To the Editor: In their randomized controlled trial, Dr Garber and colleagues1 provided important information on the successful prevention of adolescent-onset depression using an evidence-based psychotherapy in high-risk adolescents. In their study, if a parent was currently depressed the adolescent did not benefit from treatment. This observation is consistent with other data suggesting that if a currently depressed mother is successfully treated, her children's symptoms are more likely to improve.
An ancillary study of children of parents receiving treatment as part of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) found that remission of maternal depression after 3 months of medication was significantly associated with reductions in the children's diagnoses and symptoms.2 Conversely, a failure to remit was associated with worsening in child outcomes, paralleling observations by Garber et al that cognitive behavioral therapy did not confer a protective effect among the offspring of currently depressed parents. The STAR*D findings were sustained in offspring of mothers who remitted later after the first 3 months of treatment3 and were supported by consistent findings in an independent randomized controlled trial covering 9 months and using another evidence-based psychotherapy for the depressed mothers.4
The combined findings of these studies suggest that a range of efficacious treatments can be recommended to prevent adolescent-onset major depression, targeting both high-risk adolescents and currently depressed parents.
Financial Disclosure: Dr Weissman reported having received investigator-initiated grants from GlaxoSmithKline, Eli Lilly, and the Josiah Macy Foundation that are no longer active. She reported currently receiving research funding from the National Institute of Mental Health, the National Institute on Drug Abuse, the National Alliance for Research on Schizophrenia and Depression, and the Sackler Foundation and receiving royalties from Oxford University Press, Perseus Press, the American Psychiatric Association Press, and MultiHealth Systems. Dr Talati reported no disclosures.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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