Predictors, Moderators, and Mediators Associated With Treatment Outcome in Randomized Clinical Trials Among Adolescents With Depression

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Abstract
Depressive disorders in adolescents (DD-A) are prevalent,1 impairing,2,3 and associated with suicide.4,5 In the United States, rates of depressive symptoms and suicide in adolescents have increased over the past 10 to 15 years.6,7 Current treatment approaches have limited benefit.8,9 The application of precision medicine hopes to improve outcomes by offering “treatment strategies that take individual variability into account.”10 Clinicians treating DD-A are expected to practice precision medicine.11 Researchers of DD-A treatment also need to understand how clinical factors are associated with outcomes to guide the development and testing of new treatment approaches.12 Information from randomized clinical trials (RCTs) can elucidate these factors, as rigorous data collection is conducted at set time points under controlled treatment conditions. A good understanding of the variables associated with depression severity outcome in RCTs for the treatment of DD-A can indicate what works for whom and how.12,13 Two previous evidence syntheses that have examined such variables14,15 have included a very limited set of relevant studies.

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