February 6, 2007
  The numbers are astonishing: 20% of children in the U.S. have some form of mental illness. Only 1 in 5 receives treatment. In a 2004 study of 439 children and adolescents with depression, researchers found an interesting phenomenon. They observed 3 groups of children: one group got Cognitive Behavioral Therapy (CBT) alone. The second group got fluoxetine alone. And the third group got both CBT plus fluoxetine. After 12 weeks of treatment: At first, it seemed as though the combination treatment of CBT and fluoxetine worked best¦ 71% of children improved with both treatments. The numbers were much lower for improvement from CBT alone or fluoxetine alone; 43.2% and 60.6%, respectively. 18 weeks: At this point in treatment, the CBT alone group had a response rate that was as good as fluoxetine alone. 36 weeks: And finally, the CBT alone group had a response rate comparable with the combined treatment group (which means that adding medication did not offer an additional benefit to CBT alone). What's more, CBT alone had the added effect of protecting against suicidal thoughts and actions. Meanwhile, those on fluoxetine alone had twice as many suicidal events as the other two groups. "There's something about getting cognitive-behavioral therapy that not only helps you get better with respect to depression, but essentially eliminates excess risk of suicidal events that you would have from getting a selective serotonin reuptake inhibitor." -          John S. March, MD, as quoted in JAMA, February 7, 2007-Vol 297, No. 5 Studies also indicate that CBT may be effective for childhood OCD and effects of sexual abuse. The details above are included in this JAMA article about for children and adolescents.