Abstract:
OBJECTIVE:The cost-effectiveness of three active interventions for major depression in adolescents was compared after 36 weeks of treatment in the Treatment of Adolescents with Depression Study. METHOD:Outpatients aged 12 to 18 years with a primary diagnosis of major depression participated in a randomized controlled trial conducted at 13 U.S. academic and community clinics from 2000 to 2004. Three hundred twenty-seven participants randomized to 1 of 3 active treatment arms, fluoxetine alone (n = 109), cognitive-behavioral therapy (n = 111) alone, or their combination (n = 107), were evaluated for a 3-month acute treatment and a 6-month continuation/maintenance treatment period. Costs of services received for the 36 weeks were estimated and examined in relation to the number of depression-free days and quality-adjusted life-years. Cost-effectiveness acceptability curves were also generated. Sensitivity analyses were conducted to assess treatment differences on the quality-adjusted life-years and cost-effectiveness measures. RESULTS:Cognitive-behavioral therapy was the most costly treatment component (mean $1,787 [in monotherapy] and $1,833 [in combination therapy], median $1,923 [for both]). Reflecting higher direct and indirect costs associated with psychiatric hospital use, the costs of services received outside Treatment of Adolescents with Depression Study in fluoxetine-treated patients (mean $5,382, median $2,341) were significantly higher than those in participants treated with cognitive-behavioral therapy (mean $3,102, median $1,373) or combination (mean $2,705, median $927). Accordingly, cost-effectiveness acceptability curves indicate that combination treatment is highly likely (>90%) to be more cost-effective than fluoxetine alone at 36 weeks. Cognitive-behavioral therapy is not likely to be more cost-effective than fluoxetine. CONCLUSIONS:These findings support the use of combination treatment in adolescents with depression over monotherapy.
journal_name
J Am Acad Child Adolesc Psychiatryauthors
Domino ME,Foster EM,Vitiello B,Kratochvil CJ,Burns BJ,Silva SG,Reinecke MA,March JSdoi
10.1097/CHI.0b013e3181a2b319subject
Has Abstractpub_date
2009-07-01 00:00:00pages
711-720issue
7eissn
0890-8567issn
1527-5418pii
S0890-8567(09)60108-8journal_volume
48pub_type
杂志文章,多中心研究,随机对照试验abstract:OBJECTIVE:The present investigation tested the hypothesis that low resting salivary cortisol concentration in preadolescent boys would be associated with aggressive behavior later in adolescence. Second, it tested whether personality traits would mediate this relation. METHOD:Resting salivary cortisol concentrations f...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/01.CHI.0000070246.24125.6D
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:To compare the pattern of familial aggregation of psychopathology in children who are good responders (GR) to methylphenidate (MPH) versus those who are poor responders (PR). METHOD:A total of 118 clinically referred children ages 6 to 12 years, diagnosed with ADHD participated in a double-blind, placebo-con...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.chi.0000184932.64294.d9
更新日期:2006-01-01 00:00:00
abstract::Part II of this review critically evaluates antidepressants' (AD) efficacy in children and adolescents with anxiety, physical, and behavioral disorders as well as AD's side-effect spectrum. AD are administered increasingly to youths with specific anxiety syndromes phenomenologically paralleling those in adults which a...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,评审
doi:10.1097/00004583-199305000-00001
更新日期:1993-05-01 00:00:00
abstract::The sudden death of three children receiving the tricyclic antidepressant medication desipramine for behavioral disorders was reported in 1990. We now provide new information about these children and describe a fourth case. Because desipramine is a useful medication for many children, these deaths pose clinical dilemm...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,评审
doi:10.1097/00004583-199307000-00013
更新日期:1993-07-01 00:00:00
abstract::This study is a clinical extension of two previous epidemiological studies on problem behavior in international adoptees. In depth pictures were obtained by clinical interviews of 132 14-year-old international adoptees and their parents. Children were selected on the basis of previously obtained Child Behavior Checkli...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199005000-00014
更新日期:1990-05-01 00:00:00
abstract::A 4-year-old girl presented for a psychiatric evaluation with reported episodes of clumsiness, aggressiveness, lack of relatedness, and temper tantrums. Her evaluation disclosed multiple developmental deficits, including cognitive, affective, and social lags. Given her individual history and her specific constellation...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199105000-00024
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:The 12-month prevalence of DSM-III-R anxiety disorders and intrafamilial stress ratings were determined in 23 children with hemophilia, 37 children with asthma, and 31 healthy children. METHOD:Diagnoses were made using the parent and child versions of the Kiddie Schedule for Affective Disorders and Schizophr...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199305000-00011
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:Several studies have documented a profile of elevated scores on the Attention Problems, Aggressive Behavior and Anxious/Depressed scales of the Child Behavior Checklist (CBCL) in youth with bipolar disorder. The sum of these scales, referred to as the CBCL Juvenile Bipolar Disorder (JBD) phenotype, has modest...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:
更新日期:2010-04-01 00:00:00
abstract::Despite recent reports that clozapine is useful for the treatment of chronic schizophrenics resistant to neuroleptics, no studies have been reported in adolescents with schizophrenia. Despite the risk of potentially fatal agranulocytosis, clozapine's use in adolescents may become important because of its lack of extra...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199201000-00024
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:To study the associations between sleep quality/quantity and performance in auditory/visual working memory tasks of different load levels. METHOD:Sixty schoolchildren aged 6 to 13 years from normal school classes voluntarily participated. Actigraphy measurement was done during a typical school week for 72 co...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 临床试验,杂志文章
doi:10.1097/00004583-200301000-00014
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:The Strengths and Difficulties Questionnaire is a 25-item instrument developed to assess emotional and behavioral problems. The current study attempted to replicate previous European structural analyses and to describe the latent dimensions that underlie responses to the parent-reported version of the Strengt...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/01.chi.0000132808.36708.a9
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:We conducted a meta-analysis to examine the following: the time course of response to selective serotonin reuptake inhibitors (SSRIs) and clomipramine in pediatric obsessive-compulsive disorder (OCD); whether higher doses of SSRIs are associated with an improved response in pediatric OCD; differences in effic...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jaac.2016.07.768
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:To examine the efficacy of a modular cognitive-behavioral therapy (CBT) protocol relative to treatment as usual (TAU) among children with high-functioning autism spectrum disorders (ASD) and clinically significant anxiety. METHOD:A total of 45 children (7-11 years of age) with high-functioning ASD and clinic...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jaac.2012.11.007
更新日期:2013-02-01 00:00:00
abstract::For several decades, national surveys and reports have well documented the serious, growing, and unmet need for mental and behavioral health services among children, adolescents, and young adults (C/A/YA) in the United States.1-3 Moreover, shortages and maldistribution of child and adolescent psychiatrists have been r...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 社论
doi:10.1016/j.jaac.2019.09.028
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:This study examined predictors of strategies used to cope with pain in children with sickle cell disease and their mothers. METHOD:Disease severity, socioeconomic status, child adjustment and adaptive behavior, maternal psychopathology, and family functioning were examined in 55 mother-child dyads to determi...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199411000-00005
更新日期:1994-11-01 00:00:00
abstract::A case highlighting the association of epilepsy with psychopathology is reported. The patient suffered a rare and extreme behavioral disturbance, characterized by persistent disruptive behavior and intermittent bizarre and violent outbursts. These outbursts often appeared purposeful, but some of them were later diagno...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199810000-00019
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:This longitudinal study examined whether responsiveness of the neurotransmitter serotonin (5-HT) in childhood predicts adolescent aggression. METHOD:Boys (N = 33) with disruptive behavior disorders who received assessments of central 5-HT function via the prolactin response to fenfluramine between 1990 and 1...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/01.chi.0000220855.79144.ae
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:To develop a reliable and valid child and parent self-report instrument to screen children with anxiety disorders. METHOD:An 85-item questionnaire was administered to 341 outpatient children and adolescents and 300 parents. Utilizing item analyses and factor analyses, the original scale was reduced to 38 ite...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199704000-00018
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:To explore the relationship between behavior problems and ethnic factors in indigenous minority Sami and Norwegian majority adolescents in northern Norway. METHOD:The Youth Self-Report (YSR) was completed by 249 Sami and 210 Norwegian students in junior high school, aged 13 to 16 years. Parents completed the...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199807000-00014
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:Examine the relations of attention-deficit/hyperactivity disorder (ADHD) diagnosis and symptom domains with parenting practices. METHOD:One hundred eighty-one children (ages 6-12 years) were assessed for ADHD and non-ADHD status via parent semistructured clinical interview (Diagnostic Interview Schedule for ...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/CHI.0b013e31819176d0
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:Younger siblings of children with autism spectrum disorder (ASD) are at high risk (HR) for developing ASD as well as features of the broader autism phenotype. Although this complicates early diagnostic considerations in this cohort, it also provides an opportunity to examine patterns of behavior associated sp...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jaac.2014.09.015
更新日期:2014-12-01 00:00:00
abstract::Child psychiatric epidemiology over the last 25 years is reviewed in terms of conceptual and methodological issues arising out of substantive findings. The Isle of Wight surveys undertaken in the mid-1960s are briefly described to establish a starting point, and progress since then is reviewed in terms of topics not o...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,评审
doi:10.1097/00004583-198909000-00001
更新日期:1989-09-01 00:00:00
abstract::The relationship between adolescent bipolar illness and personality disorder has not been explored. Studies of adult bipolars suggest a bipolar illness/borderline personality disorder (BPD) association. Twenty euthymic bipolar teens were assessed using the Personality Disorders Examination. Thirty-five percent met DSM...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199005000-00004
更新日期:1990-05-01 00:00:00
abstract::The period spanning late childhood and early adulthood is of critical importance to mental health. This is a time of extensive brain reorganization, driven by interactions between environmental exposures, changes in the social role of individuals, and biologically programmed processes, which sets the foundation for ad...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 评论,社论
doi:10.1016/j.jaac.2019.03.010
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:Bulimia nervosa (BN) is characterized by excessive attention to self and specifically to body shape and weight, but the ventral attention (VAN) and default mode (DMN) networks that support attentional and self-referential processes are understudied in BN. This study assessed whether altered functional connect...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2018.09.433
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To design a treatment manual and adherence measure for attachment-based family therapy (ABFT) for adolescent depression and to collect pilot data on the treatment's efficacy. METHOD:Over a period of 2 years, 32 adolescents meeting criteria for major depressive disorder (MDD) were randomly assigned to 12 week...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004583-200210000-00008
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To assess the presence of traits of separation anxiety disorder in boys referred clinically for gender identity disorder. METHOD:One hundred fifteen boys were referred to a specialty clinic for concerns about their gender identity development. They were divided into two subgroups: one group met the complete ...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199606000-00019
更新日期:1996-06-01 00:00:00
abstract::In 1977, training directors of 55 child psychiatry training programs agreed to provide the Committee on Certification in Child Psychiatry of the American Board of Psychiatry and Neurology, Inc. with confidential data about the clinical performance of each of their graduates in 1978, 1979, and 1980. Information about 2...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199009000-00024
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:To examine the social, family background, and individual antecedents of conduct disorder (CD) and oppositional defiant disorder (ODD), the extent to which CD and ODD symptoms were predicted by common environmental risk factors, and the extent to which the antecedents of CD and ODD accounted for the comorbidit...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1016/j.jaac.2010.08.005
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:Because ADHD is heterogeneous with respect to psychiatric comorbidity, familiality, and learning disabilities, it was hypothesized that such features might influence the severity and pattern of neuropsychological function in ADHD. METHOD:Subjects were 9- to 20-year-old males with DSM-III-R ADHD (n = 65) and ...
journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
doi:10.1097/00004583-199508000-00011
更新日期:1995-08-01 00:00:00