According to a new study, the risk of a relapse looms large over nearly half of the teenagers who have recovered from a major bout of depression [a mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity] , irrespective of the kind of therapy they have undergone for the condition.The danger of depression [a mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity] returning was more pronounced in girls and among those who suffered from anxiety.

Lead author of the study, Dr John Curry, professor of psychiatry and behavioral sciences at Duke University Medical Center, Durham, North Carolina stated, "People on short-term treatment programs that didn't really follow through didn't do as well in the long run.

“Big studies like this give clinicians justification for really pushing people to stay in the programs. It's like when you're taking an antibiotic [chemical substances, produced by living organisms or synthesized (created) in laboratories, for the purpose of killing other organisms that cause disease.] , you have to take it all even if you [start] feeling better. The idea is to treat adolescent depression aggressively until all symptoms are gone and the person is better."

Details of the study
The researchers followed the progress of 196 adolescents (110 females and 86 males) diagnosed with major depressive disorder who were part of the Treatment for Adolescents with Depression Study (TADs). The participants were randomly assigned to a short-term treatment intervention program of an antidepressant, psychotherapy, a combination of both, or a placebo for 12 weeks.

A follow-up at five years
A follow-up at five years revealed that the teenagers responded well to all the treatments in the first few years. Nearly 96.4 percent recovered from the initial episode of depression within three and a half years. However, in 47 percent of the recovered teens, the depressive symptoms re-emerged within two years. It was also noted that 57 percent of the female patients experienced a relapse as opposed to 32.9 percent of males.

In addition, the risk of depression returning was elevated in youngsters more prone to an anxiety disorder (61.9 percent vs. 42.2 percent of those without anxiety disorders). Also, teens experiencing a relapse scored high on scales of suicidal thoughts and behaviors.

Curry stated, "Contrary to our hypotheses, neither full response to short-term treatment nor treatment with a combination of fluoxetine and cognitive behavioral therapy reduced the risk of recurrence. "However, short-term treatment non-responders were more likely to experience recurrence than full and partial responders. Females were significantly more likely to have a recurrence than males."

Implications of the study
It is quite clear that though short-term treatment sessions reduce depression, they do not prevent its return completely. The new study reinforces the need for more potent treatments to prevent recurrence of major depression relapse. John Curry stated, “The results do indicate that we need to continue to develop better treatments and that we need to figure out what is triggering the second episodes and find better ways to help them cope with stress without getting into another depressive episode.

“I don't think we need to keep people in weekly treatment beyond 36 weeks, but we may need some way to monitor their symptoms going further forward so we can institute treatment if needed.”The results are published in the journal Archives of General Psychiatry.