Journal of the American Academy of Child & Adolescent Psychiatry
ArticlesImpact of Comorbidity on a Cognitive-Behavioral Group Treatment for Adolescent Depression
Section snippets
Participants and Procedures
Our sample consisted of 151 adolescent (aged 14–18), who were originally recruited and treated in two controlled clinical trials. In the first clinical trial (Lewinsohn et al., 1990), which occurred between 1986 and 1988, 55 adolescents who met DSM-III criteria for major depressive disorder (MDD) or dysthymia were randomly assigned to treatment condition and completed posttreatment assessment. Participants and their parents completed extensive diagnostic and psychosocial measures at intake,
H 1 : Severity at Intake
BDI scores at intake were examined as a function of TOTAL lifetime comorbidity. As shown in Table 1, adolescents with any comorbidity had significantly higher BDI average intake scores compared with adolescents with no history of comorbidity.
BDI intake scores for the three constituent comorbidity diagnoses were also compared. Statistically significant intake BDI differences were found for the participants with ANX versus those with no ANX (BDI mean [SD] = 29.8 [9.7] versus 23.2 [10.0],
DISCUSSION
Which treatments work, for which patients, with which characteristics? This often-posed question is relevant to the present investigation. Given the prevalence of psychiatric comorbidity among adolescents with mood disorders, teasing apart the relative benefits of depression-specific treatments for youths with and without comorbidity is particularly important. Although the general issues of psychiatric comorbidity has received a great deal of research attention, its specific impacts on clinical
REFERENCES (23)
- et al.
Predictors of treatment efficacy in a clinical trial of three psychosocial treatments for adolescent depression
J Am Acad Child Adolesc Psychiatry
(1998) - et al.
Cognitive-behavioral group treatment of adolescent depression: prediction of outcome
Behav Ther
(1992) - et al.
Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions
J Am Acad Child Adolesc Psychiatry
(1999) - et al.
Five-year course of major depression: effects of comorbid alcoholism
J Affect Disord
(1996) - et al.
Comparison between treatment completers and noncompleters among dually diagnosed substance-abusing adolescents
J Am Acad Child Adolesc Psychiatry
(1992) - et al.
Cognitive-behavioral treatment for depressed adolescents
Behav Ther
(1990) - et al.
Major depression in community adolescents: age at onset, episode duration, and time to recurrence
J Am Acad Child Adolesc Psychiatry
(1994) - et al.
Adolescent psychopathology, III: the clinical consequences of comorbidity
J Am Acad Child Adolesc Psychiatry
(1995) - et al.
Retrospective assessment of prepubertal major depression with the Kiddie-SADS-E
J Am Acad Child Psychiatry
(1982) - et al.
Comorbidity of panic and major depressive disorder
J Psychiatr Res
(1993)
An inventory for measuring depression
Arch Gen Psychiatry
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This research was supported in part by NIMH awards MH41278 and MH40501 (to Dr. Lewinsohn), and MH56238 (to Dr. Rohde).