The efficacy of antidepressants on overall well-being and self-reported depression symptom severity in youth: a meta-analysis

Psychother Psychosom. 2014;83(3):158-64. doi: 10.1159/000356191. Epub 2014 Apr 12.

Abstract

Background: Recent meta-analyses of the efficacy of second-generation antidepressants for youth have concluded that such drugs possess a statistically significant advantage over placebo in terms of clinician-rated depressive symptoms. However, no meta-analysis has included measures of quality of life, global mental health, self-esteem, or autonomy. Further, prior meta-analyses have not included self-reports of depressive symptoms.

Methods: Studies were selected through searching Medline, PsycINFO, and the Cochrane Central Register for Controlled Trials databases as well as GlaxoSmithKline's online trial registry. We included self-reports of depressive symptoms and pooled measures of quality of life, global mental health, self-esteem, and autonomous functioning as a proxy for overall well-being.

Results: We found a nonsignificant difference between second-generation antidepressants and placebo in terms of self-reported depressive symptoms (k = 6 trials, g = 0.06, p = 0.36). Further, pooled across measures of quality of life, global mental health, self-esteem, and autonomy, antidepressants yielded no significant advantage over placebo (k = 3 trials, g = 0.11, p = 0.13).

Discussion: Though limited by a small number of trials, our analyses suggest that antidepressants offer little to no benefit in improving overall well-being among depressed children and adolescents.

Publication types

  • Meta-Analysis

MeSH terms

  • Adolescent
  • Age Factors
  • Antidepressive Agents, Second-Generation / therapeutic use*
  • Child
  • Depression / drug therapy*
  • Depression / psychology
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / psychology
  • Humans
  • Mental Health / statistics & numerical data
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Personal Autonomy
  • Placebos
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Quality of Life*
  • Randomized Controlled Trials as Topic*
  • Self Concept
  • Self Report
  • Severity of Illness Index

Substances

  • Antidepressive Agents, Second-Generation
  • Placebos