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This is the VOA Special English Health Report.

Depression can cause long periods of sadness and hopelessness, feelings of low self-worth, even physical pain. It is the leading cause of suicide.

The World Health Organization says more than one hundred twenty million people worldwide suffer from depression. But many people may not know it can start at a young age. In the United States, for example, health officials estimate that about five percent of adolescents are depressed.

Researchers in the United States have just reported on a study of more than three hundred patients ages twelve to seventeen. All suffered from major depression disorder, the most common form of the disease.

The researchers divided them into three groups. One received the antidepressant drug Prozac. Another received cognitive behavioral therapy. The third received both.

The study found that the best treatment was a combination of antidepressant and cognitive behavioral therapy, or C.B.T. This kind of therapy teaches patients to recognize and deal with the thoughts that can result from depression.

It centers on current feelings instead of past events.

At twelve weeks, the researchers found reduced levels of depression in all three groups. But they say the group receiving the combination of treatments had the greatest reduction. This continued through the end of the nine-month study.

The researchers say eighty-six percent of those who received both treatments had improved. This was compared to eighty-one percent each in the two other groups.

The study did not include an untreated control group. So there is no way to know for sure if it was the treatment that eased the depression.

The findings by Duke University researchers appear in the Archives of General Psychiatry. The National Institute of Mental Health paid for the seventeen million dollar study.

The researchers say the group that received Prozac alone had a higher rate of suicidal thoughts than the other two groups. Experts say antidepressant drugs can increase the risk of suicidal thinking and behavior in teenagers.

And, earlier this year, the government asked drug makers to extend that warning to patients age eighteen to twenty-four during initial treatment. Generally that means the first one to two months.

And that's the VOA Special English Health Report, written by Caty Weaver. To learn about World Mental Health Day, observed each year on October tenth, go to www.unsv.com. I'm Steve Ember.