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David J. Miklowitz, PhD; David A. Axelson, MD; Boris Birmaher, MD; L. Miriam Dickinson, PhD

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We appreciate Dr Kuehner's insightful comments. First, we calculated recovery from depression in all participants who showed significant depressive symptoms at intake, including patients who began in a syndromally depressed, mixed, or subsyndromally depressed state. Subsyndromal depressive symptoms were strongly associated with poor psychosocial functioning in a 2-year follow-up of children diagnosed with bipolar spectrum disorders.¹

Table 1 in our article reports that, of the 58 adolescents, 18 (31.0%) met DSM-IV criteria for a major depressive disorder at entry (>2 weeks in the past 3 months with Adolescent Longitudinal Interval Follow-up Evaluation² depression scores 5), and 25 (43.1%) met our research criteria for subsyndromal depression (1-2 weeks in the past 3 months with Adolescent Longitudinal Interval Follow-up Evaluation depression scores 3 [subthreshold] and <5). The 3 patients (5.2%) who entered in a mixed . . . [Full Text of this Article]

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