Treatment for depression enhances protection: Findings from the treatment for adolescents with depression study (TADS)

The Treatment for Adolescents With Depression Study (TADS) evaluates the effectiveness of fluoxetine, CBT, and their combination relative to placebo in adolescents with MDD. This report examines treatment influences on protective factors: self-concept and problem-solving skills (individual domain), and family connectedness, parent-child relations, and parental support (family domain). Protective factors were measured prior to treatment, and after 12 and 36 weeks of treatment. Nearly all protective factors improved with treatment. Treatment groups differed in their impact on protective factors. Combined treatment generally outperformed all other groups. CBT enhanced problem-solving skills more than fluoxetine. Fluoxetine enhanced parents' perceptions of parent-child relations by 12 weeks. CBT raised adolescents' perceptions of family connectedness by 36 weeks. CBT has a unique impact on problem-solving ability. Parent and adolescent perceptions of family domain protective factors differ, in that parent perceptions tend to respond quickly to fluoxetine, while adolescent perceptions respond to CBT over time.