Impact of comorbid anxiety in an effectiveness study of interpersonal psychotherapy for depressed adolescents.

OBJECTIVE

To assess the impact of comorbid anxiety on treatment for adolescent depression in an effectiveness study of interpersonal psychotherapy for depressed adolescents (IPT-A).

METHOD

A randomized clinical trial was conducted from April 1, 1999, through July 31, 2002. Sixty-three depressed adolescents, ages 12 to 18, received either IPT-A or treatment as usual delivered by school-based mental health clinicians. Adolescents with and without probable comorbid anxiety disorders were compared on depression and overall functioning. All analyses used an intent-to-treat design.

RESULTS

Comorbid anxiety was associated with higher depression scores at baseline (p <.01) and poorer depression outcome posttreatment (p <.05). IPT-A was nonsignificantly more effective in treating the depression of adolescents with comorbid anxiety (p =.07). Adolescents whose depression and functioning improved during the course of treatment also showed an improvement in anxiety (p <.01), largely irrespective of treatment condition.

CONCLUSIONS

Adolescents with comorbid depression and anxiety present with more severe depression and may be more difficult to treat. Structured treatments like IPT-A may be particularly helpful for comorbidly depressed adolescents as compared to supportive therapy.