WESTPORT, Aug 31 (Reuters) - Cognitive-behavioral therapy (CBT) was more effective overall than systemic-behavioral family therapy (SBFT) or nondirective supportive therapy (NST) in treating adolescents with major depressive disorder, according to a report in the September Journal of the American Academy of Child and Adolescent Psychiatry.

CBT proved especially effective in adolescents with a comorbid anxiety disorder, but its effectiveness "...plummeted in the face of maternal depressive symptoms," Dr. David A. Brent of the Western Psychiatric Institute and Clinic, Pittsburgh, and colleagues, note in the paper.

Dr. Brent and his colleagues tested the effectiveness of 12 to 16 weekly sessions of CBT, SBFT, and NST in 107 adolescents with major depression.

Overall, adolescents who displayed a comorbid anxiety disorder, greater cognitive depression, and greater hopelessness were more likely to remain depressed following treatment than were the others. When the researchers controlled for these factors, they found that adolescents who received NST were 5.8 times more likely to be depressed than those who received CBT. Those who received SBFT were 3.7 times more likely than the CBT group to remain depressed.

That fact that CBT remained effective, even when controlling for multiple predictors of poor outcome, suggests to the research team that "CBT may be...more likely to work well under 'real world' conditions in the reduction of depressive symptoms."

Journal of the American Academy of Child and Adolescent Psychiatry, 1998;37:906-914.