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Psychological treatment of depression in children and adolescents

A review of treatment research

Published online by Cambridge University Press:  03 January 2018

Richard Harrington*
Affiliation:
Department of Child and Adolescent Psychiatry, Royal Manchester Children's Hospital, Manchester
Jane Whittaker
Affiliation:
Department of Child and Adolescent Psychiatry, Royal Manchester Children's Hospital, Manchester
Philp Shoebridge
Affiliation:
Department of Child and Adolescent Psychiatry, Royal Manchester Children's Hospital, Manchester
*
Professor Richard Harrington, Department of Child and Adolescent Psychiatry, Royal Manchester Children's Hospital, Pendlebury, Manchester M27 1HA. Fax: 0161 728 2294. E-mail: [email protected]

Abstract

Background

This paper reviews research on the psychological treatment of depression in children.

Method

Manual and computer literature searches were performed.

Results

The most promising psychological interventions for depression in children are individual rather than family therapies. Cognitive – behavioural therapy seems to be an effective treatment for depressive symptoms and mild depressive disorders. It may also be a useful preventive intervention, though this remains to be conclusively demonstrated. There have been no systematic studies comparing psychological treatments with medication.

Conclusions

Studies comparing psychological treatments and medication are now required.

Type
Review Article
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

Asarnow, J. R., Goldstein, M. J., Lompson, M., et al (1993) One-year outcomes of depressive disorders in child psychiatric inpatients: evaluation of the prognostic power of a brief measure of expressed emotion. Journal of Child Psychology and Psychiatry, 34, 129137.Google Scholar
Barrett, P. M., Dadds, M. R. & Rapee, R. M. (1996) Family treatment of childhood anxiety: a controlled trial. Journal of Consulting and Clinical Psychology, 64, 333342.Google Scholar
Beardslee, W. R., v Salt, P., Porterfield, K., et of (1993) Comparison of preventive interventions for families with parental affective disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 254263.CrossRefGoogle ScholarPubMed
Beardslee, , Wright, E., Rothberg, P. C., et al (1996) Response of families to two preventive intervention strategies: long-term differences in behavior and attitude change. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 774782.Google Scholar
Beck, A. T., Rush, A. J., Shaw, B. F., et al (1979) Cognitive Therapy of Depression. New York: Guilford Press.Google Scholar
Brady, E. U. & Kendall, P. C. (1992) Comorbidity of anxiety and depression in children and adolescents. Psychological Bulletin, III, 244255.Google Scholar
Brent, D., Holder, D., Kolko, D., et al (1997) A clinical psychotherapy trial for adolescent depression comparing cognitive, family, and supportive treatments. Archives of General Psychiatry, 54, 877885.Google Scholar
Brent, , Kolko, D., Birmaher, B., et al (1998) A clinical trial of three psychosocial treatments for adolescent depression: predictors of overall and differential treatment efficacy. Journal of the American Academy of Child and Adolescent Psychiatry, in press.CrossRefGoogle Scholar
Butler, L., Meizitis, S., Friedman, R., et al (1980) The effect of two school-based intervention programs on depressive symptoms in pre-adolescents. American Educational Research Journal, 17, 111119.Google Scholar
Clarke, G. N., Hops, H., Lewinsohn, P. M., et al (1992) Cognitive-behavioral group treatment of adolescent depression: prediction of outcome. Behavior Therapy, 23, 341354.CrossRefGoogle Scholar
Clarke, , Hawkins, W., Murphy, M., et al (1993) School-based primary prevention of depressive symptomatology in adolescents. Findings from two studies. Journal of Adolescent Research, 8, 183204.Google Scholar
Clarke, , Hawkins, W., Murphy, M., et al (1995) Targeted prevention of unipolar depressive disorder in an at-risk sample of high school adolescents: a randomized trial of a group cognitive intervention. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 312321.CrossRefGoogle Scholar
Cole, D. A. (1990) Relation of social and academic competence to depressive symptoms in childhood. Journal of Abnormal Psychology, 99, 422429.Google Scholar
Cooper, P. J. & Goodyer, I. (1993) A community study of depression in adolescent girls: I. Estimates of symptom and syndrome prevalence. British Journal of Psychiatry, 163, 369374.Google Scholar
Curry, J. F. & Craighead, W. E. (1990) Attributional style in clinically depressed and conduct disordered adolescents. Journal of Clinical and Consulting Psychology, 58, 109116.CrossRefGoogle ScholarPubMed
Elkin, I., Shea, T., Watkins, J. T., et al (1989) National Institute of Mental Health treatment of depression collaborative research program. General effectiveness of treatments. Archives of General Psychiatry, 46, 971982.Google Scholar
Emslie, G., Rush, A., Weinberg, W., et al (1997) A double-blind, randomized placebo-controlled trial of fluoxetine in depressed children and adolescents. Archives of General Psychiatry, 54, 10311037.CrossRefGoogle ScholarPubMed
Fine, S., Forth, A., Gilbert, M., et al (1991) Group therapy for adolescent depressive disorder: a comparison of social skills and therapeutic support. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 79–75.Google ScholarPubMed
Goodyer, I. M., Herbert, J., Tamplin, A., et al (1997) Short-term outcome of major depression: II. Life events, family dysfunction, and friendship difficulties as predictors of persistent disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 474480.Google Scholar
Gorell-Barnes, G. (1994) Family therapy. In Child and Adolescent Psychiatry: Modem Approaches (3rd edn) (eds Rutter, M. Taylor, E. & Hersov, L.), pp. 946965. Oxford: Blackwell Scientific.Google Scholar
Graham, P. (1994) Prevention. In Child and Adolescent Psychiatry: Modern Approaches (3rd edn) (eds Rutter, M., Taylor, E. & Hersov, L.), pp. 815828. Oxford: Blackwell Scientific.Google Scholar
Hammen, C. (1991) Depression Runs in Families. The Social Context of Risk and Resilience in Children of Depressed Mothers. New York: Springer-Verlag.Google Scholar
Harrington, R. C. (1992) Annotation: the natural history and treatment of child and adolescent affective disorders. Journal of Child Psychology and Psychiatry, 33, 12871302.Google Scholar
Harrington, R. C. (1993) Depressive Disorder in Childhood and Adolescence. Chichester: Wiley Google Scholar
Harrington, R. C. (1996) Family-genetic findings in child and adolescent depressive disorders. International Review of Psychiatry, 8, 355368.CrossRefGoogle Scholar
Harrington, R. C. (1997) Roles of the child and adolescent mental health service in preventing later depressive disorder: problems and prospects. Child Psychology and Psychiatry Review, 2, 4657.Google Scholar
Harrington, R. C., Fudge, H., Rutter, M., et al (1990) Adult outcomes of childhood and adolescent depression: I. Psychiatric status. Archives of General Psychiatry, 47, 465473.CrossRefGoogle ScholarPubMed
Harrington, R. C., Fudge, H., Rutter, M., et al (1991) Adult outcomes of childhood and adolescent depression: II. Risk for antisocial disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 434439.Google Scholar
Harrington, R. C., Bredenkamp, D., Groothues, C., et al (1994) Adult outcomes of childhood and adolescent depression. III. Links with suicidal behaviours. Journal of Child Psychology and Psychiatry, 35, 13801391.CrossRefGoogle ScholarPubMed
Harrington, R. C., & Vostanis, P. (1995) Longitudinal perspectives and affective disorder in children and adolescents. In The Depressed Child and Adolescent. Developmental and Clinical Perspectives (ed. Goodyer, I. M.), pp. 311341. Cambridge: Cambridge University Press.Google Scholar
Harrington, R. C., Rutter, M., Weissman, M., et al (1997) Psychiatric disorders in the relatives of depressed probands. I. Comparison of prepubertal, adolescent and early adult onset forms. Journal of Affective Disorders, 42, 922.Google Scholar
Harrington, R. C., Whittaker, J., Shoebridge, P., et al (1998a) Systematic review of efficacy of cognitive–behavioural therapies in child and adolescent depressive disorder. British Medical Journal, 316, 15591563.CrossRefGoogle ScholarPubMed
Harrington, R. C., Kerfoot, M., Dyer, E., et al (1998b) Randomized trial of a home-based family intervention for children who have deliberately poisoned themselves. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 512518.Google Scholar
Harrington, R. C., Wood, A. & Verduyn, C. (1998c) Principles and practice of cognitive-behavioural therapy in clinically depressed adolescents. In Cognitive Behaviour Therapy for Children and their Families (ed. Graham, P.), pp. 163200. Cambridge: Cambridge University Press.Google Scholar
Hazell, P., O'Connell, D., Heathcote, D., et al (1995) Efficacy of tricyclic drugs in treating child and adolescent depression: a meta-analysis. British Medical Journal, 310, 897901.Google Scholar
Hibbs, E. D. & Jensen, P. S., (eds) (1996) Psychosocial Treatments for Child and Adolescent Disorders. Empirically Based Strategies for Clinical Practice. Washington, DC: American Psychological Association.Google Scholar
Hodges, K., Kline, J., Stern, L., et al (1982) The development of a child assessment interview for research and clinical use. Journal of Abnormal Child Psychology, 10, 173189.CrossRefGoogle ScholarPubMed
Jaycox, L. H., Reivich, K. J., Gillham, , et al (1994) Prevention of depressive symptoms in school children. Behavior Research and Therapy, 32, 801816.Google Scholar
Jayson, D., Wood, A. J., Kroll, L., et al (1998) Predictors of response to cognitive-behaviour therapy in adolescent depressive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 3539.Google Scholar
Kahn, J. S., Kehle, T. J., Jenson, W. R., et al (1990) Comparison of cognitive-behavioral, relaxation, and self-modeling interventions for depression among middle-school students. School Psychology Review, 2, 196211.Google Scholar
Kaslow, N. J., Rehm, L. P., Pollack, S. L., et al (1998) Attributional style and self-control behavior in depressed and nondepressed children and their parents. Journal of Abnormal Child Psychology, 16, 163175.Google Scholar
Kazdin, A. E. (1997) Practitioner review: psychosocial treatments for conduct disorder in children. Journal of Child Psychology and Psychiatry, 38, 161178.Google Scholar
Kendall, P. C., Stark, K. D. & Adam, T. (1990) Cognitive deficit or cognitive distortion in childhood depression. Journal of Abnormal Child Psychology, 18, 255270.CrossRefGoogle ScholarPubMed
Kendall, P. C., Fannery-Schroeder, E., Panichelli-Mindel, S. M., et al (1997) Therapy for youths with anxiety disorders: a second randomized clinical trial. Journal of Consulting and Clinical Psychology, 65, 366380.CrossRefGoogle ScholarPubMed
King, C. A. & Kirschenbaum, D. S. (1990) An experimental evaluation of a school-based program for children at risk: Wisconsin early intervention. Journal of Community Psychology, 18, 167177.Google Scholar
Klerman, G. L. & Weissman, M. M. (1992) Interpersonal psychotherapy. In Handbook of Affective Disorders (2nd edn) (ed. Paykel, E. S.), pp. 501510. Edinburgh: Churchill Livingstone.Google Scholar
Kolvin, I., Garside, R. F., Nicol, A. R., et al (1981) Help Starts Here. London: Tavistock.Google Scholar
Kovacs, M. (1981) Rating scales to assess depression in school aged children. Acta Paedopsychiatrica, 46, 305315.Google ScholarPubMed
Kovacs, M., Feinberg, T. L., Crouse-Novak, M. A., et al (1984a) Depressive disorders in childhood. I. A longitudinal prospective study of characteristics and recovery. Archives of General Psychiatry, 41, 229237.Google Scholar
Kovacs, M., Feinberg, T. L., Crouse-Novak, M., et al (1984b) Depressive disorders in childhood. II. A longitudinal study of the risk for a subsequent major depression. Archives of General Psychiatry, 41, 643649.CrossRefGoogle Scholar
Kovacs, M., & Goldston, D. (1991) Cognitive and social cognitive development of depressed children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 388392.Google Scholar
Kroll, L., Harrington, R. C., Gowers, S., et al (1996) Continuation of cognitive-behavioural treatment in adolescent patients who have remitted from major depression. Feasibility and comparison with historical controls. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 11561161.Google Scholar
Lewinsohn, P. M., Clarke, G. N., Hops, H., et al (1990) Cognitive-behavioural treatment for depressed adolescents. Behavior Therapy, 21, 385401.Google Scholar
Lewinsohn, P. M., Clarke, G. N., Rohde, P., et al (1996) A course in coping: a cognitive-behavioral approach to the treatment of adolescent depression. In Psychosocial Treatments for Child and Adolescent Disorders. Empirically Based Strategies for Clinical Practice (eds Hibbs, E. & Jensen, P. S.), pp. 109135. Washington, DC: American Psychological Association.Google Scholar
Uddle, B. & Spence, S. H. (1990) Cognitive-behavioural therapy with depressed primary school children: a cautionary note. Behavioural Psychotherapy, 18, 85102.Google Scholar
Marcotte, D. & Baron, P. (1993) L'efficacité d'une stratégie d'intervention émotivo-rationnelle auprès d'adolescents dépressifs du milieu scolaire. Canadian Journal of Counselling, 27, 7792.Google Scholar
McCauley, E., Mitchell, J. R., Burke, P., et al (1988) Cognitive attributes of depression in children and adolescents. Journal of Consulting and Clinical Psychology, 56, 903908.Google Scholar
Meyer, A. (1957) Psychobiology: A Science of Man. Springfield, IL: C. C. Thomas.Google Scholar
Moreau, D., Mufson, L., Weissman, M. M. L., et al (1991) Interpersonal psychotherapy for adolescent depression: description of modification and preliminary application. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 642651.Google Scholar
Mufson, L., Moreau, D., Weissman, M. M., et al (1993) Interpersonal Psychotherapy for Depressed Adolescents. New York: Guilford Press.Google Scholar
Mufson, L., Moreau, D., & Weissman, M. M., (1996) Focus on relationships: interpersonal psychotherapy for adolescent depression. In Psychosocial Treatments for Child and Adolescent Disorders: Empirically Based Strategies for Clinical Practice (eds Hibbs, E. D. & Jensen, P. S.), pp. 137155. Washington. DC: American Psychological Association.CrossRefGoogle Scholar
Myers, K., McCauley, E., Calderon, R., et al (1991) The three-year longitudinal course of suicidally and predictive factors for subsequent suicidally in youths with major depressive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 804810.Google Scholar
Pocock, S. J. (1983) Clinical Trials: A Practical Approach. Chichester: Wiley.Google Scholar
Puig-Antich, J. & Chambers, W. (1978) The Schedule for Affective Disorders and Schizophrenia for School-Age Children. New York: New York State Psychiatric Institute.Google Scholar
Radioff, L. S. (1997) The CES-D scale. Applied Psychological Measurement, 1, 385401.Google Scholar
Rao, U., Weissman, M. M., Martin, J. A., et al (1993) Childhood depression and risk of suicide: preliminary report of a longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 2127.CrossRefGoogle ScholarPubMed
Reed, M. K. (1994) Social skills training to reduce depression in adolescents. Adolescence, 29, 293302.Google Scholar
Rehm, L. P. & Sharp, R. N. (1996) Strategies for childhood depression. In Cognitive Therapy with Children and Adolescents: A Casebook for Clinical Practice (eds Reineke, M. A., Dattilio, F. M. & Freeman, A.), pp. 103123. New York: Guilford Press.Google Scholar
Reynolds, W. M. (1987) Reynolds Adolescent Depression Scale. Odessa. FL: Psychological Assessment Resources.Google Scholar
Reynolds, W. M. & Coats, K. I. (1986) A comparison of cognitive-behavioural therapy and relaxation training for the treatment of depression in adolescents. Journal of Consulting and Clinical Psychology, 54, 653660.Google Scholar
Rossello, J. & Bernal, G. (1996) Adapting cognitive-behavioural and interpersonal treatments for depressed Puerto Rican adolescents. In Psychosocial Treatments for Child and Adolescent Disorders: Empirically Based Strategies for Clinical Practice (eds Hibbs, E. D. & Jensen, P. S.), pp. 157185. Washington. DC: American Psychological Association.Google Scholar
Sandler, I. N., West, S. G., Baca, L., et al (1992) Linking empirically based theory and evaluation: the family bereavement program. American Journal of Community Psychology, 20, 491521.Google Scholar
Scott, J. & Moorhead, S. (1998) Cognitive therapy training for psychiatrists. Advances in Psychiatric Treatment, 4, 39.Google Scholar
Stark, K. D. (1990) Childhood Depression: School-Based Intervention. New York: Guilford.Google Scholar
Stark, K. D., Reynolds, W. M. & Kaslow, N. (1987) A comparison of the relative efficacy of self-control therapy and a behavioral problem-solving therapy for depression in children. Journal of Abnormal Child Psychology, 15, 91113.Google Scholar
Strober, M., Schmidt-Lackner, S., Freeman, R., et al (1995) Recovery and relapse in adolescents with bipolar affective illness: a five-year naturalistic, prospective follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 724731.Google Scholar
Vostanis, P., Feehan, C., Grattan, E., et al (1996a) Treatment for children and adolescents with depression: lessons from a controlled trial. Clinical Child Psychology and Psychiatry, 1, 199212.Google Scholar
Vostanis, P., Feehan, C., Grattan, E., et al (1996b) A randomized controlled out-patient trial of cognitive-behavioural treatment for children and adolescents with depression: nine-month follow-up. Journal of Affective Disorders, 40, 105116.Google Scholar
Weisz, J. R., Thurber, C. A., Sweeney, L., et al (1997) Brief treatment of mild-to-moderate child depression using primary and secondary control enhancement training. Journal of Consulting and Clinical Psychology, 65, 703707.Google Scholar
Wilkes, T. C. R., Belsher, G., Rusher, A. J., et al (eds) (1994) Cognitive Therapy for Depressed Adolescents. New York: Guilford.Google Scholar
Wood, A. J., Harrington, R. C. & Moore, A. (1996) Controlled trial of a brief cognitive-behavioural intervention in adolescent patients with depressive disorders. Journal of Child Psychology and Psychiatry, 37, 737746.Google Scholar
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