Brent 1997

Methods	Methodological quality: high 1. Randomisation method: adequate 2. Dropouts: numbers, and reasons in each group were described; intention‐to‐treat analysis performed 3. Outcome assessment: a. Assessors: patients are not blinded to treatment status, no self‐report b. Measures: clearly defined and valid c. Follow‐up duration: appropriate ‐ 24 months after treatment end 4. Baseline characteristics: reported, and comparable 5. Entry criteria: clearly defined
Participants	107 adolescent patients (aged 13‐18) with DSM‐III‐R major depressive disorder, recruited from a child and adolescent mood and anxiety disorder clinic. Inclusions: normal intelligence, living with at least 1 parent/guardian, with an intake BDI>12. Exclusions: psychosis, bipolar I or II disorder, obsessive‐compulsive disorder, eating disorder, substance abuse within the past 6 months, ongoing physical or sexual abuse, pregnancy, and chronic medical illness. Number of therapists unknown. Therapists received intensive training for 6 months by manual and were supervised throughout the trial.
Interventions	RCT to compare three conditions. Both experimental and control interventions involved 12‐16 weekly sessions of about 1 hour and a boosterphase (2‐4 sessions in as many months); family psychoeducation about affective illness and its treatment, and a psychoeducational manual. T1 (n:37) = individual cognitive behaviour therapy ‐ emphasis on collaborative empiricism, socialising the patient to the cognitive therapy model, and the monitoring and modification of automatic thoughts, assumptions and beliefs. T2 (n:35) = systemic behaviour family therapy (SBFT) ‐ extensive socialisation to the treatment model and education about depression, parenting and developmental issues and emphasizes skill building and positive practice in sessions and at home. C (n:35) = individual nondirective supportive therapy (NST) ‐ to establish, maintain, and build rapport, provide support, and aid the patient in affect identification and expression of feelings through reflective listening, provision of accurate empathy, and discussion of patient‐initiated options for addressing personal problems.
Outcomes	1. Measures: a. The School Age Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Versions (K‐SADS‐P/E) b. Beck Depression Inventory (BDI) c. Dichotomous measure of depressive outcome: sustained (at least 3 consecutive sessions) achievement of a BDI score less than 9 (BDI<9) d. Children's Global Assessment Scale (CGAS) 2. Follow‐up times Assessments at baseline, 6 weeks, the end of treatment (12 to 16 weeks), every three months thereafter for 1 year, and 24 months after treatment ended. Postintervention: T1 superior to T2 on response time, self‐reported symptoms, and remission rate. 1 and 2 years follow‐up: no differences in rates of MDD and clinical recovery between groups.
Notes	Non‐compliance: T1&T2&C = 12/107 Withdrawal: T1&T2&C = 17/107 Integrity check
Risk of bias
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	D ‐ Not used