Distinct treatment trajectories vary for childhood 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.
- 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