TABLE 1

Direct Evidence

SourceDesignBrief Description of InterventionPopulationSample SizeLength of Follow-UpSummary of Results
Mufson et al, 200426RCTSchool-based health clinic clinicians administered interpersonal therapy for adolescents vs treatment as usualReferred adolescents6316 wk (4 wk after end of treatment)Adolescents treated with QI compared with usual care showed greater symptom reduction and improvement in overall functioning
Walker et al, 200215RCT20-min consultations with practice nurses to discuss health concernsTeenagers invited to general practice consultations15163 and 12 moRecognition of possible depression resulted in improved mental health outcomes at 3 and 12 months; 97% of attenders said they would recommend intervention to a friend
Asarnow et al, 200523RCTQI intervention in 5 primary care clinics, with care managers supporting PCCs in evaluating and managing adolescents' depressionDepressed adolescents4186 moQI adolescents reported significantly fewer depressive symptoms, higher mental health-related quality of life, and greater satisfaction with mental health care
Clarke et al, 200525RCTHMO usual care, (including SSRI medications, pediatric visits, or mental health treatments) vs HMO usual care plus 5–9 sessions of CBTDepressed adolescents in an HMO15252 wkAt 52-week follow-up there was some advantage for the CBT condition on some (but not all) measures. Significantly better outcomes among the “severely depressed” youth receiving the CBT program compared to severely depressed youth receiving only usual care SSRIs; No differences among less depressed youth.
  • HMO indicates health maintenance organization.