Depression in youth is prevalent and disabling and tends to presage a chronic and recurrent course of illness and impairment in adulthood. Clinical trial research in youth depression has a 30 year history, and evidence-based treatment reviews appeared in 1998 and 2008. The current review of 42 randomized controlled trials (RCTs) updates these reviews to include RCTs published between 2008 and 2014 (N = 14) and re-evaluates previously reviewed literature. Given the growing maturity of the field, this review utilized a stringent set of methodological criteria for trial inclusion, most notable for excluding trials based in sub-clinical samples of youth that had been included in previous reviews (N = 12) and including well-designed RCTs with null and negative findings (N = 8). Findings from the current review suggest that evidence for child treatments is notably weaker than for adolescent interventions, with no child treatments achieving well-established status and the evidentiary basis of treatments downgraded from previous reports. Cognitive behavioral therapy (CBT) for clinically depressed children appears to be possibly efficacious, with mixed findings across trials. For depressed adolescents, both CBT and Interpersonal Psychotherapy (IPT) are well-established interventions, with evidence of efficacy in multiple trials by independent investigative teams. This positive conclusion is tempered by the small size of the IPT literature (N = 6) and concern that CBT effects may be attenuated in clinically complicated samples and when compared against active control conditions. In conclusion, data on predictors, moderators, and mediators are examined and priorities for future research discussed.

clinicaltrials.gov Identifier: NCT01147614.

The current investigation examined the internal structure and discriminant validity of the parent-report Mood and Feelings Questionnaire (MFQ-P), a commonly used measure of depressive symptoms in youth. A total of 1493 families with youth ages 5 to 18 (61.02 % male) presenting for treatment at an outpatient mental health clinic were randomly allocated to an Exploratory Sample 1 or to a Replication Sample 2. Internal structure of the MFQ-P was examined using exploratory factor analysis in Sample 1 (N = 769) and then replicated using confirmatory factor analysis in Sample 2 (N = 724). Results of the exploratory factor analysis yielded a 5-factor structure comprised of core mood, vegetative, suicidality, cognitive, and agitated distress symptom subscales. The 5-factor solution was replicated in Sample 2 with adequate fit, (CFI = 0.908, TLI = 0.974, RMSEA =0.067). Results lend statistical support for 5 candidate subscales of the MFQ-P. These potential subscales may aid in efficient identification of critical symptoms of depression.