Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder.

OBJECTIVE To determine whether cognitive behaviour therapy is an effective treatment for childhood and adolescent depressive disorder. DESIGN Systematic review of six randomised trials comparing the efficacy of cognitive behaviour therapy with inactive interventions in subjects aged 8 to 19 years with depressive disorder. MAIN OUTCOME MEASURE Remission from depressive disorder. RESULTS The rate of remission from depressive disorder was higher in the therapy group (129/208; 62%) than in the comparison group (61/168; 36%). The pooled odds ratio was 3.2 (95% confidence interval 1.9 to 5.2), suggesting a significant benefit of active treatment. Most studies, however, were based on relatively mild cases of depression and were of only moderate quality. CONCLUSIONS Cognitive behaviour therapy may be of benefit for depressive disorder of moderate severity in children and adolescents. It cannot, however, yet be recommended for severe depression. Definitive large trials will be required to determine whether the results of this systematic review are reliable.