Treatment of adolescents with major depression: implications of the DST and the melancholic clinical subtype.

Of 38 adolescents hospitalized with major depression, 47% of those receiving psychosocial treatment alone responded. Of the non-responders then treated with combined tricyclic antidepressants and psychosocial treatment, 92% responded. The melancholic subtype and dexamethasone suppression test non-suppression were associated with failure to respond to psychosocial treatment alone. Implications for controlled studies are discussed.