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Title: Clinical implications of comorbid behaviour disorder and adolescent depression
Author: Dubicka, Bernadka Walentina
ISNI:       0000 0004 2670 8322
Awarding Body: The University of Manchester
Current Institution: University of Manchester
Date of Award: 2009
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To investigate whether comorbid behaviour disorder (conduct disorder, CD; oppositional defiant disorder, ODD) predicts treatment outcomes in depressed adolescents; to describe the characteristics of depressed adolescents with and without behaviour disorder (BD); and to examine whether there is a differential effect of cognitive behavioural therapy (CBT) on these outcomes in depressed adolescents with CD, ODD or no BD. Depressed adolescents with CD at baseline and 12 weeks will have greater overall difficulties, impairment, suicidality and depression than adolescents with ODD or no BD. There will be a significant CBT treatment within each group. CD cases are more likely to be poorer attenders and will show less improvement than cases of ODD or those with no BD. ODD cases will have intermediate findings for severity and improvement. Overall, there will be an improvement in behavioural symptoms after 12 weeks of treatment. A clinical sample of 208 adolescents with persistent moderate to severe depression was recruited for a randomised controlled trial (Adolescent Depression Anti depressant and Psychotherapy Trial, ADAPT). At baseline there were 30 cases of CD, 31 cases of ODD and 147 adolescents with no BD. Subjects all received a selective serotonin re-uptake inhibitor (SSRl) and treatment as usual (TAU), and half the sample was randomised to receiving weekly CBT during a 12 week acute treatment phase. Depressed adolescents with CD are likely to demonstrate greater impairment and suicidality than those with no BD or ODD, however, show similar levels of improvement after treatment with an SSRl and TAU, with or without CBT. Depressed adolescents with CD can benefit from depression treatment and should be monitored closely for suicide risk.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available