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Psychotherapy should be first-line treatment for depression in young people, trial finds

If antidepressants have a role, they have more of a role in people at the older end of the age range. The take-home message from the study is that the first-line treatment for young people with depression should be psychotherapy.

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Young people seeking support for depression should be offered psychotherapy as the first line of treatment, a clinical trial by researchers at Orygen, the National Centre of Excellence in Youth Mental Health, has found.

Associate Professor Christopher Davey, head of mood disorder research at Orygen, said the clinical trial results emphasised the importance of a multi-faceted approach to treating depression in young people.

“The results suggest that we should really be focusing on providing good quality psychotherapy, such as cognitive behavioural therapy, to young people and keeping medication as the second line of treatment,” Associate Professor Davey said.

Psychotherapy refers to a range of psychological therapies provided by a counsellor, psychologist or psychiatrist. Cognitive behavioural therapy is the most common psychotherapy for treating depression in young people.

The randomized, double blind, placebo-controlled clinical trial involved 153 young people aged 15-25 who had been diagnosed with depression and were being treated at youth mental health services in north-west Melbourne. All trial participants received cognitive behavior therapy for 12 weeks coupled with either the common antidepressant fluoxetine or a placebo medication.

The trial results have been published in The Lancet Psychiatry.

Associate Professor Davey said at the end of treatment there were no significant differences in symptom improvement between the two groups, suggesting that the addition of fluoxetine did not affect the participants’ mental health outcomes.

However, this does not suggest that antidepressants should not be used in treating depression.

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“Antidepressants can be very useful for some people,” Associate Professor Davey said. “Anyone considering the role of antidepressants in their treatment should discuss this with their doctor or clinician.

“Our study found some evidence to suggest that if antidepressants have a role, they have more of a role in people at the older end of our age range. The take-home message from the study is that the first-line treatment for young people with depression should be psychotherapy.”

This is of particular interest to members of the LGBTQIA community because 41% of non-binary people said they harmed themselves in the last year compared to 20% of LGBT women and 12% of GBT men. One in six LGBT people (16%) said they drank alcohol almost every day over the last year.


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