Extract

Background and study aims Depression in adolescents is a very serious problem with over half of those diagnosed retaining their problem into young adulthood. The current best treatment involves psychological treatment together with an anti-depressant (fluoxetine). After 6 months only 20% show full recovery, 30% improve but are not fully recovered, a further 30% are left with a high number of residual depressive symptoms, and 20% do not respond at all. The reasons for the poor responses are unclear. Thus many patients remain at considerable risk of relapse in the weeks and months following the end of treatment. Given that depression in adulthood is one of the three most important health burdens on UK society, and adolescent brain functioning may influence later development, finding ways to decrease the risk of adolescent recurrent depression through adequate treatment of early episodes would be a major public health advance. The aim of this study is to find out whether increasing the amount and quality of psychological treatments offered in one or both of two ways will increase treatment response, reduce the level of residual symptoms and decrease the proportion of patients at risk for depressive relapse. Who can participate? Patients aged 11 - 17 with severe unipolar major depression What does the study involve? Participants are randomly allocated to one of three groups. One group receives 'treatment as usual' (TAU), generally addressing the life situation of the adolescent and the family plus fluoxetine. The other two groups also receive TAU but also have either brief psychodynamic psychotherapy or cognitive behaviour therapy, the treatments with the strongest evidence and most commonly offered routinely in the NHS but often inadequately or for too short a period. We do not expect that the specialist therapies on their own would effectively treat depression but we predict that, in conjunction with TAU, one or both the therapies will generate better outcomes than TAU alone over a 12-month period. What are the possible benefits and risks of participating? Not provided at time of registration Where is the study run from? Cambridgeshire and Peterborough NHS Foundation Trust (UK) When is the study starting and how long is it expected to run for? October 2009 to March 2015 Who is funding the study? 1. NIHR Health Technology Assessment Programme - HTA (UK) 2. Department of Health (UK) Who is the main contact? Prof. Ian Goodyer [email protected]

Inclusion criteria

• Unipolar major depression of moderate to severe severity

Links

• ictrp
• isrctn