***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate effectiveness of the Adolescent Coping With Depression ( CWD-A ) course , a cognitive-behavioral group intervention for depressed adolescents with comorbid conduct disorder . METHOD Between 1998 and 2001 , 93 nonincarcerated adolescents ( ages 13 - 17 years ) meeting criteria for major depressive disorder and conduct disorder were recruited from a county juvenile justice department and r and omly assigned to the CWD-A or a life skills/tutoring control condition . Participants were assessed post-treatment and at 6- and 12-month follow-up . Dichotomous outcomes were analyzed with logistic regression ; dimensional measures were analyzed using r and om effects regression . RESULTS Major depressive disorder recovery rates post-treatment were greater in CWD-A ( 39 % ) compared with life skills/tutoring control ( 19 % ) ( odds ratio 2.66 , 95 % confidence interval = 1.03 - 6.85 ) . CWD-A participants reported greater reductions in Beck Depression Inventory-II ( r2 = 0.055 , p = .033 ) and Hamilton Depression Rating Scale ( r2 = 0.047 , p = .039 ) scores and improved social functioning ( r2 = 0.064 , p = .019 ) post-treatment . Group differences in major depressive disorder recovery rates at 6- and 12-month follow-up were nonsignificant , as were differences in conduct disorder both post-treatment and during follow-up . CONCLUSIONS This is the first r and omized , controlled trial of a psychosocial intervention with adolescents with major depressive disorder and conduct disorder . Although the CWD-A appears to be an effective acute treatment for depression in adolescents with multiple disorders , findings emphasize the need to improve long-term outcomes for depressed adolescents with psychiatric comorbidity and imply that interventions for comorbid population s focus directly on each specific disorder OBJECTIVE To assess olanzapine 's  efficacy and tolerability in adolescents with schizophrenia . METHOD One hundred seven inpatient and outpatient adolescents ( olanzapine , n = 72 , mean age 16.1 years ; placebo , n = 35 , mean age 16.3 years ) with schizophrenia participated in this r and omized ( 2:1 ) , international , multisite , industry-sponsored trial . All patients met DSM-IV-TR criteria for schizophrenia , and they were treated for up to 6 weeks with flexible doses of olanzapine ( 2.5 - 20.0 mg/day ) or placebo . Last-observation-carried-forward mean changes from baseline to endpoint on the anchored version of the Brief Psychiatric Rating Scale for Children , Clinical Global Impression Scale-Severity of Illness , and Positive and Negative Syndrome Scale ( PANSS ) were assessed . RESULTS More olanzapine-treated versus placebo-treated  patients completed the trial ( 68.1 % versus 42.9 % , p = .020 ) . Compared with placebo-treated patients , olanzapine-treated adolescents had significantly greater improvement in Brief Psychiatric Rating Scale for Children total ( p = .003 ) , Clinical Global Impressions Scale-Severity of Illness ( p = .004 ) , PANSS total ( p = .005 ) , and PANSS positive scores ( p = .002 ) . Olanzapine-treated patients gained significantly more baseline-to-endpoint weight ( 4.3 kg versus 0.1 kg , p < .001 ) . Significantly more olanzapine-treated versus placebo-treated patients gained 7 % or greater of their body weight at any time during treatment ( 45.8 % versus 14.7 % , p = .002 ) . Prolactin and triglyceride mean baseline-to-endpoint changes were significantly higher in olanzapine-treated versus placebo-treated adolescents . The incidence of treatment-emergent significant changes in fasting glucose , cholesterol , or triglycerides did not differ between the groups at endpoint , but significantly more olanzapine-treated patients had high triglycerides at any time during treatment . CONCLUSIONS Olanzapine-treated adolescents with schizophrenia experienced significant symptom improvement . Significant increases in weight , triglycerides , uric acid , most liver function tests , and prolactin were observed during olanzapine treatment . Clinical trial registration information-Olanzapine Versus Placebo in the Treatment of Adolescents With Schizophrenia . URL : http://www . clinical trials.gov . Unique identifier : NCT00051298 OBJECTIVE To describe the development and initial evaluation of the Coping Course , a cognitive-behavioral group intervention design ed to enhance general coping and problem-solving skills among incarcerated youth . METHOD Between 2001 and 2002 , 76 male adolescents incarcerated at a youth correctional facility were assessed by question naire and r and omly assigned to either the Coping Course ( n = 46 ) or usual care ( n = 30 ) . Participants repeated the question naire after completion of the intervention . A second correctional facility served as an additional source of control group data ( n = 62 ) . RESULTS Significant condition x time effects were present for seven of the examined measures : Youth Self-Report externalizing scores , three measures from the Life Attitudes Scale , self-esteem , one measure of social adjustment , and cognitive-behavioral therapy knowledge . Age and race/ethnicity did not moderate effects . Comparing control group participants with youth at a separate correctional facility who did not receive the Coping Course indicated that change was uniquely associated with participation in the intervention . CONCLUSIONS Our goal was to take an efficacious adolescent depression group intervention and modify it for use with youth in correctional facilities . Preliminary findings are promising and provide evidence for future research of cognitive-behavioral group treatments with incarcerated youth Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more The CONSORT ( Consoli date d St and ards of Reporting Trials ) statement is used worldwide to improve the reporting of r and omized , controlled trials . Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating experience . This prospect i ve study examines the predictive validity of the Dutch version of the Structured Assessment of Violence Risk in Youth ( SAVRY ) by examining relationships between SAVRY scores and various types of disruptive behavior during  residential treatment .  The SAVRY , a risk assessment instrument , was coded for 66 male adolescents on the basis of file information and interviews . The adolescents were referred to Rentray , a juvenile correctional and treatment facility , by the Dutch juvenile courts because of severe behavioral problems or serious offenses . Institutional infractions were retrieved from incident registration files , which included acts of physical violence , verbal threat , verbal abuse , and violation of institutional rules . The interrater reliability of the  SAVRY scores was good . The predictive validity of the SAVRY  for physical violence against persons was excellent ( Risk Total : AUC=.80 , r = .33 ; Summery Risk Rating : AUC = .86 , r = .48 ) . The SAVRY also had good predictive validity for violence against objects , verbal threats and violations of rules , but not for verbal abuse . Implication s for assessment and management of violent behavior among adolescents in residential treatment are discussed This study examined the effect of four treatment conditions on self-concept and reduction of psychological stress in adolescent delinquent females . The treatments were Rational State Directed Imagery , a cognitive behavioral approach that utilized intensive muscle relaxation and vivid-emotive-imagery , a rational ( cognitive ) restructuring treatment , a placebo condition , and a no treatment control . Ss were assigned r and omly to one of these treatment groups , which met 1 hour per week for 6 consecutive weeks , with in-vivo homework assignments also utilized . Statistically scale were noted for the RSDI group at the posttest and at a 2-month follow-up , which supports the therapeutic efficacy of this treatment . Support was found for the effectiveness of the rational ( cognitive ) restructuring approach immediately posttreatment ; however these effects disappeared at the 2-month follow-up . The placebo and control groups showed no significant effects at either posttreatment or the follow-up . These results suggest that RSDI has potential for use as a short-term psychotherapeutic approach when self-concept modification is a primary goal The purpose of this study is to test our hypothesis that muscle relaxation is effective on the psychological well-being of juvenile delinquents . Subjects were 16 juvenile delinquents who had entered a reform school . Subjects were divided into two groups . The muscle relaxation group received muscle relaxation therapy once a week for a total of 4 times . The control group spent an ordinary daily life in the reformatory . Psychological question naires used were the Rosenzweig Picture Frustration Study ( P-F study ) , the Psychological Stress Response Scale ( PSRS ) , and the Eysenck Personality Question naire ( EPQ ) . There was a significant Group × Time interaction of the Group Conformity Rating ( GCR ) of the P-F study ( F [ 1,14 ] = 10.1 , P=0.007 ) . There were no significant interactions in the other psychological subscales . Thus , muscle relaxation therapy may improve frustration tolerance among juvenile delinquents BACKGROUND New treatments for conduct disorder are sorely needed . We aim ed to test the efficacy of divalproex sodium for the treatment of conduct disorder . METHOD Seventy-one youths with conduct disorder according to DSM-IV criteria were enrolled in a r and omized , controlled , 7-week clinical trial . Subjects were all adolescent males with at least 1 crime conviction . Subjects were r and omized into high- and low-dose conditions and were openly managed by a clinical team . Subjects and independent outcome raters were blinded to condition . Clinical Global Impressions-Severity of Illness ( CGI-S ) and CGI-Improvement ( CGI-I ) ratings , Weinberger Adjustment Inventory ratings , and staff ratings of behavioral privilege were used to assess outcome . RESULTS Intent-to-treat analyses showed significant associations between assignment to the high-dose condition and ratings on the CGI-S ( p = .02 ) and CGI-I ( p = .0008 ) . Self-reported weekly impulse control was significantly better in the high-dose condition ( p < .05 ) , and association between improvement in self-restraint and treatment condition was of borderline statistical significance ( p < .06 ) . Parallel analyses comparing outcome by blood drug level achieved strengthened the results , as expected . CONCLUSION This preliminary study in a most difficult population suggests a role for divalproex sodium in the treatment of conduct disorder . Divalproex sodium improved self-reported impulse control and self-restraint , variables shown to be predictive of criminal recidivism . Studies are needed of longer-term impact and side-effect profiles . This is one of few controlled psychopharmacologic studies of conduct disorder BACKGROUND Successful treatment of conduct disorder remains difficult . On the basis of a positive response to divalproex among adolescent boys with conduct disorder , we conducted an analysis of the impact of baseline comorbid diagnoses and personality factors on the likelihood of treatment response to divalproex . METHOD Seventy-one adolescent boys with conduct disorder ( DSM-IV ) and a history of at least 1 offense against persons were r and omly assigned to receive high- or low-dose divalproex for 7 weeks . Evaluations included best estimate diagnoses , the Clinical Global Impressions-Severity of Illness scale ( CGI-S ) and CGI-Improvement scale ( CGI-I ) , the 62-item Weinberger Adjustment Inventory ( WAI-62 ) assessment of distress and restraint , the Response Evaluation Measure assessment of immature and mature defenses , and the Achenbach Youth Self-Report assessment of overall psychopathology . All were conducted at study entry and exit , and the WAI-62 was conducted weekly throughout the 7-week study period . Treatment response was defined as a rating of much improved or very much improved on the CGI-I. Data were collected from June 1997 to April 1998 . RESULTS Fifty-eight subjects completed the study and were eligible for inclusion in the analysis . Plasma divalproex level ( p = .003 ) and immature defenses ( p = .004 ) were significant positive predictors of treatment response , while restraint ( p = .01 ) and level and range of psychopathology ( p = .04 ) were significant predictors of nonresponse . Comorbidities or distress ( p = .06 ) were not significantly associated with treatment outcome . CONCLUSION Predictors of response to divalproex treatment for conduct disorder were identified , despite the small sample size in this study . The pattern of positive and negative predictors of response to divalproex , an antikindling agent , tends to support a model of kindling-reinforced reactive/affective/defensive/impulsive aggression among adolescent boys with conduct disorder . Additional studies are needed to identify more subtle predictors of treatment response and to clarify the mechanisms contributing to the development of conduct disorder OBJECTIVE To derive and test a series of brief  diagnosis-specific scales 
    Output:
    
Screening accuracy was typically modest .
An exemplar decision model was developed for depression , which identified a number of the likely key drivers of uncertainty , including the prevalence of unidentified mental health problems , the severity of mental health problems and their relationship to generic measures of outcome and the impact of treatment on recidivism .
Evidence on the clinical effectiveness and cost-effectiveness of screening for mental health problems in young people who offend is currently lacking .