Depressive Symptoms and Clinical Status During the Treatment of Adolescent Suicide Attempters (TASA) Study

Benedetto Vitiello*, David A. Brent, Laurence L. Greenhill, Graham Emslie, Karen Wells, John T. Walkup, Barbara Stanley, Oscar Bukstein, Betsy D. Kennard, Scott Compton, Barbara Coffey, Mary F. Cwik, Kelly Posner, Ann Wagner, John S. March, Mark Riddle, Tina Goldstein, John Curry, Lisa Capasso, Taryn Mayes & 5 others Sa Shen, S. Sonia Gugga, J. Blake Turner, Shannon Barnett, Jamie Zelazny

*Corresponding author for this work

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Objective: To examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide. Method: Adolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depressive disorder (96.0% had major depressive disorder), and a Children's Depression Rating Scale-Revised (CDRS-R) score of 36 or higher, entered a 6-month treatment with antidepressant medication, cognitive-behavioral therapy focused on suicide prevention, or their combination (Comb), at five academic sites. Treatment assignment could be either random or chosen by study participants. Intent-to-treat, mixed effects regression models of depression and other relevant ratings were estimated. Improvement and remission rates were computed with the last observation carried forward. Results: Most patients (n = 104 or 84%) chose treatment assignment, and overall, three fourths (n = 93) received Comb. In Comb, CDRS-R declined from a baseline adjusted mean of 49.6 (SD 12.3) to 38.3 (8.0) at week 12 and to 27.0 (10.1) at week 24 (p < .0001), with a Clinical Global Impression -defined improvement rate of 58.0% at week 12 and 72.2% at week 24 and a remission (CDRS-R ≤28) rate of 32.5% at week 12 and 50.0% at week 24. The CDRS-R and the Scale for Suicidal Ideation scores were correlated at baseline (r= 0.43, p < .0001) and declined in parallel. Conclusions: When vigorously treated with a combination of medication and psychotherapy, adolescents with depression who have recently attempted suicide show rates of improvement and remission of depression that seem comparable to those observed in nonsuicidal adolescents with depression.

Original languageEnglish (US)
Pages (from-to)997-1004
Number of pages8
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume48
Issue number10
DOIs
StatePublished - Oct 1 2009

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Suicide
Depression
Therapeutics
Attempted Suicide
Suicidal Ideation
Major Depressive Disorder
Cognitive Therapy
Depressive Disorder
Psychotherapy
Antidepressive Agents
Observation

Keywords

  • adolescents
  • depression
  • suicide
  • treatment

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

Vitiello, Benedetto ; Brent, David A. ; Greenhill, Laurence L. ; Emslie, Graham ; Wells, Karen ; Walkup, John T. ; Stanley, Barbara ; Bukstein, Oscar ; Kennard, Betsy D. ; Compton, Scott ; Coffey, Barbara ; Cwik, Mary F. ; Posner, Kelly ; Wagner, Ann ; March, John S. ; Riddle, Mark ; Goldstein, Tina ; Curry, John ; Capasso, Lisa ; Mayes, Taryn ; Shen, Sa ; Gugga, S. Sonia ; Turner, J. Blake ; Barnett, Shannon ; Zelazny, Jamie. / Depressive Symptoms and Clinical Status During the Treatment of Adolescent Suicide Attempters (TASA) Study. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2009 ; Vol. 48, No. 10. pp. 997-1004.
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abstract = "Objective: To examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide. Method: Adolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depressive disorder (96.0{\%} had major depressive disorder), and a Children's Depression Rating Scale-Revised (CDRS-R) score of 36 or higher, entered a 6-month treatment with antidepressant medication, cognitive-behavioral therapy focused on suicide prevention, or their combination (Comb), at five academic sites. Treatment assignment could be either random or chosen by study participants. Intent-to-treat, mixed effects regression models of depression and other relevant ratings were estimated. Improvement and remission rates were computed with the last observation carried forward. Results: Most patients (n = 104 or 84{\%}) chose treatment assignment, and overall, three fourths (n = 93) received Comb. In Comb, CDRS-R declined from a baseline adjusted mean of 49.6 (SD 12.3) to 38.3 (8.0) at week 12 and to 27.0 (10.1) at week 24 (p < .0001), with a Clinical Global Impression -defined improvement rate of 58.0{\%} at week 12 and 72.2{\%} at week 24 and a remission (CDRS-R ≤28) rate of 32.5{\%} at week 12 and 50.0{\%} at week 24. The CDRS-R and the Scale for Suicidal Ideation scores were correlated at baseline (r= 0.43, p < .0001) and declined in parallel. Conclusions: When vigorously treated with a combination of medication and psychotherapy, adolescents with depression who have recently attempted suicide show rates of improvement and remission of depression that seem comparable to those observed in nonsuicidal adolescents with depression.",
keywords = "adolescents, depression, suicide, treatment",
author = "Benedetto Vitiello and Brent, {David A.} and Greenhill, {Laurence L.} and Graham Emslie and Karen Wells and Walkup, {John T.} and Barbara Stanley and Oscar Bukstein and Kennard, {Betsy D.} and Scott Compton and Barbara Coffey and Cwik, {Mary F.} and Kelly Posner and Ann Wagner and March, {John S.} and Mark Riddle and Tina Goldstein and John Curry and Lisa Capasso and Taryn Mayes and Sa Shen and Gugga, {S. Sonia} and Turner, {J. Blake} and Shannon Barnett and Jamie Zelazny",
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Vitiello, B, Brent, DA, Greenhill, LL, Emslie, G, Wells, K, Walkup, JT, Stanley, B, Bukstein, O, Kennard, BD, Compton, S, Coffey, B, Cwik, MF, Posner, K, Wagner, A, March, JS, Riddle, M, Goldstein, T, Curry, J, Capasso, L, Mayes, T, Shen, S, Gugga, SS, Turner, JB, Barnett, S & Zelazny, J 2009, 'Depressive Symptoms and Clinical Status During the Treatment of Adolescent Suicide Attempters (TASA) Study', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 48, no. 10, pp. 997-1004. https://doi.org/10.1097/CHI.0b013e3181b5db66

Depressive Symptoms and Clinical Status During the Treatment of Adolescent Suicide Attempters (TASA) Study. / Vitiello, Benedetto; Brent, David A.; Greenhill, Laurence L.; Emslie, Graham; Wells, Karen; Walkup, John T.; Stanley, Barbara; Bukstein, Oscar; Kennard, Betsy D.; Compton, Scott; Coffey, Barbara; Cwik, Mary F.; Posner, Kelly; Wagner, Ann; March, John S.; Riddle, Mark; Goldstein, Tina; Curry, John; Capasso, Lisa; Mayes, Taryn; Shen, Sa; Gugga, S. Sonia; Turner, J. Blake; Barnett, Shannon; Zelazny, Jamie.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 48, No. 10, 01.10.2009, p. 997-1004.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Depressive Symptoms and Clinical Status During the Treatment of Adolescent Suicide Attempters (TASA) Study

AU - Vitiello, Benedetto

AU - Brent, David A.

AU - Greenhill, Laurence L.

AU - Emslie, Graham

AU - Wells, Karen

AU - Walkup, John T.

AU - Stanley, Barbara

AU - Bukstein, Oscar

AU - Kennard, Betsy D.

AU - Compton, Scott

AU - Coffey, Barbara

AU - Cwik, Mary F.

AU - Posner, Kelly

AU - Wagner, Ann

AU - March, John S.

AU - Riddle, Mark

AU - Goldstein, Tina

AU - Curry, John

AU - Capasso, Lisa

AU - Mayes, Taryn

AU - Shen, Sa

AU - Gugga, S. Sonia

AU - Turner, J. Blake

AU - Barnett, Shannon

AU - Zelazny, Jamie

PY - 2009/10/1

Y1 - 2009/10/1

N2 - Objective: To examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide. Method: Adolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depressive disorder (96.0% had major depressive disorder), and a Children's Depression Rating Scale-Revised (CDRS-R) score of 36 or higher, entered a 6-month treatment with antidepressant medication, cognitive-behavioral therapy focused on suicide prevention, or their combination (Comb), at five academic sites. Treatment assignment could be either random or chosen by study participants. Intent-to-treat, mixed effects regression models of depression and other relevant ratings were estimated. Improvement and remission rates were computed with the last observation carried forward. Results: Most patients (n = 104 or 84%) chose treatment assignment, and overall, three fourths (n = 93) received Comb. In Comb, CDRS-R declined from a baseline adjusted mean of 49.6 (SD 12.3) to 38.3 (8.0) at week 12 and to 27.0 (10.1) at week 24 (p < .0001), with a Clinical Global Impression -defined improvement rate of 58.0% at week 12 and 72.2% at week 24 and a remission (CDRS-R ≤28) rate of 32.5% at week 12 and 50.0% at week 24. The CDRS-R and the Scale for Suicidal Ideation scores were correlated at baseline (r= 0.43, p < .0001) and declined in parallel. Conclusions: When vigorously treated with a combination of medication and psychotherapy, adolescents with depression who have recently attempted suicide show rates of improvement and remission of depression that seem comparable to those observed in nonsuicidal adolescents with depression.

AB - Objective: To examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide. Method: Adolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depressive disorder (96.0% had major depressive disorder), and a Children's Depression Rating Scale-Revised (CDRS-R) score of 36 or higher, entered a 6-month treatment with antidepressant medication, cognitive-behavioral therapy focused on suicide prevention, or their combination (Comb), at five academic sites. Treatment assignment could be either random or chosen by study participants. Intent-to-treat, mixed effects regression models of depression and other relevant ratings were estimated. Improvement and remission rates were computed with the last observation carried forward. Results: Most patients (n = 104 or 84%) chose treatment assignment, and overall, three fourths (n = 93) received Comb. In Comb, CDRS-R declined from a baseline adjusted mean of 49.6 (SD 12.3) to 38.3 (8.0) at week 12 and to 27.0 (10.1) at week 24 (p < .0001), with a Clinical Global Impression -defined improvement rate of 58.0% at week 12 and 72.2% at week 24 and a remission (CDRS-R ≤28) rate of 32.5% at week 12 and 50.0% at week 24. The CDRS-R and the Scale for Suicidal Ideation scores were correlated at baseline (r= 0.43, p < .0001) and declined in parallel. Conclusions: When vigorously treated with a combination of medication and psychotherapy, adolescents with depression who have recently attempted suicide show rates of improvement and remission of depression that seem comparable to those observed in nonsuicidal adolescents with depression.

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