Outcome at 6 months for 50 adolescents with major depression treated in a health maintenance organization.

OBJECTIVE: To examine the short-term outcome of adolescents with major depressive disorder treated in a health maintenance organization (HMO) setting. METHOD: Fifty consecutive adolescents meeting DSM-IV criteria for major depressive disorder at intake to an HMO clinic completed a Beck Depression Inventory (BDI), Columbia Impairment Scale, and Youth Self-Report (YSR), and a parent completed a Child Behavior Checklist at intake and 2, 4, and 6 months later. RESULTS: Thirty-three percent, 40.6%, and 33% of reporting subjects showed improved mood (defined as BDI score < 9), with 78%, 64%, and 72% reporting (defined as completing a BDI) at 2, 4, and 6 months, respectively. Initial level of impairment correlated with BDI score at 2 months (p = .02) and 4 months (p = .01). Attention problems at intake as measured by the YSR correlated with BDI score at 2 months (p = .002) and 6 months (p = .003). CONCLUSIONS: A minority of adolescents treated with limited, nonspecific psychotherapy and selective serotonin reuptake inhibitors have a BDI score of less than 9 at 2, 4, or 6 months. Self-report of attention problems at intake correlates with ongoing depressive symptomatology.

Duke Scholars

Author John David Hamilton Medicine, Infectious Diseases