Inclusion and Exclusion Criteria

We adopted the following inclusion criteria: (1) Study design: randomized controlled trial, cohort study and clinical trial; (2) Study subjects: adolescent patients diagnosed with depression; (3) Intervention: fluoxetine plus CBT (treatment group) in relation to fluoxetine alone (control group); (4) Outcome measures: response rate, incidence of adverse reactions, one-year recurrence rate, Hamilton Depression Scale score (HAMD), Children’s Depression Rating Scale–Revised score (CDRS-R), and Clinical Global Impression Severity score (CGI). Adverse effects included headache, nausea, hyperhidrosis, dizziness, lethargy and incidents of suicide or NSSI.

We excluded studies for the following reasons: (1) literature not related to adolescent depression; (2) duplicate literature: more than one report based on the same study population published, in which case only the most comprehensive publication was included in this meta-analysis; (3) literature in which relevant data were not provided, and the data and original text could not be obtained; (4) literature with poor quality, missing data; (5) case reports, systematic reviews, and animal experiments.