Source: DGNews  |  Posted 8 years ago

By Paula Moyer

MIAMI BEACH, FL -- October 27, 2003 -- Adolescents who are treated for depression in community clinics have lower response rates than those seen in clinical trials, according to findings presented here October 17th at the 50th Anniversary Meeting of the American Academy of Child and Adolescent Psychiatry.

"The research with which we are presented reflects rather cleaned-up samples," said Leo Bastiaens, MD, a clinical associate professor of psychiatry, University of Pittsburgh, where he practices in community mental health centres. "In the real world, patients come to us with a variety of comorbid conditions and problems that may interfere with successful treatment. We need to collect data in the real world to address this gap."

The study involved 24 boys and 28 girls with a mean age of 14.5 years (range 12 to 18 years). Patients had undergone evaluation with the Mini International Neuropsychiatric Interview (MINI) and their parents had completed the Adolescent Symptom Inventory-IV. The study included all patients who had a depressive disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV).

Dr. Bastiaens and his colleagues evaluated patients with the Beck Depression Inventory-Primary Care Version (BDI-PC) and the Sheehan Disability Scale (SDS).

At baseline, patients had an average Global Assessment of Functioning (GAF) score of 45.9. The SDS patient evaluation averaged 12; the SDS parent evaluation was an average of 18. The BDI-PC was an average of 4.2.

All patients received treatment with an antidepressant from the selective serotonin reuptake inhibitor (SSRI) class and had follow-up visits that ranged in frequency from monthly to bimonthly.

Thirty-four patients completed the 6-month study. Among those completing the study, patient and clinician ratings showed that 41% of patients were considered responders to antidepressant therapy and, when parent evaluations were considered, the response rate dropped to 35%. The rates for those who showed some improvement were 82% for patient and clinician ratings and 71% when parent ratings were included.

These responses show the gap between clinical trials, which often exclude several comorbid conditions, and often have more support in their structure for continuing with treatment, Dr. Bastiaens said.

[Study title: Six-Month Response to Antidepressants in Community Clinic Adolescents. Abstract C35]