What is the best treatment option for adolescent depression: psychotherapy, pharmacotherapy, or a combination of both?

Abstract

What is the best treatment option for adolescent depression: psychotherapy, pharmacotherapy, or a combination of both? Adolescents, like adults may experience depression. However this differs in symptoms from adult depression. The research question for this paper focuses on the optimal treatment for adolescent depression: psychotherapy only, pharmacotherapy only or a combination of both. The population studied was adolescents of both sexes aged 13-19 years experiencing depression. The intervention used was treating adolescent depression by psychotherapy only whilst comparison intervention was treating adolescent depression with either pharmacotherapy only or a combination of psychotherapy and pharmacotherapy. The outcome will present the best treatment for adolescent depression. The inclusion and exclusion criteria applied were the following: adolescents, experiencing depression between the ages of 13- 19; both sexes; mainly Randomized Control Studies; publication dates between the years of 2000-2011; conducted in any type of settings (in or out-patient); written in English language and available in full-text. The dissertation title was divided into three parts so as to facilitate the search. The search was conducted by using several databases and other sources. About 35 articles were selected. However, the research question was further refined to Cognitive Behavioural Therapy (CBT) as the psychotherapy form of choice and Selective Serotonin Reuptake Inhibitors (SSRis) as pharmacotherapy. However, 29 articles were excluded for various reasons. Finally, six research articles were chosen as the key papers for appraisal meeting all inclusion criteria. The Critical Appraisal Tools such as Critical Appraisal Skills Programme (CASP) tool was the chosen method for appraisal. The main result from the evidence indicated that combination treatment produced the most effective results in treating adolescents with depression when compared to treatment with psychotherapy only or pharmacology only. The conclusion is that combination treatment is the optimal treatment for adolescent depression. One desired outcome is combination treatment would be recommended and implicated as the treatment of choice for depression in such population in Malta. B.Sc.(Hons) Mental Health Nursing April 2012 Key words: ADOLESCENT DEPRESSION; PSYCHOTHERAPY; PHARMACOLOGY; CHILD AND ADOLSCENT PSYCHIATRY; COMBINATION TREATMENT; CBT