Remission and residual symptoms after short-term treatment in the Treatment of Adolescents with Depression Study (TADS)
Remission and residual symptoms after short-term treatment in the Treatment of Adolescents with Depression Study (TADS)
复制标题
DOI：
10.1097/01.chi.0000242228.75516.21
复制
发表时间：
2006-12-01
影响因子：
13.3
通讯作者：
March, John
中科院分区：
文献类型：
--
作者：
Kennard, Betsy;Silva, Susan;March, John
目的：确定参与青少年抑郁症治疗研究 (TADS) 的抑郁青少年的缓解率，该研究是一项多中心临床试验，随机将 439 名患有重度抑郁症 (MDD) 的青少年接受为期 12 周的氟西汀 (FLX) 治疗、认知行为治疗 (CBT)、联合治疗 (COMB) 或服用安慰剂 (PBO) 的临床治疗。方法：使用治疗结束时儿童抑郁评分修订量表 (CDRS-R) 总分为 28 分或以下作为缓解标准，通过逻辑回归检查缓解率，控制部位。各治疗组还检查了缓解者 MDD 诊断的丧失和残留症状（定义为临床总体印象改善 (CGI-I) 评分为 1（极大改善）或 2（极大改善））。结果：治疗 12 周后，439 名青少年中有 102 名（23%）达到缓解。COMB 组的缓解率（37%）显着高于其他治疗组（FLX、FLX、 23%；CBT，16%），COMB 与 FLX 的比值比为 2.1，COMB 与 CBT 的比值比为 3.3，COMB 与 PBO 的比值比为 3.0。结论：FLX 和 CBT 联合治疗在缓解率方面优于单一疗法和 PBO，但总体缓解率仍然较低，并且在 12 周治疗结束时残留症状很常见。
Objective: To ascertain remission rates in depressed youth participating in the Treatment for Adolescents With Depression Study (TADS), a multisite clinical trial that randomized 439 adolescents with major depressive disorder (MDD) to a 12-week treatment of fluoxetine (FLX), cognitive-behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO).Method: Using an end-of-treatment Children's Depression Rating Scale-Revised (CDRS-R) total score of 28 or below as the criterion for remission, rates of remission were examined with logistic regression, controlling for site. Loss of MDD diagnosis and residual symptoms in responders (defined as Clinical Global Impressions-Improvement (CGI-I) score of 1 (very much improved) or 2 (much improved) were also examined across treatment groups.Results: After 12 weeks of treatment, 102 (23%) of 439 youths had reached remission. The remission rate was significantly higher in the COMB group (37%) relative to the other treatment groups (FLX, 23%; CBT, 16%; PBO, 17%), with odds ratios of 2.1 for COMB versus FLX, 3.3 for COMB versus CBT, and 3.0 for COMB versus PBO. In addition, 71% of subjects across treatment groups no longer met criteria for MDD at the end of acute treatment. Fifty percent of the youths who responded by CGI-I criteria continued to have residual symptoms, such as sleep or mood disturbances, fatigue, and poor concentration.Conclusions: The combination of FLX and CBT was superior to both monotherapy and PBO in terms of remission rates, but overall rates of remission remain low and residual symptoms are common at the end of 12 weeks of treatment.