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Half of Teens Treated for Depression Will Relapse

Posted Nov 01 2010 1:00pm
Girls more prone than boys to illness' return within 5 years of therapy, researchers find

Monday, November 1, 2010
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MONDAY, Nov. 1 (HealthDay News) -- Although almost all teens who were treated for major depression initially recovered, about half ended up suffering a relapse within five years, a new study found.

And those recurrences were more likely to strike girls than boys, the researchers found.

"We've known for a long time that people are going to revert back to depression -- that 50 percent would relapse even though they had recovered. I don't think that surprised many people," said Keith Young, vice chair for research in the department of psychiatry and behavioral science at Texas A&M Health Science Center College of Medicine. Young was not involved with the study.

Study lead author John Curry, a professor of psychiatry and behavioral sciences at Duke University, said the findings point up the "need to develop treatments that will prevent recurrence of second depression."

Although some of those treatments may be coming down the pipeline, Young emphasized that the new study provides a clue as to what clinicians could be doing better.

"People on short-term treatment programs that didn't really follow through didn't do as well in the long run. Big studies like this give clinicians justification for really pushing people to stay in the programs," said Young. "It's like when you're taking an antibiotic, you have to take it all even if you [start] feeling better. The idea is to treat adolescent depression aggressively until all symptoms are gone and the person is better."

The findings are published in the Nov. 1 issue of Archives of General Psychiatry.

According to background information in the article, almost 6 percent of adolescent girls and 4.6 percent of boys suffer from major depressive disorder.

Although studies have looked at the short-term outcomes of treatment (which tend to be good), less is known about what happens over the longer term, the study authors stated.

The authors conducted a follow-up of 86 boys and 110 girls with an average of age of about 14 who had participated in a previous randomized trial of four different treatments for major depression: the antidepressant fluoxetine (Prozac) alone; cognitive behavioral therapy alone; a combination of Prozac plus cognitive behavioral therapy; or a placebo.

Not surprisingly, those who had responded completely to treatment (no symptoms) were more likely to experience full recovery than teens who had only responded partially to their treatment, or not at all.

But almost 47 percent of teens in the original study who had received treatment for 12 weeks had a relapse, regardless of which treatment group they had been in and regardless of how well they had been two years after the study.

Girls were more likely to suffer depression again than boys (about 58 percent versus 33 percent, respectively), as were teens with an anxiety disorder.

Why were girls more at risk?

"I don't really know but girls did have more anxiety and that might be the factor, because anxiety disorders also predicted recurrence. And it's generally true that girls have more anxiety disorders than boys," Curry said.

The authors of a second study in the same issue of the journal matched police and medical records of sexual abuse with a listing of psychiatric cases in Victoria, Australia.

The nearly 3,000 children who had been sexually abused were about twice as likely to develop psychosis in later life, and 2.6 times more likely to develop schizophrenia, said researchers led by Margaret Cutajar of Monash University, in Victoria.

The risk was higher if the abuse involved penetration, especially if it occurred during the ages of 12 through 16, and if more than one abuser was involved, the researchers said.

SOURCE: John Curry, Ph.D., professor of psychiatry and behavioral sciences, Duke University, Durham, N.C.; Keith A. Young, Ph.D., vice chair for research, department of psychiatry and behavioral science, Texas A&M Health Science Center College of Medicine, and core leader for neuroimaging and genetics, Center of Excellence for Research on Returning War Veterans, Temple, Texas; Nov. 1, 2010, Archives of General Psychiatry


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