Disorders - Depressive Disorders
Goodyer, I. M., Wilkinson, P. O.
BACKGROUND: Over the past two decades new and key
randomized controlled trials have reported the efficacy, clinical and cost effectiveness of psychological and pharmacological treatments for
adolescents with major depression. METHOD(S): The literature was searched through pubmed, psychinfo, scopus and web of science for randomized
controlled trials of current major depression together with meta-analyses and systematic reviews of trials between 2000 and 2017. Those specific to
the adolescent years (11-18 years) were taken as the primary source for this narrative review. Additional selected studies in adults were used to
illustrate methodological issues. RESULT(S): Manualized psychological therapies and the SSRI fluoxetine are more effective than active placebo in the
treatment of major depressions. Mild to moderate illnesses attending community-based services are likely to benefit from psychological treatment
alone. Moderately to severely ill patients attending clinic and hospital services are likely to benefit from monotherapies or combining psychological
and pharmacological treatment. Antidepressants carry a small but significant side-effect risk including increased suicidality. Side effects from
psychotherapies are somewhat lower but specific negative consequences remain less well characterized. There is some evidence that CBT-based
approaches prevent onset of major depression episode in well adolescents at high-risk. Other psychological interventions have not been adequately
studied. There has been only limited identification of treatment moderators and no clear understanding of therapeutic mechanisms. CONCLUSION(S):
There is now a range of clinically effective treatments for depressed adolescents. Future research needs to reveal moderators of and mechanisms for
individual differences to treatment response, determine psychotherapies of value for milder depressions, enhance our understanding of safety and
side-effects for all treatments, and consider how to reduce and treat treatment-resistant cases. Copyright © 2018 Association for Child and
Adolescent Mental Health.
Journal of child psychology and psychiatry, and allied
disciplines, 60(3) : 232-243
- Year: 2019
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Antidepressants
(any), Psychological Interventions
(any)
Matos, A. P.
This study evaluated whether Arnarson and Craighead's (2009, 2011) developmentally based
behavioral and cognitive program that prevented the initial episode of depressive disorders among Icelandic adolescents could be adapted to prevent
depressive disorders among \"at-risk\" Portuguese adolescents. One hundred sixty-eight Portuguese mid-adolescents (primarily 14 to 15 years old), who
had subsyndromal symptoms of depression but who had never met criteria for a depressive disorder, were identified by classroom screening with the CDI
and subsequent K-SADS-PL interview. All 168 adolescents were offered participation in the 14-week prevention program; 70 agreed to participate in the
program, and 98 agreed to participate only in an assessment control group. Psychological disorders were evaluated at baseline, 6-, 12-, 18-, and 24-
month assessments. During the 2-year follow-up period, 12 students in the assessment-only group experienced an initial depressive disorder versus 2
in the prevention group. Survival analyses indicated a significantly lower rate of initial episodes of depressive disorders, chi2(1) =
4.261, p = .039, among the prevention group participants compared to the assessment only comparison group. The hazard ratio was .207, and the NNT was
11. Survival analyses indicated no significant differences between the prevention condition and the assessment only condition in the occurrence of
other psychiatric disorders, chi2(1) = 1.080, p = .299. The findings indicate the program can be successfully adapted for use in Portuguese schools,
and they provide a preliminary indication that those \"at-risk\" adolescents who chose to participate in the program, compared to those who chose to
participate only in the assessments, developed fewer initial episodes of depressive disorders over the course of 24 months. The program effects were
similar to the outcomes of the prior study of this program in Iceland. As in the Icelandic version of the program, its effects appeared to be
specific to the depressive disorders for which the program was designed. Copyright © 2018
Behavior
Therapy, 50(4) : 743-754
- Year: 2019
- Problem: Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions
Fristad, M.A., Vesco, A.T., Young, A.S., Healy, K., Nader, E.S., Gardner, W., Seidenfeld, A.M., Wolfson, H.L., Arnold, L.
The goal of this study
is to evaluate feasibility and estimate effect sizes of omega-3 fatty acids (OMEGA3), individual-family psychoeducational psychotherapy (PEP), their
combination, and moderating effects of maternal depression and psychosocial stressors in youth with depression. In a pilot 2 x 2 randomized
controlled trial, 72 youth (ages 7-14; 57% Caucasian, 57% male) with major depression, dysthymia, or depression not otherwise specified were
randomized to 12 weeks of OMEGA3, PEP + placebo, OMEGA3 + PEP, or placebo. OMEGA3 versus placebo was double-masked. Evaluators masked to condition
assessed depressive severity at baseline (randomization) and at 2, 4, 6, 9, and 12 weeks using the Children's Depression Rating Scale-Revised. Side
effects were either absent or mild. PEP was administered with 74% fidelity. Remission was 77%, OMEGA3 + PEP; 61%, PEP + placebo; 44%, OMEGA3; 56%,
placebo. Intent-to-treat analyses found small to medium effects of combined treatment (d = .29) and OMEGA3 monotherapy (d = .42), but negligible
effect for PEP + placebo (d < .10), all compared to placebo alone. Relative to placebo, youth with fewer social stressors responded better to OMEGA3
(p = .04), PEP (p = .028), and their combination (p = .035), and those with maternal depression responded better to PEP (p = .020) than did those
without maternal depression. Remission rates were favorable compared to other studies of psychotherapy and comparable to an existing randomized
controlled trial of OMEGA3; results warrant further evaluation in a larger sample. OMEGA3 was well tolerated. Active treatments show significantly
more placebo-controlled depression improvement in the context of maternal depression and fewer stressors, suggesting that they may benefit depression
with a more endogenous than environmental origin. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Journal of Clinical Child and Adolescent Psychology, 48(Suppl 1) : S105-
S118
- Year: 2019
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions, Fish oil (Omega-3 fatty acids), Omega 3 fatty
acids (e.g. fish oil, flax oil)
Fite, P. J., Cooley, J. L., Poquiz, J., Williford, A.
OBJECTIVE:
Due to the limited effectiveness of extant prevention and intervention strategies, the current study is an initial evaluation of a cognitive
behavioral group intervention, originally designed to treat symptoms of depression and anxiety, for youth who experienced peer victimization. METHOD
(S): Twelve third- through fifth-grade youth participated in the intervention, and their data were compared with 12 youth who were a part of a
naturalistic control group. Additionally, school-wide data are reported to provide overall school trends. RESULT(S): Whereas the intervention group
participants exhibited decreases in relational victimization, depressive symptoms, and passive coping, the control group participants exhibited
nonsignificant increases in relational victimization, depressive symptoms, and passive coping. School-wide data also indicated overall increases in
relational victimization and depressive symptoms, but no changes in passive coping. CONCLUSION(S): Findings suggest that cognitive behavioral group
interventions may provide a promising avenue for addressing the mental health needs of victimized elementary school-age youth. Copyright © 2018 Wiley
Periodicals, Inc.
Journal of Clinical
Psychology, 75(1) : 46-65
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Dale, L. P., Vanderloo, L., Moore, S., Faulkner,
G.
Problem: A 2011 review of reviews reported small to moderate associations between physical activity (PA)and
depression, anxiety and self-esteem among children and youth (aged 5-17 years). Due to the increase in reviews examining PA and mental health
outcomes in children and youth over the past decade, we conducted an umbrella review to determine the current state of the literature, including
whether effects were moderated by dose and type of PA, age, sex, or severity of mental illness. Method(s): We systematically reviewed literature
published from 2010 onwards from six online databases to identify and summarize findings from systematic reviews examining PA and depression,
anxiety, and self-esteem outcomes in children and youth. We assessed review quality using the AMSTAR 2 critical appraisal tool. Result(s): We
identified 26 reviews examining depression (n = 16), anxiety (n = 2), and self-esteem (n = 14). Half of the eligible reviews were considered to be of
low or critically low quality (n = 13). PA had positive mental health outcomes for children and youth, specifically for reduction in
depression/depressive symptoms and improvements in physical self-concept, a self-esteem sub-domain. Little research has examined PA and anxiety. The
moderator analyses reviewed revealed stronger effects in populations with clinical diagnoses (e.g. depression)and for interventions consisting of
regular, supervised, group-based aerobic exercise. Conclusion(s): PA appears to be an effective intervention for reducing depression/depressive
symptoms and improving physical self-perceptions, although additional high-quality research and moderator analyses are needed to determine what type
of PA interventions may result in better mental health outcomes for children and youth. Copyright © 2018 Elsevier Ltd
Mental Health and Physical Activity, 16 : 66-79
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Rose-Clarke, K., Bentley, A., Marston, C., Prost, A.
Background Adolescents aged 10-19 represent one sixth of
the world's population and have a high burden of morbidity, particularly in low-resource settings. We know little about the potential of community-
based peer facilitators to improve adolescent health in such contexts. Methods We did a systematic review of peer-facilitated community-based
interventions for adolescent health in low- and middle-income countries (LMICs). We searched databases for randomised controlled trials of
interventions featuring peer education, counselling, activism, and/or outreach facilitated by young people aged 10-24. We included trials with
outcomes across key areas of adolescent health: infectious and vaccine preventable diseases, undernutrition, HIV/AIDS, sexual and reproductive
health, unintentional injuries, violence, physical disorders, mental disorders and substance use. We summarised evidence from these trials
narratively. PROSPERO registration: CRD42016039190. Results We found 20 studies (61,014 adolescents). Fourteen studies tested interventions linked to
schools or colleges, and 12 had non-peer-facilitated components, e.g. health worker training. Four studies had HIV-related outcomes, but none
reported reductions in HIV prevalence or incidence. Nine studies had clinical sexual and reproductive health outcomes, but only one reported a
positive effect: a reduction in Herpes Simplex Virus-2 incidence. Three studies had violence-related outcomes, two of which reported reductions in
physical violence by school staff and perpetration of physical violence by adolescents. Seven studies had mental health outcomes, four of which
reported reductions in depressive symptoms. Finally, we found eight studies on substance use, four of which reported reductions in alcohol
consumption and smoking or tobacco use. There were no studies on infectious and vaccine preventable diseases, undernutrition, or injuries.
Conclusions There are few trials on the effects of peer-facilitated community-based interventions for adolescent health in LMICs. Existing trials
have mixed results, with the most promising evidence supporting work with peer facilitators to improve adolescent mental health and reduce substance
use and violence. Copyright © 2019 Rose-Clarke et al. This is an open access article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PLoS ONE, 14 (1) (no
pagination)(e0210468) :
- Year: 2019
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other service delivery and improvement
interventions
David, O. A., Cardos, R. A. I., Matu, S.
Therapeutic games represent a promising
solution for addressing emotional difficulties in youths. The aim of the present study was to investigate the effectiveness of the REThink game, in
helping children and adolescents, to develop psychological resilience. Therefore, 165 children aged between 10 and 16 years were randomly assigned in
one of the three groups: 54 participants in the REThink condition, 55 participants in the Rational Emotive Behavior Education condition, and 56
participants in the waitlist condition.
European Child & Adolescent
Psychiatry, 28(1) : 111-122
- Year: 2019
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Black, S.R., Blampied, N., Arnold, L., Fristad, M.A.
Using both group (nomothetic) and individual
(idiographic) approaches to measuring clinical change may provide more information about the effectiveness of an intervention than either approach
alone. The current study re-examined previously published data from two randomized clinical trials of omega-3 fatty acids and Individual-Family
Psychoeducational Psychotherapy as treatment for mood disorders in youth, using modified Brinley plots, a method of illustrating individuals'
treatment response in the context of group information. Although the original nomothetic approach provided information about the average effect of
treatment, modified Brinley plots gave more information about individual children's outcomes. Practicing clinicians in particular could use modified
Brinley plots to track treatment trajectories and outcomes for specific clients and subsequently use these data to inform treatment planning.
(PsycINFO Database Record (c) 2019 APA, all rights reserved)
Clinical Psychology: Science and Practice, 26(1) : 1-17
- Year: 2019
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Psychoeducation, Fish oil (Omega-3 fatty acids), Omega 3 fatty
acids (e.g. fish oil, flax oil)
Levinson, J., Kohl, K., Baltag, V., Ross, D. A.
Schools are the
only institution regularly reaching the majority of school-age children and adolescents across the globe. Although at least 102 countries have school
health services, there is no rigorous, evidence-based guidance on which school health services are effective and should be implemented in schools. To
investigate the effectiveness of school health services for improving the health of school-age children and adolescents, a systematic review of
systematic reviews (overview) was conducted. Five databases were searched through June 2018. Systematic reviews of intervention studies that
evaluated school-based or school-linked health services delivered by a health provider were included. Review quality was assessed using a modified
Ballard and Montgomery four-item checklist. 1654 references were screened and 20 systematic reviews containing 270 primary studies were assessed
narratively. Interventions with evidence for effectiveness addressed autism, depression, anxiety, obesity, dental caries, visual acuity, asthma, and
sleep. No review evaluated the effectiveness of a multi-component school health services intervention addressing multiple health areas. From the
limited amount of information available in existing systematic reviews, the strongest evidence supports implementation of anxiety prevention
programs, indicated asthma education, and vision screening with provision of free spectacles. Additional systematic reviews are needed that analyze
the effectiveness of comprehensive school health services, and specific services for under-researched health areas relevant for this population.
Copyright © 2019 Levinson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PLoS ONE, 14 (6) (no pagination)(e0212603) :
- Year: 2019
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Universal prevention, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Silk, Jennifer S., Price, Rebecca B., Rosen, Dana, Ryan, Neal D., Forbes, Erika E., Siegle, Greg J., Dahl, Ronald E., McMakin, Dana L., Kendall, Philip C., Ladouceur, Cecile D.
Objective:
Children who are fearful and anxious are at heightened risk for developing depression in adolescence. Treating anxiety disorders in pre-/early
adolescence may be one mechanism through which depressive symptoms later in adolescence can be prevented. We hypothesized that anxious youth who
responded positively to cognitive-behavioral therapy (CBT) for anxiety would show reduced onset of depressive symptoms 2 years later compared to
treatment nonresponders, and that this effect would be specific to youth treated with CBT compared to an active supportive comparison treatment.
Method: Participants were 80 adolescents ages 11 to 17 years who had previously completed a randomized trial comparing predictors of treatment
response to CBT and child-centered therapy (CCT). Youth met DSM-IV criteria for generalized, separation, and/or social anxiety disorder at the time
of treatment. The present study was a prospective naturalistic 2-year follow-up examining trajectories toward depression, in which participants were
reassessed for depressive symptoms 2 years after anxiety treatment. Treatment response was defined as a 35% reduction in independent evaluator-rated
anxiety severity on the Pediatric Anxiety Rating Scale after treatment. Results: As hypothesized, lower levels of depressive symptoms were observed
in anxious youth who responded to CBT for anxiety (beta = -0.807, p = .004) but not CCT (beta = 0.254, p = .505). Sensitivity analyses showed that
the effects were driven by girls. Conclusion: Findings suggest that CBT for anxiety is a promising approach to preventing adolescent depressive
symptomatology, especially among girls. The results highlight the need for better early screening for anxiety and better dissemination of CBT
programs targeting anxiety in youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Journal of the American Academy of Child &
Adolescent Psychiatry, 58(3) : 359-367
- Year: 2019
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Supportive
therapy, Other Psychological Interventions
Young, J.F., Jones, J.D., Sbrilli, Marissa D., Benas, J.S., Spiro, C.N., Haimm, C.A., Gallop, R., Mufson, L., Gillham, J.E.
Adolescence represents a
vulnerable developmental period for depression and an opportune time for prevention efforts. In this study, 186 adolescents with elevated depressive
symptoms (M age = 14.01, SD = 1.22; 66.7% female; 32.2% racial minority) were randomized to receive either Interpersonal Psychotherapy-Adolescent
Skills Training (IPT-AST; n = 95) delivered by research clinicians or group counseling (GC; n = 91) delivered by school counselors. We previously
reported the short-term outcomes of this school-based randomized controlled trial: IPT-AST youth experienced significantly greater improvements in
depressive symptoms and overall functioning through 6-month follow-up. Here, we present the long-term outcomes through 24 months postintervention. We
examined differences in rates of change in depressive symptoms and overall functioning and differences in rates of depression diagnoses. Youth in
both conditions showed significant improvements in depressive symptoms and overall functioning from baseline to 24-month follow-up, demonstrating the
efficacy of school-based depression prevention programs. However, the two groups did not differ in overall rates of change or in rates of depression
diagnoses from baseline to 24-month follow-up. Although IPT-AST demonstrated advantages over GC in the short term, these effects dissipated over
long-term follow-up. Specifically, from 6- to 24-month follow-up, GC youth showed continued decreases in depressive symptoms, whereas IPT-AST youth
showed a nonsignificant increase in symptoms. GC youth remained relatively stable in overall functioning, whereas IPT-AST youth experienced a small
but statistically significant worsening in functioning. This study highlights the potential of school-based depression prevention efforts and the
need for further research. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Journal of Clinical Child and Adolescent Psychology, 48(Suppl 1) : S362-
S370
- Year: 2019
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Interpersonal therapy (IPT), Skills training, Supportive
therapy
Harrer, M., Adam, S. H., Baumeister, H., Cuijpers, P., Karyotaki, E., Auerbach, R. P., Kessler, R. C., Bruffaerts,
R., Berking, M., Ebert, D. D.
OBJECTIVES: Mental health disorders are
highly prevalent among university students. Universities could be an optimal setting to provide evidence-based care through the Internet. As part of
the World Mental Health International College Student initiative, this systematic review and meta-analysis synthesizes data on the efficacy of
Internet-based interventions for university students' mental health. METHOD(S): A systematic literature search of bibliographical databases
(CENTRAL, MEDLINE, and PsycINFO) for randomized trials examining psychological interventions for the mental health (depression, anxiety, stress,
sleep problems, and eating disorder symptoms), well-being, and functioning of university students was performed through April 30, 2018. RESULT(S):
Forty-eight studies were included. Twenty-three studies (48%) were rated to have low risk of bias. Small intervention effects were found on
depression (g = 0.18, 95% confidence interval [CI; 0.08, 0.27]), anxiety (g = 0.27, 95% CI [0.13, 0.40]), and stress (g = 0.20, 95% CI [0.02, 0.38]).
Moderate effects were found on eating disorder symptoms (g = 0.52, 95% CI [0.22-0.83]) and role functioning (g = 0.41, 95% CI [0.26, 0.56]). Effects
on well-being were non-significant (g = 0.15, 95% CI [-0.20, 0.50]). Heterogeneity was moderate to substantial in many analyses. After adjusting for
publication bias, effects on anxiety were not significant anymore. DISCUSSION: Internet interventions for university students' mental health can
have significant small-to-moderate effects on a range of conditions. However, more research is needed to determine student subsets for which
Internet-based interventions are most effective and to explore ways to increase treatment effectiveness. Copyright © 2018 John Wiley & Sons, Ltd.
International journal of methods in psychiatric
research, 28(2) : e1759
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), 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)