Examining Treatment Options in Youth With Major Depressive Disorder: Observations From the TX-YDSRN Registry Study

Authors

Emine Rabia Ayvaci
Karabi Nandy
Ryan Becker
Laura Stone
Abu Minhajuddin
Holli Slater
Lynnel C Goodman
Sarah M Wakefield
Eric A Storch
Joseph C Blader
Cesar A Soutullo
Graham J Emslie
Madhukar H Trivedi

Publication Date

1-1-2025

Journal

Psychiatric Research and Clinical Practice

DOI

10.1176/appi.prcp.20240117

PMID

40548323

PMCID

PMC12178205

PubMedCentral® Posted Date

3-24-2025

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Abstract

Objective: Treatment decisions for depression are a complex process, influenced by factors such as clinical characteristics, socioeconomic factors, and patient/caregiver preferences. This study examines the characteristics of treatment options during the first month of enrollment among depressed youth.

Methods: Data for 646 depressed youth were extracted from the Texas Youth Depression and Suicide Research Network study. Participants' treatments during the first month were categorized as no treatment (NT), psychotherapy only (THER), pharmacotherapy only (MED), or a combination of psychotherapy and pharmacotherapy (COMB). Sociodemographic and clinical features were compared across these treatment types.

Results: 7% were on NT, 5% on THER, 35% on MED, and 53% on COMB. The MED group was more likely to have low income compared to the COMB group. Compared to the MED group, COMB treatment had higher depression severity and suicidality. The NT group showed higher rates of social risk compared to the group with COMB. Treatment groups did not differ significantly in sex or race. When treatment preferences were examined, 40% of youth on MED expressed a preference for COMB treatment.

Conclusions: Treatment options vary with demographic characteristics, depression severity, suicidality, and high-risk social factors. The finding that youth on MED are more likely to have low income compared to COMB treatment, despite a preference for COMB treatment among many, may suggest a potential barrier to accessing comprehensive treatment options.

Relevance to clinical practice: Findings highlight the need to address barriers to combination treatment, which is preferred by youth and caregivers for managing depression.