Disorders - Depressive Disorders
Rynn, Moira, Wagner, Karen Dineen, Donnelly, Craig, Ambrosini, Paul, Wohlberg, Christopher J., Landau,
Phyllis, Yang, Ruoyong
OBJECTIVE: The aim of
this study was to assess the long-term safety, tolerability, and efficacy of sertraline 50-200 mg once-daily in children (6-11 year olds) and
adolescents (12-18 year olds) with a Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnosis of major depressive
disorder (MDD). METHODS: This study consisted of a 24-week open-label observational study of children and adolescents who had completed either of two
10-week double-blind, placebo-controlled trials. The Children's Depression Rating Scale-Revised (CDRS-R) was the primary measure of efficacy.
RESULTS: Two hundred ninety nine (299) patients completed the acute studies and were eligible for the extension study. Of these, 226 enrolled, but 5
did not receive treatment. Of 221 patients (107 children and 114 adolescents), 62.4% completed the study. The endpoint mean daily dose was 109.9
mg/day. The mean decrease in CDRS-R score from double-blind baseline was 34.8 points (p < 0.001), with patients showing continued improvement in
CDRS-R scores regardless of which treatment they received in the double-blind studies. At endpoint, 86% of patients met CDRS-R responder and 58%
CDRS-R remitter criteria. CONCLUSIONS: Sertraline appears to be well tolerated and safe over 24 weeks of treatment in children and adolescents with
MDD. Children and adolescents treated with sertraline appear to have increased improvement over that seen in the first 10 weeks of treatment. These
findings need confirmation in placebo-controlled studies.
Journal
of Child & Adolescent Psychopharmacology, 16(1-2) : 103-16
- Year: 2006
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs)
Rooney, Rosanna, Roberts, Clare, Kane,
Robert, Pike, Lisbeth, Winsor, Amber, White, Julia, Brown, Annette
The outcomes of a new universal program aimed at preventing depressive symptoms and disorders in
8- to 9-year-old children are presented. The Positive Thinking Program is a mental health promotion program based on cognitive and behavioural
strategies. It is designed to meet the developmental needs of children in the middle primary school Years 4 and 5. Four state primary schools were
randomly assigned to receive the program implemented by psychologists or to a control condition involving their regular Health Education curriculum.
Seventy-two children participated in the intervention condition and 48 children in the control condition. Children completed measures of depressive
and anxiety symptomatology, depressive disorders, and attribution style. The intervention was associated with reductions in depressive symptoms and
more positive attributions at post-intervention. Compared to the control group, there was a lower prevalence of depressive disorders at posttest and
fewer intervention group children developed a depressive disorder at a 9-month follow-up. (PsycINFO Database Record (c) 2007 APA, all rights
reserved) (journal abstract).
Australian Journal of Guidance & Counselling, 16(1) : 76-
90
- Year: 2006
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Sanford, Mark, Boyle, Michael, McCleary, Lynn, Miller, Jennifer, Steele, Margaret, Duku, Eric, Offord,
David
OBJECTIVE: To obtain preliminary evidence of the feasibility and effectiveness of
adjunctive family psychoeducation in adolescent major depressive disorder. METHOD: Participants were from outpatient clinics in Hamilton and London,
Ontario. Over 24 months, 41 adolescents ages 13 through 18 years meeting major depressive disorder criteria were recruited (31 in Hamilton, 10 in
London). Participants were randomized to usual treatment or usual treatment plus family psychoeducation. Outcome measures were readministered at 2
weeks, mid-treatment, posttreatment, and 3-month follow-up. Intent-to-treat analyses used chi2 and t tests and growth curve analysis. Standardized
effects based on growth curve estimates were calculated for continuous outcomes. RESULTS: The London site was withdrawn because of poor participant
retention. In Hamilton, no participant missed more than one assessment and there was good family psychoeducation adherence. Compared to controls,
participants in the experimental group showed greater improvement in social functioning and adolescent-parent relationships (with medium standardized
effect size > 0.5), and parents reported greater satisfaction with treatment. CONCLUSIONS: There were positive treatment effects on family and social
functioning processes postulated to mediate the clinical course of major depressive disorder. The study provides support for further evaluation of
family psychoeducation in this clinical population.
Journal of the American Academy of Child &
Adolescent Psychiatry, 45(4) : 386-495
- Year: 2006
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation
Spence, Sh, Sheffield, J. K, Donovan,
C. L.
In this study, the authors examined the 2-, 3-, and 4-year outcomes of a
school-based, universal approach to the prevention of adolescent depression. Despite initial short-term positive effects, these benefits were not
maintained over time. Adolescents who completed the teacher-administered cognitive-behavioral intervention did not differ significantly from
adolescents in the monitoring-control condition in terms of changes in depressive symptoms, problem solving, attributional style, or other indicators
of psychopathology from preintervention to 4-year follow-up. Results were equivalent irrespective of initial level of depressive symptoms. Copyright
2005 APA
Journal of Consulting & Clinical Psychology, 73(1) : 160-
7
- Year: 2005
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Problem solving therapy (PST), Other Psychological Interventions
Possel, P., Baldus, C., Horn, A. B., Groen, G., Hautzinger, M.
Background: Depressive disorders in adolescents are a widespread and increasing problem.
Prevention seems a promising and feasible approach. Methods: We designed a cognitive-behavioral school-based universal primary prevention program and
followed 347 eighth-grade students participating in a randomized controlled trial for three months. Results: In line with our hypothesis,
participants in the prevention program remained on a low level of depressive symptoms, having strong social networks. The control group showed
increasing depressive symptoms and a reduced social network. Contrary to our expectations, students low in self-efficacy benefited more from the
program than high self-efficient students. Social network did not mediate the relationship between participation in the prevention program and
changes in depressive symptoms. Conclusions: Our results show that the prevention program had favorable effects. Further research is needed to
explore the impact of self-efficacy on the effects of prevention programs. copyright 2004 Association for Child Psychology and Psychiatry.
Journal of Child Psychology & Psychiatry
& Allied Disciplines., 46(9) : 982-994
- Year: 2005
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Kowalenko, N., Rapee, R. M., Simmons, J., Wignall, A., Hoge, R., Whitefield, K., Starling, J., Stonehouse,
R., Baillie, A.
J.
This article reports on the effectiveness of an early intervention program,
'Adolescents Coping with Emotions' (ACE), for depression in girls. ACE was assessed in a short-term wait-list control trial. In 1999, 882 students
(aged 13-16 years) were screened using the Children's Depression Inventory (CDI). One hundred and seventy-nine students (63% female) who scored
above the CDI cut-off (of 18) were offered the program and 143 (65% female) agreed to participate. On a school basis, participants were allocated to
the intervention group (n = 76; 56% female) who commenced the program within one month, or to a wait-list control condition (control group, n = 50;
79% female) who commenced the ACE program after 10 weeks. Data analysis was conducted for 82 female participants. All students completed the CDI,
Adolescent Coping Scale and Children's Automatic Thoughts Scale at pre- and post-intervention. The intervention group also completed a 6-month
follow-up. At post-intervention, female ACE participants reported significantly reduced depressive symptoms and significantly improved coping skills
compared with the control group. Using cognitive-behavioural and interpersonal techniques, the ACE program diminished depressive symptoms and
increased coping skills in girls screening at-risk for depression. copyright 2005 SAGE Publications.
Clinical Child
Psychology & Psychiatry, 10(4) : 493-507
- Year: 2005
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Jeong, Y. J., Hong, S. C., Myeong, S.
L., Park, M. C., Kim, Y. K., Suh, C. M.
This study
assessed the profiles of psychological health and changes in neurohormones of adolescents with mild depression after 12 weeks of dance movement
therapy (DMT). Forty middle school seniors (mean age: 16 years old) volunteered to participate in this study and were randomly assigned into either a
dance movement group (n = 20) or a control group (n = 20). All subscale scores of psychological distress and global scores decreased significantly
after the 12 weeks in the DMT group. Plasma serotonin concentration increased and dopamine concentration decreased in the DMT group. These results
suggest that DMT may stabilize the sympathetic nervous system. In conclusion, DMT may be effective in beneficially modulating concentrations of
serotonin and dopamine, and in improving psychological distress in adolescents with mild depression. Copyright copyright 2005 Taylor & Francis
Inc.
International Journal of Neuroscience., 115(12) : 1711-
1720
- Year: 2005
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art
Hyun, M., Hyang-In, C., Young-Ja, L.
This study examined the
effects of cognitive - behavioral group therapy (CBT) on the self-esteem, depression, and self-efficacy of runaway adolescents residing in a shelter
in Seoul, South Korea. The study used a control group pretest - posttest design. The experimental group and the control group consisted of 14 and 13
male subjects, respectively, with subjects having been randomly assigned to these groups. The experimental group participated in a CBT that consisted
of eight sessions over an 8-week period; the control group did not participate in the program. To examine the effects of the CBT on dependent
variables, the Wilcoxon signed rank test was used. The scores on depression decreased significantly (z = -2.325, p = .02) and those on self-efficacy
increased significantly (z = -2.098, p = .03) after the intervention in the experimental group. There was no significant change on self-esteem (z =
-1.19, p = .23). In the control group, the scores on depression, self-esteem, and self-efficacy did not change significantly after the intervention
period. The CBT developed in this study consisted of structured and specific content that could be usefully applied to runaway adolescents residing
in a shelter.
Applied Nursing Research, 18 : 160-166
- Year: 2005
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Lynch, Frances L., Hornbrook, Mark, Clarke, Gregory N., Perrin, Nancy, Polen, Michael R., O'Connor,
Elizabeth, Dickerson, John
CONTACT: Depression is common in adolescent offspring of depressed parents and can be prevented,
but adoption of prevention programs is dependent on the balance of their incremental costs and benefits. OBJECTIVE: To examine the incremental cost-
effectiveness of a group cognitive behavioral intervention to prevent depression in adolescent offspring of depressed parents. DESIGN: Cost-
effectiveness analysis of a recent randomized controlled trial. SETTING: Kaiser Permanente Northwest, a large health maintenance organization.
PARTICIPANTS: Teens 13 to 18 years old at risk for depression. INTERVENTIONS: Usual care (n = 49) or usual care plus a 15-session group cognitive
therapy prevention program (n = 45). MAIN OUTCOME MEASURES: Clinical outcomes were converted to depression-free days and quality-adjusted life-years.
Total health maintenance organization costs, costs of services received in other sectors, and family costs were combined with clinical outcomes in a
cost-effectiveness analysis comparing the intervention with usual care for 1 year after the intervention. RESULTS: Average cost of the intervention
was $1632, and total direct and indirect costs increased by $610 in the intervention group. However, the result was not statistically significant,
suggesting a possible cost offset. Estimated incremental cost per depression-free day in the base-case analysis was $10 (95% confidence interval, -
$13 to $52) or $9275 per quality-adjusted life-year (95% confidence interval, -$12 148 to $45 641). CONCLUSIONS: Societal cost-effectiveness of a
brief prevention program to reduce the risk of depression in offspring of depressed parents is comparable to that of accepted depression treatments,
and the program is cost-effective compared with other health interventions commonly covered in insurance contracts.
Archives of General Psychiatry, 62(11) : 1241-8
- Year: 2005
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Cornelius, J. R., Clark, D. B., Bukstein, O. G., Kelly,
T. M., Salloum, I. M., Wood, D. S.
The goal of this
3-year follow-up evaluation was to determine whether the decreases in drinking and in depressive symptoms that were noted during our acute phase
study with fluoxetine in comorbid adolescents persisted at a 3-year follow-up evaluation. At the 3-year follow-up evaluation, the group continued to
demonstrate significantly fewer DSM criteria for an AUD and fewer BDI depressive symptoms and also consumed fewer standard drinks than they had
demonstrated at the baseline of the acute phase study. However, 7 of the 10 participants demonstrated MDD at the 3-year follow-up assessment, and 4
demonstrated an AUD. The presence of a MDD was significantly correlated with the presence of an AUD at both the 1-year and the 3-year follow-up
assessments. Four of the participants restarted SSRI medications during the follow-up period. Half of the subjects graduated from college during the
3-year assessment period, despite their residual depressive symptoms and drinking. We conclude that the long-term therapeutic effects of an acute
phase trial of fluoxetine plus psychotherapy slowly decrease but did not disappear when fluoxetine is discontinued shortly after the acute phase
trial. The high rate of MDD at follow-up suggests that longer term antidepressant medication treatment may be needed for at least some comorbid
adolescents. copyright 2004 Elsevier Ltd. All rights reserved.
Addictive Behaviors, 30(4) : 807-
814
- Year: 2005
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy
Cornelius, Jack R., Clark, Duncan B., Bukstein, Oscar G., Birmaher, Boris, Salloum, Ihsan M., Brown, Sandra A.
This paper reviews the results
of an acute phase trial and a five-year follow-up study of fluoxetine in adolescents with major depression and a substance use disorder (SUD). This
study included a 12-week open label acute phase study of 13 comorbid adolescents, followed by comprehensive assessments conducted 1, 3, and 5 years
after entry into an acute phase fluoxetine trial. The results of the acute phase study and of the 1, 3, and 5-year follow-up assessments have already
been published in four papers. The current paper was designed to cover the results of the study across the entire 5-year time spectrum of the study,
and to summarize the clinical results across that entire time period. The data from this pilot study suggest that the long-term (5-year) clinical
course for the Alcohol Dependence, Cannabis Dependence, and academic functioning of comorbid adolescents following acute phase treatment with SSRIs
is generally good. However, the long-term clinical course for the Major Depression of that comorbid adolescent population is surprisingly poor.
[References: 29]
Addictive Behaviors, 30(9) : 1824-
33
- Year: 2005
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy
Clarke, Gregory, Debar, Lynn, Lynch, Frances, Powell, James, Gale, John, O'Connor, Elizabeth, Ludman,
Evette, Bush, Terry, Lin, Elizabeth H., vonKorff, Michael, Hertert, Stephanie
Objective: To test a collaborative-care, cognitive-behavioral therapy (CBT) program adjunctive to selective serotonin reuptake
inhibitor (SSRI) treatment in HMO pediatric primary care. Method: A randomized effectiveness trial comparing a treatment-as-usual (TAU) control
condition consisting primarily of SSRI medication delivered outside the experimental protocol (n = 75) versus TAU SSRI plus brief CBT (n = 77).
Participants were identified by a recent dispense of SSRI medication followed by telephone screening. Adolescents with a diagnosis of major
depressive disorder (n = 152) were enrolled. The CBT program employed cognitive restructuring and/or behavioral activation training. Therapists
consulted with prescribing pediatricians to improve medication adherence. Results: Through 1-year follow-up, the authors found CBT advantages on the
Short Form-12 Mental Component Scale (p = .04), reductions in TAU outpatient visits (p = .02), and days' supply of all medications (p = .01). No
effects were detected for major depressive disorder episodes; a nonsignificant trend favoring CBT was detected on the Center for Epidemiology
Depression Scale (p = .07). Conclusions: The authors detected a weak CBT effect, possibly rendered less significant by the small sample and likely
attenuated by the unexpected reduction in SSRI pharmacotherapy in the CBT condition. Small, incremental improvements over monotherapy, such as
observed in this study, most likely represent the new norm in adolescent depression treatment research. (PsycINFO Database Record (c) 2007 APA, all
rights reserved) (journal abstract).
Journal of the American Academy of Child & Adolescent Psychiatry, 44(9) : 888-
898
- Year: 2005
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)