–75.CrossRefGoogle ScholarPubMed
7.Connolly, SD, Bernstein, GA.Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry 2007;46:267–283.CrossRefGoogle ScholarPubMed
8.Birmaher, B, Brent, D, Bernet, W et al. Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry 2007;46:1503–1526.CrossRefGoogle ScholarPubMed
9.NICE. Depression in Children and Young People. Identification and Management in Primary, Community and Secondary Care. 2005. URL http://www.nice.org.uk [accessed on April 2011].Google Scholar
10.Baldwin, DS, Anderson, IM, Nutt, DJ et al. Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2005;19:567–596.CrossRefGoogle ScholarPubMed
11.Thorpe, L, Whitney, DK, Kutcher, SP, Kennedy, SH.Clinical guidelines for the treatment of depressive disorders. VI. Special populations. Can J Psychiatry 2001;46(Suppl. 1):63S–76S.Google ScholarPubMed
12.Tandon, M, Pruett, JRAn overview of the use of antidepressants in children and adolescents. Mo Med 2008;105:79–84.Google ScholarPubMed
13.van Engeland, H.Pharmacotherapy and behaviour therapy–competition or cooperation? Acta Paedopsychiatr 1993;56:123–127.Google ScholarPubMed
14.March, J, Silva, S, Petrycki, S et al. Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial. JAMA 2004;292:807–820.Google ScholarPubMed
15.Brent, D, Emslie, G, Clarke, G et al. Switching to another SSRI or to venlafaxine with or without cognitive behavioral therapy for adolescents with SSRI-resistant depression: the TORDIA randomized controlled trial. JAMA 2008;299:901–913.CrossRefGoogle ScholarPubMed
16.Goodyer, I, Dubicka, B, Wilkinson, P et al. Selective serotonin reuptake inhibitors (SSRIs) and routine specialist care with and without cognitive behaviour therapy in adolescents with major depression: randomised controlled trial. BMJ 2007; 335:142.CrossRefGoogle ScholarPubMed
17.Clarke, G, Debar, L, Lynch, F et al. A randomized effectiveness trial of brief cognitive-behavioral therapy for depressed adolescents receiving antidepressant medication. J Am Acad Child Adolesc Psychiatry 2005;44:888–898.CrossRefGoogle ScholarPubMed
18.Walkup, JT, Albano, AM, Piacentini, J et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med 2008;359:2753–2766.CrossRefGoogle ScholarPubMed
19.Dubicka, B, Elvins, R, Roberts, C, Chick, G, Wilkinson, P, Goodyer, IM.Combined treatment with cognitive-behavioural therapy in adolescent depression: meta-analysis. Br J Psychiatry 2010;197:433–440.CrossRefGoogle ScholarPubMed
20.Jadad, AR, Moore, RA, Carroll, D et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996;17:1–12.CrossRefGoogle ScholarPubMed
21.Egger, M, Smith, GD, Phillips, AN.Meta-analysis: Principles and procedures. BMJ 1997;315:1533–1537.CrossRefGoogle ScholarPubMed
22.Molenaar, PJ, Dekker, J, Van, R, Hendriksen, M, Vink, A, Schoevers, RA.Does adding psychotherapy to pharmacotherapy improve social functioning in the treatment of outpatient depression? Depress Anxiety 2007;24:553–562.CrossRefGoogle ScholarPubMed
23.Sharp, DM, Power, KG, Simpson, RJ, Swanson, V, Anstee, JA.Global measures of outcome in a controlled comparison of pharmacological and psychological treatment of panic disorder and agoraphobia in primary care. Br J Gen Pract 1997;47:150–155.Google Scholar
24.Curry, J, Rohde, P, Simons, A et al. Predictors and moderators of acute outcome in the Treatment for Adolescents with Depression Study (TADS). J Am Acad Child Adolesc Psychiatry 2006;45:1427–1439.CrossRefGoogle ScholarPubMed
25.Asarnow, JR, Emslie, G, Clarke, G et al. Treatment of selective serotonin reuptake inhibitor-resistant depression in adolescents: predictors and moderators of treatment response. J Am Acad Child Adolesc Psychiatry 2009;48:330–339.Google ScholarPubMed
26.March, JS, Silva, S, Petrycki, S et al. The Treatment for Adolescents With Depression Study (TADS): long-term effectiveness and safety outcomes. Arch Gen Psychiatry 2007;64:1132–1143.Google ScholarPubMed