Distinct treatment trajectories vary for childhood depression

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Finding variations in treatment patterns can help close the gap treatment gaps youths with depression.
Finding variations in treatment patterns can help close the gap treatment gaps youths with depression.

(Healthday News) — For youths with depression, there are distinct treatment trajectories, which have varying health outcomes, according to a study published online Nov. 20 in JAMA Pediatrics.

Nina R. Joyce, PhD, from Harvard Medical School in Boston, and colleagues conducted a longitudinal cohort study of youths aged 18 years or younger with a new diagnosis of depression and at least 12 months of follow-up from diagnosis. The authors used latent class models fit to summary measures of psychotherapy and antidepressant use in the 12 months after diagnosis. Data were included for 84,909 individuals with a mean age of 15.0 at index diagnosis.

The researchers found that 70% of individuals received psychotherapy at any point during the assessment period, and 40% were dispensed antidepressants. There were 8 classes identified with distinct treatment trajectories, which were classified into 4 groups: 3 classes received dual therapy (22%), 2 received antidepressant monotherapy (18%), 2 received psychotherapy monotherapy (48%), and 1 class received no treatment (13%). The most common class received psychotherapy monotherapy; during the assessment and post-assessment periods they had the lowest incidence of attempted suicide and inpatient hospitalizations. The highest incidence of attempted suicide during the assessment period and post-assessment period was seen for the group receiving dual therapy.

"In our sample, 13% of youths received no treatment, and 18% received antidepressants without concomitant psychotherapy," the authors write.

Reference

  1. Nina R. Joyce, Megan S. Schuler, Scott E. Hadland, Laura A. Hatfield. Variation in the 12-Month Treatment Trajectories of Children and Adolescents After a Diagnosis of Depression. JAMA Pediatr. Published online November 20, 2017. doi:10.1001/jamapediatrics.2017.3808
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