Major depressive disorder is a recurrent condition affecting approximately 2% of children and 8% of adolescents (1,2). Untreated, this disorder has a significant impact on psychosocial functioning and increases the risk for suicidality and the development of other disorders, such as substance abuse (2). Pediatric acute randomized controlled studies have shown response rates of 40%-60% to psychosocial and pharmacological treatments (2, 3). Remission rates, however, even for the combination of psychosocial and pharmacological treatments, are relatively low (30%-40%), indicating that a substantial proportion of youths remain symptomatic (2-5). The presence of residual depressive symptoms has been associated with a worse course and a higher risk of relapse or recurrence of major depressive episodes. Thus, more efficacious treatments are needed that target acute symptoms of depression and increase the rates of remission.
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