The 'Treatment for Adolescents with Depression Study' (TADS, ClinicalTrials.gov, identifier: NCT00006286) was a cornerstone, randomized controlled trial evaluating the effectiveness of standard treatment options for major depression in adolescents. Whereas previous TADS analyses examined primarily effect modifications of treatment-placebo differences by various patient characteristics, less is known about the modification of intertreatment differences, and hence, patient characteristics that might guide treatment selection. We sought to fill this gap by estimating patient-specific inter-treatment differences as a function of patients' baseline characteristics. We did so by applying the 'model-based random forest', a recently-introduced machine learning-based method for evaluating effect heterogeneity that allows for the estimation of patient-specific treatment effects as a function of arbitrary baseline characteristics. Treatment conditions were cognitive-behavioural therapy (CBT) alone, fluoxetine (FLX) alone, and the combination of CBT and fluoxetine (COMB). All inter-treatment differences (CBT vs. FLX; CBT vs. COMB; FLX vs. COMB) were evaluated across 23 potential effect modifiers extracted from previous studies. Overall, FLX was superior to CBT, while COMB was superior to both CBT and FLX. Evidence for effect heterogeneity was found for the CBT-FLX difference and the FLX-COMB difference, but not for the CBT-COMB difference. Baseline depression severity modified the CBT-FLX difference; whereas baseline depression severity, patients' treatment expectations, and childhood trauma modified the FLX-COMB difference. All modifications were quantitative rather than qualitative, however, meaning that the differences varied only in magnitude, but not direction. These findings imply that combining CBT with fluoxetine may be superior to either therapy used alone across a broad range of patients. Keywords 4 adolescent; major depressive disorder; second-generation antidepressive agents; cognitive therapy; randomized controlled trial; effect heterogeneity Brent, D.A., 2007. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials.

Introduction: To examine and compare the Health-Related Quality of Life (HRQoL) and disease-specific HRQoL of pediatric renal dialysis and transplant patients based on patients' perspectives. The coping strategies employed by these two groups of patients were also investigated. Methods: Ten adolescents who had undergone kidney transplants (mean age 17.80 Ϯ 1.55 years) and 19 adolescents who were receiving dialysis treatments (mean age 17.16 Ϯ 2.19 years) participated in the study and were asked to complete three questionnaires: PedsQL 4.0 Generic Core Module, PedsQL End-Stage Renal Disease Module, and the KIDCOPE.

Adolescents (246, ages 12 through 15 years) attending four Singaporean secondary schools from three categories (nonselective, moderately selective, and highly selective) completed the Attitudes Toward Women Scale for Adolescents (AWSA), rated the importance of 10 characteristics of the ideal woman and man, and drew the ideal person in an activity. Less traditional attitudes toward women's roles were found among girls than among boys, and among students attending highly selective schools compared to those at tending a nonselective school. Ratings of the importance of qualities of the ideal person also varied by school category and by gender. Differences by school category remained significant after covarying out indicators of socioeconomic status and primary language spoken at home. The school setting may provide a context in which gender ideologies and values of adolescents develop.

The ‘Treatment for Adolescents with Depression Study’ (TADS, ClinicalTrials.gov, identifier: NCT00006286) was a cornerstone, randomized controlled trial evaluating the effectiveness of standard treatment options for major depression in adolescents. Whereas previous TADS analyses examined primarily effect modifications of treatment-placebo differences by various patient characteristics, less is known about the modification of inter-treatment differences, and hence, patient characteristics that might guide treatment selection. We sought to fill this gap by estimating patient-specific inter-treatment differences as a function of patients’ baseline characteristics. We did so by applying the ‘model-based random forest’, a recently-introduced machine learning-based method for evaluating effect heterogeneity that allows for the estimation of patient-specific treatment effects as a function of arbitrary baseline characteristics. Treatment conditions were cognitive-behavioural therapy (CBT) alone, fluoxetine (FLX) alone, and the combination of CBT and fluoxetine (COMB). All inter-treatment differences (CBT vs. FLX; CBT vs. COMB; FLX vs. COMB) were evaluated across 23 potential effect modifiers extracted from previous studies. Overall, FLX was superior to CBT, while COMB was superior to both CBT and FLX. Evidence for effect heterogeneity was found for the CBT-FLX difference and the FLX-COMB difference, but not for the CBT-COMB difference. Baseline depression severity modified the CBT-FLX difference; whereas baseline depression severity, patients’ treatment expectations, and childhood trauma modified the FLX-COMB difference. All modifications were quantitative rather than qualitative, however, meaning that the differences varied only in magnitude, but not direction. These findings imply that combining CBT with fluoxetine may be superior to either therapy used alone across a broad range of patients.

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