Disorders - Depressive Disorders
Roberts,
Clare, Kane, Robert, Thomson, Helen, Bishop, Brian, Hart, Bret
A controlled trial was conducted to evaluate a prevention program aimed at reducing
depressive and anxious symptoms in rural school children. Seventh-grade children with elevated depression were selected. Nine primary schools (n =
90) were randomly assigned to receive the program, and 9 control schools (n = 99) received their usual health education classes. Children completed
questionnaires on depression, anxiety, explanatory style, and social skills. Parents completed the Child Behavior Checklist (T. M. Achenbach, 1991).
No intervention effects were found for depression. Intervention group children reported less anxiety than the control group after the program and at
6-month follow-up and more optimistic explanations at postintervention. Intervention group parents reported fewer child internalizing and
externalizing symptoms at postintervention only.
Journal of Consulting & Clinical Psychology, 71(3) : 622-
8
- Year: 2003
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Spence, Sh, Sheffield, J. K., Donovan, C. L.
This study evaluated the effectiveness of the Problem Solving For Life program as a
universal approach to the prevention of adolescent depression. Short-term results indicated that participants with initially elevated depressions
scores (high risk) who received the intervention showed a significantly greater decrease in depressive symptoms and increase in life problem-solving
scores from pre- to postintervention compared with a high-risk control group. Low-risk participants who received the intervention reported a small
but significant decrease in depression scores over the intervention period, whereas the low-risk controls reported an increase in depression scores.
The low-risk group reported a significantly greater increase in problem-solving scores over the intervention period compared with low- risk controls.
These results were not maintained, however, at 12-month follow-up.
Journal of Consulting &
Clinical Psychology, 71(1) : 3-13
- Year: 2003
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Problem solving therapy (PST), Other Psychological Interventions
Mulder, Roger
T., Watkins, William G. A., Joyce, Peter R., Luty, Suzanne E.
BACKGROUND: Multiple lines of
evidence suggest continuity from adolescent to adult depression, but treatment response is different in the two groups. There is some consensus that
noradrenergic drugs are ineffective in adolescent depression. The aim of this study was to see whether this poor response extended to young adults.
METHODS: Patients from two randomised studies on prediction of antidepressant response were used. The subjects were divided into a youth sample (ages
18-24) and an older sample (ages 25 and over). The 6-week percentage response, based on HDRS scores, and the number of patients in remission (i.e.,
HDRS < or =7) at 6 weeks were compared in subjects who received a serotonergic (clomipramine (mean dose 145 mg) and fluoxetine (mean dose 27 mg)) or
a noradrenergic (desipramine (mean dose 200 mg) and nortriptyline (mean dose 100 mg)) antidepressant. RESULTS: There were no significant differences
between the two studies, except for a small variation in baseline Hamilton scores. Young adults had a poorer response to noradrenergic
antidepressants than they did to serotonergic antidepressants, whereas there was no differential response in the older age group. Young adults had a
lower rate of remission on a noradrenergic antidepressant (38% noradrenergic versus 72% serotonergic) but there was no significant difference in
remission rates in older adults (65% noradrenergic versus 57% serotonergic) or the sample as a whole (54% noradrenergic versus 62% serotonergic).
LIMITATIONS: The age cut-off at 24 is somewhat arbitrary. One study was double-blind while the other was open. There was no placebo control.
DISCUSSION: While the response rate to noradrenergic antidepressants in young adults is lower, it is not clear whether this is comparable to
adolescents. The reasons for a reduced response may be related to maturation of the noradrenergic system in the brain. Our results suggest that age
may be one factor to consider when choosing antidepressants for patients.
Journal of Affective
Disorders, 76(1-3) : 143-9
- Year: 2003
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Serotonin-norepinephrine reuptake inhibitors
(SNRIs)
Nelson, Eve-Lynn, Barnard, Martha, Cain, Sharon
Effective cognitive-behavioral
treatments for childhood depression have developed over the last decade, but many families face barriers to such care. Telemedicine increases access
to psychological interventions by linking the child and the clinician using videoconferencing (VC). The current study evaluated an 8-week,
cognitive-behavioral therapy (CBT) intervention for childhood depression either face-to-face (F2F) or over VC. The telemedicine setup included two
PC-based PictureTel systems at 128 kilibits per second (kbps). Success was defined by (1) decreasing depressive symptoms at similar rates in both the
VC group and the F2F group and (2) demonstrating the feasibility of a randomized controlled trial in telemental health. Children were assessed for
childhood depression using the mood section of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present Episode (K-
SADS-P). Twenty-eight children were randomized to either F2F or VC treatment. The participants completed the K-SADS-P and the Children's Depression
Inventory (CDI) at pre- and post-treatment. The CBT treatment across the two conditions was effective. The overall response rate based on post-
evaluation with the K-SADS-P was 82%. For the CDI total score, both the Time and the Group by Time effects were significant (p < 0.05). The
interaction effect reflected a faster rate of decline in the CDI total score for the VC group. The study serves as a model for building on past
research to implement a randomized controlled trial. This information provides persuasive research data concerning treatment effectiveness for
clinicians, families, and funders.
Telemedicine Journal & E-Health, 9(1) : 49-
55
- Year: 2003
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Puskar, Kathryn, Sereika, Susan, Tusaie-
Mumford, Kathleen
PROBLEM:
Incidence of depressive symptoms and lack of sufficient adaptive coping skills in adolescents. METHODS: A randomized controlled study to test the
effectiveness of a group-administered, cognitive-behavioral interventions method, TKC, on rural adolescents (N = 89). Outcomes were measured by
changes in the scores on an Adolescent Depression Scale and the Coping Response Inventory pre/post intervention, at 6 and at 12 months. FINDINGS:
Results indicated improvement in depressive symptomatology and certain coping skills. Students in the intervention reported a higher use of cognitive
problem-solving coping strategies. CONCLUSIONS: The role of a psychiatric nurse in the school system providing short-term psychoeducation
interventions is a practical and effective mental health practice.
Journal
of Child & Adolescent Psychiatric Nursing, 16(2) : 71-80
- Year: 2003
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Jane-Llopis,
Eva, Hosman, Clemens, Jenkins, Rachel, Anderson, Peter
BACKGROUND: Worldwide, 340 million people are affected by depression, with high
comorbid, social and economic costs. AIMS: To identify potential predictors of effect in prevention programmes. METHOD: A meta-analysis was made of
69 programmes to reduce depression or depressive symptoms. RESULTS: The weighted mean effect size of 0.22 was effective for different age groups and
different levels of risk, and in reducing risk factors and depressive or psychiatric symptoms. Programmes with larger effect sizes were multi-
component, included competence techniques, had more than eight sessions, had sessions 60-90 min long, had a high quality of research design and were
delivered by a health care provider in targeted programmes. Older people benefited from social support, whereas behavioural methods were detrimental.
CONCLUSIONS: An 11% improvement in depressive symptoms can be achieved through prevention programmes. Single trial evaluations should ensure high
quality of the research design and detailed reporting of results and potential predictors. [References: 84]
British Journal of Psychiatry, 183 : 384-97
- Year: 2003
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Kataoka, S. H., Stein, B. D., Jaycox, L. H., Wong, M., Escudero, P., Tu, W., Zaragoza, C., Fink, A.
Objective: To pilot-test a school mental health program for Latino immigrant students who have been exposed to community violence.
Method: In this quasi-experimental study conducted from January through June 2000, 198 students in third through eighth grade with trauma-related
depression and/or posttraumatic stress disorder symptoms were compared after receiving an intervention or being on a waitlist. The intervention
consisted of a manual-based, eight-session, group cognitive-behavioral therapy (CBT) delivered in Spanish by bilingual, bicultural school social
workers. Parents and teachers were eligible to receive psychoeducation and support services. Results: Students in the intervention group (n = 152)
had significantly greater improvement in posttraumatic stress disorder and depressive symptoms compared with those on the waitlist (n = 47) at 3-
month follow-up, adjusting for relevant covariates. Conclusions: A collaborative research team of school clinicians, educators, and researchers
developed this trauma-focused CBT program for Latino immigrant students and their families. This pilot test demonstrated that this program for
traumatized youths, designed for delivery on school campuses by school clinicians, can be implemented and evaluated in the school setting and is
associated with a modest decline in trauma-related mental health problems.
Journal of the American Academy of Child & Adolescent Psychiatry, 42(3) : 311-
8
- Year: 2003
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Milin,
Robert, Walker, Selena, Chow, Joy
OBJECTIVE: Treating adolescents with depression remains a major clinical and public health challenge. Because of the
serious morbidity and mortality associated with adolescent major depressive disorder (MDD), there is a need to review the published literature on
treatment efficacy to establish effective treatment choices for these adolescents. METHOD: We reviewed the recent literature on the treatment of MDD
in adolescents using the Medline and PsycINFO computerized databases. RESULTS: Results of open studies of MDD treatment in adolescents suggested
therapeutic efficacy; however, later, better-controlled studies are more difficult to interpret, owing to the high rate of improvement with placebo.
Currently, there is limited evidence of robust, effective therapeutic interventions in children and in adolescent depressive disorders. CONCLUSIONS:
Despite limitations, current findings from studies investigating selective serotonin reuptake inhibitors (SSRIs), cognitive-behavioural therapy, and
interpersonal therapy generally support these treatments as safe and effective for adolescent MDD. Still, further investigations into these
treatments for adolescent depression are warranted. [References: 85]
Canadian Journal of Psychiatry, 48(9) : 600-6
- Year: 2003
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Psychological Interventions
(any)
Lock, S, Barrett, P.M
The present paper presents the results of a
longitudinal study evaluating the effects of a universal school-based intervention for child anxiety at two developmental stages. The study involved
a cohort of 733 children enrolled in grade 6 (n = 336, 45.6%) aged between 9 and 10 years, and grade 9 (n = 401, 54.4%) aged between 14 and 16 years.
Participants were allocated to either a school-based cognitive-behavioural intervention or to a monitoring group, and completed standardised measures
of anxiety, depression and coping style. Young people identified as \"at risk\" of an anxiety disorder were assessed for a clinical diagnosis with a
structured diagnostic interview. Findings showed universal intervention as potentially successful in reducing symptoms of anxiety and increasing
coping skills in children. Primary school children reported the greatest changes in anxiety symptoms, suggesting earlier preventive intervention was
potentially more advantageous than later intervention. Developmental differences in anxiety, depression and coping strategies are discussed in
addition to the implications and limitations of this study and directions for future research.
Behaviour Change, 20(4) : 183-
199
- Year: 2003
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Lowry-Webster, Hayley M., Barrett, Paula M., Lock, Sally
In 2001 we evaluated a universal prevention trial of anxiety during childhood, and also examined
the effects of the program on levels of depression. Participants were 594 children aged 10-13 years from seven schools in Brisbane, Australia, who
were randomly assigned to an intervention or control group on a school-by-school basis. The intervention was based on the group CBT program FRIENDS
(Barrett, Lowry-Webster & Holmes, 1999a, 1999b, 1999c). Results were examined universally (for all children) and for children who scored above the
clinical cut-off for anxiety at pre-test. At 12-month follow-up, intervention gains were maintained, as measured by self-reports and diagnostic
interviews. Eighty-five per cent of children in the intervention group who were scoring above the clinical cut-off for anxiety and depression were
diagnosis free in the intervention condition, compared to only 31.2% of children in the control group. Implications of these findings are examined,
alongside limitations and directions for future research. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (journal abstract).
Behaviour Change, 20(1) : 25-43
- Year: 2003
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Layne, Ann E., Bernstein, Gail A., Kushner, Matt
G.
OBJECTIVE: To identify predictors of treatment response to 8 weeks of cognitive-
behavioral therapy (CBT) among anxious-depressed adolescents with school refusal, half of whom received imipramine plus CBT and half of whom received
placebo plus CBT. METHOD: A hierarchical multiple regression analysis was used to evaluate the following variables as potential predictors of
treatment response as measured by school attendance at the end of treatment: baseline severity (school attendance at baseline), drug group
(imipramine versus placebo), presence of separation anxiety disorder (SAD), and presence of avoidant disorder (AD). RESULTS: Baseline attendance, CBT
plus imipramine, SAD, and AD were significant predictors of treatment response and accounted for 51% of the variance in outcome. Specifically, a
higher rate of attendance at baseline and receiving imipramine predicted a better response to treatment whereas the presence of SAD and AD predicted
a poorer response to treatment. The relationship between sociodemographic variables and treatment outcome was also evaluated. Age and socioeconomic
status were unrelated to school attendance after treatment. Males had significantly higher rates of attendance after treatment than females.
CONCLUSIONS: Adolescents with school refusal are a heterogeneous population and require individualized treatment planning. Variables such as
diagnosis and severity at the start of treatment should be taken into consideration when planning treatment.
Journal of the American Academy of Child & Adolescent Psychiatry, 42(3) : 319-
26
- Year: 2003
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Tricyclic antidepressants, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Bearman, S. K., Stice, E., Chase, A.
Because depressive and bulimic pathologies often co-occur among adolescent girls, a preventive program focusing on both disturbances
would have clinical utility. Thus, we developed a cognitive-behavioral intervention targeting body dissatisfaction, an established risk factor for
both conditions. A randomized prevention trial with late adolescent girls suggested that the intervention reduced body dissatisfaction, negative
affect, depressive symptoms, and bulimic symptoms, but not dieting. Effects persisted through 3-month follow-up, but most faded by 6-month follow-up.
Intervention effects on negative affect, depressive symptoms, and bulimic symptoms appeared to be mediated by change in body dissatisfaction.
Participant age, ethnicity, and body mass did not moderate intervention effects. Results suggest that an intervention that improves body satisfaction
might reduce depressive and bulimic symptoms but imply that greater emphasis on preventing future symptoms might be necessary for persistent
effects.
Behavior Therapy, 34(3) : 277-293
- Year: 2003
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)