Relapse Risk for Recovered Hard to Treat Depression Teens

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Those young people, who get to the remission stage by the time six months have passed, are still at risk of relapse according to new research now published in the Journal of Clinical Psychiatry.

These teens are ones who are dealing with hard to treat depression; the data which backs up the relapse prognosis is from long term analysis from a NIMH-funded study. The end result of the research is a reiteration that there is a need for highly aggressive treatment needed for teenagers who have stubborn hard to eradicate depression.

The name of the study was: Treatment of Resistant Depression in Adolescents (TORDIA) study. Those young people who had shown no signs of improvement from their depression in the initial action when serotonin uptake inhibitor antidepressants were used, were given a random assigning to the study. Four different interventions were possible, each of which would last for 12 weeks.

There was the opportunity to switch to a different drug of this nature (SSRI) or to a serotonin reuptake inhibitor, so too the patients could have had their drug treatment changed to venlafaxine plus CBT.

After a six month period, four in ten of the subjects experienced total remission from their depression. At that point they were removed from the study and directed to continue with their care within their own community, with their only return booked in for a year and a half down the line.

Out of 334 young people who had commenced the study more than 60% had reached the point of remission by the year and a half period. There were some patients who even at this point still complained of experiencing residual symptoms, these symptoms included low self esteem, fatigue, and irritability.

If there was more severe depression evident at this ‘baseline’ point of a year and a half those individuals were less likely to arrive at remission at the end point, whilst those who were early responders perhaps within the first month and a half of treatment were more likely to get to the point of remission. The drugs applied in the initial treatment it was evident, didn’t influence the time at which remission occurred or the rate of remission.

The study found that whilst 130 participants had show remission by the six month mark, more than a quarter of these had a relapse by the year and a half point. It was noted that whites stood a smaller chance of relapse than ethnic minorities.

It was concluded by the study authors that effective interventions are needed early in the process of treatment, this was needed as more than a third of the teenagers in the study did not recover at all, and the quarter of all relapses was a very high stat. The authors also determined from the study that there is a need for new methods to make an accurate identification of who will and who will not, respond early to treatment.

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