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Imipramine plus cognitive-behavioral therapy in the treatment of school refusal.
- Source :
-
Journal of the American Academy of Child and Adolescent Psychiatry [J Am Acad Child Adolesc Psychiatry] 2000 Mar; Vol. 39 (3), pp. 276-83. - Publication Year :
- 2000
-
Abstract
- Objective: To investigate the efficacy of 8 weeks of imipramine versus placebo in combination with cognitive-behavioral therapy (CBT) for the treatment of school-refusing adolescents with comorbid anxiety and major depressive disorders.<br />Method: This was a randomized, double-blind trial with 63 subjects entering the study and 47 completing. Outcome measures were weekly school attendance rates based on percentage of hours attended and anxiety and depression rating scales.<br />Results: Over the course of treatment, school attendance improved significantly for the imipramine group (z = 4.36, p < .001) but not for the placebo group (z = 1.26, not significant). School attendance of the imipramine group improved at a significantly faster rate than did that of the placebo group (z = 2.39, p = .017). Over the 8 weeks of treatment, there was a significant difference between groups on attendance after controlling for baseline attendance; mean attendance rate in the final week was 70.1% +/- 30.6% for the imipramine group and 27.6% +/- 36.1% for the placebo group (p < .001). Defining remission as 75% school attendance, 54.2% of the imipramine group met this criterion after treatment compared with only 16.7% from the placebo group (p = .007). Anxiety and depression rating scales decreased significantly across treatment for both groups, with depression on the Children's Depression Rating Scale-Revised decreasing at a significantly faster rate in the imipramine group compared with the placebo group (z = 2.08, p = .037).<br />Conclusions: Imipramine plus CBT is significantly more efficacious than placebo plus CBT in improving school attendance and decreasing symptoms of depression in school-refusing adolescents with comorbid anxiety and depression.
- Subjects :
- Adolescent
Antidepressive Agents, Tricyclic adverse effects
Child
Combined Modality Therapy
Depressive Disorder, Major drug therapy
Depressive Disorder, Major psychology
Double-Blind Method
Female
Humans
Imipramine adverse effects
Male
Phobic Disorders psychology
Antidepressive Agents, Tricyclic administration & dosage
Cognitive Behavioral Therapy
Imipramine administration & dosage
Phobic Disorders drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0890-8567
- Volume :
- 39
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Child and Adolescent Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 10714046
- Full Text :
- https://doi.org/10.1097/00004583-200003000-00008