Journal of the American Academy of Child & Adolescent Psychiatry
SPECIAL SECTION: TREATMENT FOR ADOLESCENTS WITH DEPRESSION STUDY-TADSPredictors and Moderators of Acute Outcome in the Treatment for Adolescents With Depression Study (TADS)
Section snippets
Participants
As described elsewhere (TADS, 2005), participants were 439 adolescents, recruited at 13 clinical sites, who met DSM-IV criteria (American Psychiatric Association, 1994) for MDD, with stable depressed mood and functional impairment. Their demographic and clinical characteristics are detailed in a previous publication (TADS, 2005) and summarized in the introductory article to this special section by March and colleagues (March et al., 2006). More than half had a diagnosis in addition to MDD; 96%
RESULTS
Results of these analyses are summarized in Table 2. Of the 21 candidate variables tested, nine were determined to be predictors of treatment outcome and three were moderators.
DISCUSSION
Younger, higher functioning, less chronically depressed adolescents with fewer melancholic features, less suicidal ideation, less hopelessness, and higher expectations for improvement from their subsequently assigned treatment were less depressed than their counterparts after acute TADS treatment. Moderators of outcome included family income, severity of depression, and cognitive distortions. Of 21 variables examined as potential moderators or predictors, 12 served one of these functions for
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See end of text for author affiliations.
National Institute of Mental Health (NIMH) Program Staff participated in the design and implementation of the TADS, analysis of the data, and in authoring this article. Lilly, Inc. provided fluoxetine and matching placebo under an independent educational grant to Duke University but otherwise had no role in the design or implementation of the study, data analysis, or in authoring this manuscript. The authors are indebted to the TADS scientific advisors (Susan Essock, Ph.D., Mount Sinai School of Medicine; Barbara Geller, M.D., Washington University in St. Louis; Joel Greenhouse, Ph.D., Carnegie Mellon University; Robert Johnson, M.D., New Jersey Medical School; James Leckman, M.D., Yale University; Lydia Lewis, Depression and Bipolar Support Alliance; Sue Marcus, Ph.D., Mount Sinai School of Medicine; Kevin Stark, Ph.D., University of Texas at Austin) for their contributions to the design and methods of the study; to our cognitive-behavioral therapy consultants, David Brent, M.D., and Greg Clarke, Ph.D.; to the Columbia Suicidality Classification Group led by Kelly Posner, Ph.D., including Maria Oquendo, M.D., Madelyn Gould, Ph.D., M.P.H., and Barbara Stanley, Ph.D.; and to the members of the NIMH Data and Safety Monitoring Board for monitoring the progress of the study. The protocol and manuals used in this study can be found on the web at https://trialweb.dcri.duke.edu/tads/manuals.html. The opinions and assertions contained in this report are the private views of the authors and are not to be construed as official or as reflecting the views of the NIMH, the National Institutes of Health, or the Department of Health and Human Services.
TADS is supported by contract RFP-NIH-NIMH 98-DS-0008 from NIMH to Duke University Medical Center (John March, principal investigator).
Disclosure: Dr. March is on the speakers' bureau of Pfizer and Eli Lilly and receives research support from Eli Lilly, Pfizer, and Wyeth. Dr. Silva is a consultant for Pfizer. Dr. Weller is a consultant for and/or receives grants from Otsuka, AstraZeneca, Pharma, Shire, and Jazz Pharmaceuticals. Dr. Ginsburg received an unrestricted research grant from Pfizer. Dr. Kratochvil receives research support from Eli Lilly, Forest, and GlaxoSmithKline and is a consultant for and on the speakers' bureau of Eli Lilly. Dr. Pathak receives research support from Forest. The other authors have no financial relationships to disclose.