Disorders - depressive disorders
Hayes, Louise, Boyd, Candice P., Sewell, Jessica
Based on promising results with adults,
Acceptance and Commitment Therapy (ACT) presents as a treatment opportunity for depressed adolescents. We present a pilot study that compares ACT
with treatment as usual (TAU), using random allocation of participants who were clinically referred to a psychiatric outpatient service. Participants
were 30 adolescents, aged M = 14.9 (SD = 2.55), with 73.6% in the clinical range for depression. At posttreatment on measures of depression
participants in the ACT condition showed significantly greater improvement statistically (d = 0.38), and 58% showed clinically reliable change with a
response ratio of 1.59 in favor of ACT. Outcomes from 3-month follow-up data are tentative due to small numbers but suggest that improvement
increased in magnitude. Measures of global functioning showed statistically significant improvement for both conditions, although clinical change
measures favored only the ACT condition. The results support conducting a larger trial of ACT for the treatment of adolescent depression. (PsycINFO
Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Mindfulness, 2(2) : 86-
94
- Year: 2011
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Acceptance & commitment therapy
(ACT)
Hasanovic, M. I., Srabovic, S., Rasidovic, M., Sehovic, M., Hasanbasic, E., Husanovic, J., Hodzic,
R.
Objective: To estimate whether psychosocial support of the
School Project UHD nullPrijateljice-Friendsnull positively affect on reducing of posttraumatic consequences in Bosnia-Herzegovina primary and
secondary school students, after the war period 1992-1995. Subjects and Methods: The stratified sample of 336 students, aged of 13.6 (plus or minus)
1.9, in primary and secondary schools, involved in psychosocial support, compared with 72 randomly selected peers from the same schools, not involved
in this project. Data were collected in December 2005 and in May 2006. The Children Depression Inventory and Index of Children Post-traumatic
Reactions were utilized. Statistical analysis involved McNemar's test, Students' t test, Chi-square test and Pearsons' correlation test. Results:
According to DSM, the prevalence of PTSD and depression among students involved in the School Project, significantly reduced from (46.1 to 13.4%;
25.6 to 1.8%, respectively) (McNemar's test, p<0.001; p<0.001, respectively). In the control group the prevalence of PTSP and depression reduced
from (30.5 to 23.6%; 22.2 to 11.1%, respectively), with no significancy (McNemar's test, P = 0.332; P = 0.077, significantly). Girls had
significantly higher prevalence of both PTSD and depression compared to the boys. Age, number of traumatic episodes, and suicidal behavior correlated
with the intensity of PTSD symptoms and depression symptoms. Conclusions: Psychosocial support within the School Project resulted with significant
reduction of PTSP and depression amongst involved students compared to controls. Schools and other institutions ought to envisage as many as possible
projects to be implemented in schools and out-of-schools in order to assist youth to easier overcome consequences of no favorable war in their
development.
Intensive Care Medicine, 37 : S420
- Year: 2011
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Erford, Bradley T., Erford, Breann M., Lattanzi, Gina, Weller, Janet, Schein, Hallie, Wolf, Emily, Hughes, Meredith, Darrow, Jenna, Savin-Murphy, Janet, Peacock, Elizabeth
Clinical trials exploring the
effectiveness of counseling and psychotherapy in treatment of depression in school-age youth composed this meta-analysis. Results were synthesized
using a random effects model for mean difference and mean gain effect size estimates. No effects of moderating variables were evident. Counseling and
psychotherapy are effective for treatment of depression in school-age youth both at termination and follow-up, and in school and nonschool settings.
(PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of Counseling &
Development, 89(4) : 439-457
- Year: 2011
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Curry, John, Silva, Susan, Rohde, Paul, Ginsburg,
Golda, Kratochvil, Christopher, Simons, Anne, Kirchner, Jerry, et-al
Context: Objectives: Design: Setting:
Participants: Main Outcome Measures: Results: Conclusions: Major depressive disorder in adolescents is common and impairing. Efficacious treatments
have been developed, but little is known about longer-term outcomes, including recurrence.To determine whether adolescents who responded to short-
term treatments or who received the most efficacious short-term treatment would have lower recurrence rates, and to identify predictors of recovery
and recurrence.Naturalistic follow-up study.Twelve academic sites in the United States.One hundred ninety-six adolescents (86 males and 110 females)
randomized to 1 of 4 short-term interventions (fluoxetine hydrochloride treatment, cognitive behavioral therapy, their combination, or placebo) in
the Treatment for Adolescents With Depression Study were followed up for 5 years after study entry (44.6% of the original Treatment for Adolescents
With Depression Study sample).Recovery was defined as absence of clinically significant major depressive disorder symptoms on the Schedule for
Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version interview for at least 8 weeks, and recurrence was defined
as a new episode of major depressive disorder following recovery.Almost all participants (96.4%) recovered from their index episode of major
depressive disorder during the follow-up period. Recovery by 2 years was significantly more likely for short-term treatment responders (96.2%) than
for partial responders or nonresponders (79.1%) (P < .001) but was not associated with having received the most efficacious short-term treatment (the
combination of fluoxetine and cognitive behavioral therapy). Of the 189 participants who recovered, 88 (46.6%) had a recurrence. Recurrence was not
predicted by full short-term treatment response or by original treatment. However, full or partial responders were less likely to have a recurrence
(42.9%) than were nonresponders (67.6%) (P = .03). Sex predicted recurrence (57.0% among females vs 32.9% among males; P = .02).Almost all depressed
adolescents recovered. However, recurrence occurs in almost half of recovered adolescents, with higher probability in females in this age range.
Further research should identify and address the vulnerabilities to recurrence that are more common among young women.
Archives of General Psychiatry, 68(3) : 263-
269
- Year: 2011
- 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)
Dean, A. J., Bellgrove, M. A., Hall, T., Phan, W. M., Eyles, D. W., Kvaskoff, D., McGrath, J. J.
Epidemiological research links vitamin D status to various brain-related outcomes. However, few trials examine whether
supplementation can improve such outcomes and none have examined effects on cognition. This study examined whether Vitamin D supplementation led to
improvements in diverse measures of cognitive and emotional functioning, and hypothesised that supplementation would lead to improvements in these
outcomes compared to placebo. Healthy young adults were recruited to a parallel-arm, double-blind trial conducted at The University of Queensland.
Participants were randomly allocated to receive Vitamin D (one capsule daily, containing 5000 IU cholecalciferol) or identical placebo capsule for
six weeks. All participants and outcome assessors were blinded to group assignment. Primary outcome measures assessed at baseline and 6 weeks were
working memory, response inhibition and cognitive flexibility. Secondary outcomes were: hallucination-proneness, psychotic-like experiences, and
ratings of depression, anxiety and anger. 128 participants were recruited, randomised and included in primary analyses (vitamin D n = 63; placebo n =
65). Despite significant increases in vitamin D status in the active group, no significant changes were observed in working memory (F = 1.09; p =
0.30), response inhibition (F = 0.82; p = 0.37), cognitive flexibility (F = 1.37; p = 0.24) or secondary outcomes. No serious adverse effects were
reported. Our findings indicate that vitamin D supplementation does not influence cognitive or emotional functioning in healthy young adults. Future
controlled trials in targeted populations of interest are required to determine whether supplementation can improve functioning in these domains.
Australian and New Zealand Clinical Trials Registry; ACTRN12610000318088.
PLoS ONE, 6(11) : e25966
- Year: 2011
- Problem: Anxiety Disorders (any), Depressive Disorders, Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Douaihy, A., Cornelius, J., Chung, R. T., Daley, D., Wood, D., Kirisci,
L., Hayes, J., et-al
The authors recently completed a first double-blind, placebo-controlled trial of fluoxetine (20 mg) in 70 adolescents and young
adults with comorbid major depressive disorder (MDD) and an cannabis use disorder (CUD), most of whom also demonstrated an alcohol use disorder
(AUD). All participants also received cognitive behavior therapy (CBT) and motivation enhancement therapy (MET) during the 12-week trial. The results
of that acute phase study suggested efficacy for CBT-MET therapy but not for fluoxetine (Cornelius et al., 2010, in DAD). A one-year follow-up (F/U)
evaluation was conducted to assess whether the improvements noted during the acute phase study persist. 68 of the 70 youth (97%) participated in the
F/U evaluation. Increases in days of marijuana use, binge days of alcohol, and days of alcohol use were noted between the end of the acute phase
trial and the 1-year F/U (p < 0.01). However, days of marijuana use and level of depressive symptoms continued to be lower at the 1-year F/U than at
the acute phase baseline. No significant differences were noted between the fluoxetine group and the placebo group during the follow-up phase, just
as none had been noted during the acute phase trial. These finding suggest that many of the clinical improvements noted during the acute phase trial
persisted at the 1-year F/U assessment.
Alcoholism: Clinical & Experimental
Research, 35 : 20A
- Year: 2011
- Problem: Depressive Disorders, Cannabis Use
- 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
Compas, B. E., Forehand, R., Thigpen, J. C., Keller, G., Hardcastle, E. J., Cole, D. A, Potts, J., Watson,
K., Rakow, A., Colletti, C., Reeslund, K., Fear, J., Garai, E., McKee, L., Merchant,
M. J., Roberts, L.
Objective: In a
long-term follow-up of a randomized controlled trial (Compas et al., 2009) to examine the effects at 18- and 24-month follow-ups of a family group
cognitive-behavioral (FGCB) preventive intervention for mental health outcomes for children and parents from families (N = 111) of parents with a
history of major depressive disorder (MDD). Method: Parents with a history of MDD and their 9- to 15-year-old children were randomly assigned to a
FGCB intervention or a written information comparison condition. Children's internalizing, externalizing, anxiety/depression, and depressive
symptoms; episodes of MDD and other psychiatric diagnoses; and parents' depressive symptoms and episodes of MDD were assessed at 18 and 24 months
after randomization. Results: Children in the FGCB condition were significantly lower in self-reports of anxiety/depression and internalizing
symptoms at 18 months and were significantly lower in self-reports of externalizing symptoms at 18 and 24 months. Rates of MDD were significantly
lower for children in the FGCB intervention over the 24-month follow-up (odds ratio = 2.91). Marginal effects were found for parents' symptoms of
depression at 18 and 24 months but not for episodes of MDD. Conclusions: Support was found for a FGCB preventive intervention for children of parents
with a history of MDD significantly reducing children's episodes of MDD over a period of 2 years. Significant effects for the FGCB intervention were
also found on internalizing and externalizing symptoms, with stronger effects at 18- than at 24-month follow-up. (copyright) 2011 American
Psychological Association.
Journal of Consulting & Clinical Psychology, 79(4) : 488-499
- Year: 2011
- 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), Psychoeducation
Cornelius, J., Douaihy, A., Chung, T., Kelly, T., Daley, D., Hayes, J., Wood, D., Kirisci, L., Clark, D.
The authors recently
completed a first long-term (4 year) follow-up study involving subjects who had participated in a double-blind, placebo-controlled acute phase trial
of fluoxetine (20 mg) in adolescents with comorbid major depressive disorder (MDD) and an alcohol use disorder (AUD). The subjects in the acute phase
trial included 50 teens who had been randomized to fluoxetine or placebo, all of whom also received motivational enhancement therapy (MET) and
cognitive behavioral psychotherapy (CBT) during the acute phase trial. During the acute phase trial, subjects in both treatment groups showed
significant decreases in alcohol use and depressive symptoms, but no significant between-group differences were noted, suggesting efficacy for CBT-
MET therapy but not for fluoxetine (Cornelius, et al., 2009). Most (72%) of the subjects who participated in the acute phase trial also participated
in the 4- year follow-up assessment study, consisting of four annual assessments over 4 years. At the four-year follow-up evaluation, ratings of
depressive symptoms and of alcohol quantity (but not frequency) were significantly lower than baseline levels, but were not significantly different
from end-of-trial levels. These findings suggest longer-term efficacy (4 year) for CBT/MET therapy for treating the depressive and alcohol-related
symptoms of MDD-AUD teens.
Alcoholism:
Clinical & Experimental Research, 35 : 20A
- Year: 2011
- Problem: Depressive Disorders, Alcohol
Use
- 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, J. R., Douaihy, A., Bukstein, O. G., Daley, D. C., Wood, S. D., Kelly, T. M., Salloum,
I. M.
Objective: Behavioral
therapies developed specifically for co-occurring disorders remain sparse, and such therapies for comorbid adolescents are particularly rare. This
was an evaluation of the long-term (2-year) efficacy of an acute phase trial of manualized cognitive behavioral therapy/motivation enhancement
therapy (CBT/MET) vs. naturalistic treatment among adolescents who had signed consent for a treatment study involving the SSRI antidepressant
medication fluoxetine and CBT/MET therapy for comorbid major depressive disorder (MDD) and an alcohol use disorder (AUD). We hypothesized that
improvements in depressive symptoms and alcohol-related symptoms noted among the subjects who had received CBT/MET would exceed that of those in the
naturalistic comparison group that had not received CBT/MET therapy. Methods: We evaluated levels of depressive symptoms and alcohol-related symptoms
at a two-year follow-up evaluation among comorbid MDD/AUD adolescents who had received an acute phase trial of manual-based CBT/MET (in addition to
the SSRI medication fluoxetine or placebo) compared to those who had received naturalistic care. Results: In repeated measures ANOVA, a significant
time by enrollment status difference was noted for both depressive symptoms and alcohol-related symptoms across the two-year time period of this
study, with those receiving CBT/MET demonstrating superior outcomes compared to those who had not received protocol CBT/MET therapy. No significant
difference was noted between those receiving fluoxetine vs. those receiving placebo on any outcome at any time point. Conclusions: These findings
suggest long-term efficacy for an acute phase trial of manualized CBT/MET for treating comorbid MDD/AUD adolescents. Large multi-site studies are
warranted to further clarify the efficacy of CBT/MET therapy among various adolescent and young adult comorbid populations. (copyright) 2011 Elsevier
Ltd.
Addictive Behaviors, 36(8) : 843-
848
- Year: 2011
- Problem: Depressive Disorders, Alcohol
Use
- Type: Controlled clinical 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
Carandang, C., Jabbal, R., MacBride, A., Elbe, D.
Objective: To review the basic pharmacology and published
literature regarding escitalopram and citalopram in child and adolescent depression. Methods: A literature review was conducted using the search
terms: 'escitalopram', 'citalopram', 'depression', 'randomized controlled trial', 'open label trial' and limits set to: Human trials,
English Language and All Child (Age 0-18). Additional articles were identified from reference information and poster presentation data. Results:
Three prospective, randomized controlled trials (RCT) were found for escitalopram in pediatric depression, and two RCTs were found for citalopram.
One RCT each for escitalopram and citalopram showed superiority over placebo on the primary out come measure. Adverse effects in escitalopram and
citalopram trials were generally mild to moderate. Suicidality was not assessed systematically in all RCTs reviewed, but did not appear to be
elevated over placebo in escitalopram RCTs. One trial reported numerically higher suicide related events for citalopram compared to placebo (14 vs.
5, p=0.06). Conclusion: At present, escitalopram and citalopram should be considered a second-line option for adolescent depression. The US Food and
Drug Administration approval of escitalopram for treatment of adolescent depression was based on a single positive RCT. This is less evidence than
typically required for approval of a drug for a new indication.
Journal of the Canadian Academy of Child & Adolescent Psychiatry, 20(4) : 315-
324
- Year: 2011
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs)
Calati, R., Pedrini, L., Alighieri, S., Alvarez, M.
I., Desideri, L., Durante, D., Favero, F., Iero, L., Magnani, G., Pericoli, V., Polmonari, A., Raggini, R., Raimondi, E., Riboni, V., Scaduto, M. C., Serretti, A., De Girolamo, G.
Calati R, Pedrini L, Alighieri S, Alvarez MI,
Desideri L, Durante D, Favero F, Iero L, Magnani G, Pericoli V, Polmonari A, Raggini R, Raimondi E, Riboni V, Scaduto MC, Serretti A, De Girolamo G.
Is cognitive behavioural therapy an effective complement to antidepressants in adolescents? A meta-analysis. Objective: Evidence on effectiveness of
combined treatments versus antidepressants alone in adolescents consists on a few studies in both major depressive and anxiety disorders. A meta-
analysis of randomised 12-week follow-up studies in which antidepressant treatment was compared to combined treatment consisting of the same
antidepressant with cognitive behavioural therapy has been performed. Methods: Data were entered into the Cochrane Collaboration Review Manager
software and were analysed within a random effect framework. A quality assessment has been performed through Jadad Scale. Results: Higher global
functioning at the Children's Global Assessment Scale was found in the combined treatment group (p < 0.0001) as well as higher improvement at the
Clinical Global Impressions Improvement Scale (p = 0.04). No benefit of combined treatment was found on depressive symptomatology at the Children's
Depression Rating Scale - Revised. Conclusion: Combined treatment seems to be more effective than antidepressant alone on global functioning and
general improvement in adolescents with major depressive and anxiety disorders. (copyright) 2011 John Wiley & Sons A/S.
Acta
Neuropsychiatrica, 23(6) : 263-271
- Year: 2011
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Balaji, M., Andrews, T., Andrew, G., Patel, V.
Purpose To evaluate the
acceptability, feasibility, and effectiveness of a population-based intervention to promote health of youth (age: 1624 years) in Goa. Methods Two
pairs of urban and rural communities were selected; one of each was randomly assigned to receive a multi-component intervention and the other wait-
listed. The intervention comprised educational institution-based peer education and teacher training (in the urban community), community peer
education, and health information materials. Effectiveness was assessed through beforeafter population surveys at baseline and at 18 months. Outcomes
were measured using a structured interview schedule with all eligible youth. Logistic regression compared each pair, adjusted for baseline
differences, on prevalence of outcomes in the domains of reproductive and sexual health (RSH), violence, mental health, substance use, and help
seeking for health concerns. Results In both intervention communities, prevalence of violence perpetrated and probable depression was significantly
lower and knowledge and attitudes about RSH significantly higher (p < .05). The rural sample also reported fewer menstrual complaints and higher
levels of help-seeking for RSH complaints by women, and knowledge and attitudes about emotional health and substance use; and, the urban sample
reported significantly lower levels of substance use, suicidal behavior, sexual abuse, and RSH complaints. Although information materials were
acceptable and feasible in both communities, community peer education was feasible only in the rural community. The institution-based interventions
were generally acceptable and feasible. Conclusions Multicomponent interventions comprising information materials, educational-institution
interventions and, in rural contexts, community peer interventions are acceptable and feasible and likely to be effective for youth health promotion.
(copyright) 2011 Society for Adolescent Health and Medicine.
Journal of Adolescent
Health, 48(5) : 453-460
- Year: 2011
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions