Disorders - depressive disorders
Bogen, S., Legenbauer, T., Gest, S., Holtmann, M.
Major depression (MDD) has been shown to
be one of the most frequent psychiatric disorders in adolescence. Prevalence rates for MDD in the young, also called juvenile depression are about 4
-8% with a tendency to increase. Symptoms of juvenile depression are similar to symptoms of MDD in adults; however, mood lability, irritability, low
frustration tolerance, somatic complaints, and social withdrawal might be more pronounced. Treating juvenile depression constitutes a challenge since
remission rates of moderate to severe depression are rather low. For mild depression, cognitive behavioural therapy (CBT) might be sufficient, but
for more severe cases, a combined therapy with antidepressants is often indicated. Studies show remission rates of less than 40% even in combination
trials with both selective serotonin reuptake inhibitors (SSRIs) and psychotherapy. Bright light therapy (BLT) is an easy applicable add-on treatment
with few side-effects and good acceptance in an inpatient psychiatric setting. Our results indicate that short duration of BLT seems to exert its
effects in particular on sleep and associated features such as chronotype. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Journal of Affective Disorders, 190 : 450-
456
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Bright light therapy
Charkhandeh, M., Talib, M. A., Hunt, C. J.
The main aim of the study was to investigate the effectiveness of two psychotherapeutic approaches, cognitive behavioral therapy
(CBT) and a complementary medicine method Reiki, in reducing depression scores in adolescents. We recruited 188 adolescent patients who were 12-17
years old. Participants were randomly assigned to CBT, Reiki or wait-list. Depression scores were assessed before and after the 12 week interventions
or wait-list. CBT showed a significantly greater decrease in Child Depression Inventory (CDI) scores across treatment than both Reiki (p<.001) and
the wait-list control (p<.001). Reiki also showed greater decreases in CDI scores across treatment relative to the wait-list control condition
(p=031). The analyses indicated a significant interaction between gender, condition and change in CDI scores, such that male participants showed a
smaller treatment effect for Reiki than did female participants. Both CBT and Reiki were effective in reducing the symptoms of depression over the
treatment period, with effect for CBT greater than Reiki. These findings highlight the importance of early intervention for treatment of depression
using both cognitive and complementary medicine approaches. However, research that tests complementary therapies over a follow-up period and against
a placebo treatment is required.
Psychiatry
Research, 239 : 325-330
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other complementary & alternative
interventions
Cheung, A., Levitt,
A., Cheng, M., Santor, D., Kutcher, S., Dubo, E., Garland, E., Weiss, M., Kiss, A.
Purpose: To examine the benefit of continuation treatment with citalopram in adolescents 13 to 18 years of age with major depression
using a multi-site randomized placebo controlled discontinuation design. Methods: Subjects with depression who responded to open label treatment with
citalopram In 12-week acute phase were randomized to continued treatment with citalopram or placebo for 24 weeks. Results: Twenty five subjects were
randomized to either continued treatment with citalopram (n = 12) versus placebo (n = 13). Seventy-five percent of subjects on citalopram (75%)
remained well as compared to placebo (62%). Time to relapse was compared between groups using the log rank test and was not found to be significantly
different (chi2(1) = 0.35, P = 0.55). A Cox proportional hazards model Including drug assignment (hazard ratio (HR = 0.51. 95% CI 0.11 to 2.36. P =
0.39), gender (HR = 0.58. 95% CI 0.14 to 2.37. P = 0.44). or HAM-score at entry to continuation phase (HR = 1.33. 95% CI 0.90 to 1.95. P = 0.95) was
not significant. Conclusion: Although we did not find statistically significant differences between citalopram and placebo, the findings suggest a
possible benefit of continued treatment with citalopram over placebo. A larger clinical trial with adequate power Is required to confirm or
disconfirm these findings. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).
Journal of the Canadian Academy of Child & Adolescent Psychiatry, 25(1) : 11-
16
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Relapse prevention
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs)
Chu, B. C., Crocco, S. T., Esseling, P., Areizaga, M. J., Lindner, A. M., Skriner, L. C.
Anxiety and depression are debilitating and commonly co-occurring in young adolescents, yet few
interventions are designed to treat both disorder classes together. Initial efficacy is presented of a school-based transdiagnostic group behavioral
activation therapy (GBAT) that emphasizes anti-avoidance in vivo exposure. Youth (N = 35; ages 12-14; 50.9% male) were randomly assigned to either
GBAT (n = 21) or WL (n = 14) after completing a double-gated screening process. Multi-reporter, multi-domain outcomes were assessed at pretreatment,
posttreatment, and four-month follow-up (FU). GBAT was associated with greater posttreatment remission rates than WL in principal diagnosis (57.1%
vs. 28.6%; X12 = 2.76, p = .09) and secondary diagnosis (70.6% vs. 10%; X12 = 9.26, p = .003), and greater improvement in Clinical Global
Impairment-Severity ratings, B = -1.10 (0.42), p = .01. Symptom outcomes were not significantly different at posttreatment. GBAT produced greater
posttreatment behavioral activation (large effect size) and fewer negative thoughts (medium effect), two transdiagnostic processes, both at the trend
level. Most outcomes showed linear improvement from pretreatment to FU that did not differ depending on initial condition assignment. Sample size was
small, but GBAT is a promising transdiagnostic intervention for youth anxiety and unipolar mood disorders that can feasibly and acceptably be applied
in school settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).
Behaviour Research & Therapy, 76 : 65-75
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Exposure therapy, Exposure
and response prevention
Clair-Michaud, M., Martin, R. A., Stein, L. A. R., Bassett, S., Lebeau, R., Golembeske, C.
The impact of Motivational Interviewing (MI) on risky behaviors of incarcerated adolescents and adults has been
investigated with promising results. Findings suggest that MI reduces substance use, improves motivation and confidence to reduce use, and decreases
risky behaviors. The current study investigated the impact of MI on general, alcohol-related, and marijuana-related delinquent behaviors in
incarcerated adolescents. Participants in the study were incarcerated adolescents in a state correctional facility in the Northeast region and were
assessed as part of a larger randomized clinical trial. Adolescents were randomly assigned to receive MI or relaxation therapy (RT) (N = 189)
treatment. Delinquent behaviors and depressive symptomatology were measured using the Delinquent Activities Scale (DAS; Reavy, Stein, Paiva, Quina, &
Rossi, 2012) and the Center for Epidemiological Studies-Depression scale (CES-D; Radloff, 1991) respectively. Findings indicate that depression
moderated treatment effects. Compared to RT, MI was better at reducing predatory aggression and alcohol-related predatory aggression 3 months post-
release when depressive symptoms were low. Identifying an efficacious treatment for these adolescents may benefit society in that it may decrease
crimes against persons (i.e., predatory aggression) post release.
Journal
of Substance Abuse Treatment, 65 : 13-19
- Year: 2016
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Relaxation
Babowitch, J. D., Antshel, K. M.
The quantitative literature on the treatment of comorbid depression and substance misuse among adolescents was
reviewed, including: (1) a synthesis of the empirical evidence of the multiple models of integrated treatment for depression and substance use, (2)
an examination of proposed mechanisms underlying symptom change in these integrated treatment models targeting depression and substance use, and (3)
a methodological critique and suggestions for future research. We reviewed 15 studies reporting on treatment outcomes among adolescents with comorbid
depression and non-tobacco related substance use disorders (SUD) and general misuse. Although there is empirical evidence linking Cognitive-
Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), and Family-Focused Therapy (FFT) to depression and SUD symptom reduction in
adolescents, few studies have provided data on mechanisms that may account for this effect. Potential mechanisms include improvements in
dysfunctional reward processing and self-efficacy. Although this review highlights promising findings for the treatment of comorbid depression and
substance misuse in adolescents, further work is warranted; as such results could have important implications for intervention development.
Journal of Affective Disorders, 201 : 25-
33
- Year: 2016
- Problem: Depressive Disorders, Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Family therapy, Motivational interviewing, includes Motivational Enhancing Therapy
Bastounis, A., Callaghan, P., Banerjee, A., Michail, M.
Mental health problems in children can be precursors of psychosocial problems in adulthood.
The aim of this study is to assess the effectiveness of the universal application of a resilience intervention (PRP and derivatives), which has been
proposed for large scale roll-out. Electronic databases were searched for published randomized controlled trials of PRP and derivatives to prevent
depression and anxiety and improve explanatory style in students aged 8-17 years. Studies were meta-analysed and effect sizes with confidence
intervals were calculated. The Quality Assessment Tool for Quantitative Studies of the Effective Public Health Practice Project was used to determine
the confidence in the effect estimates. Nine trials from Australia, the Netherlands and USA met the inclusion criteria. No evidence of PRP in
reducing depression or anxiety and improving explanatory style was found. The large scale roll-out of PRP cannot be recommended. The content and
structure of universal PRP should be re-considered.\rCopyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by
Elsevier Ltd. All rights reserved.
Journal of Adolescence, 52 : 37-48
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Brunwasser, SM., Garber, J.
The
objective of this study was to evaluate the current state of evidence of the effectiveness of depression prevention programs for youth, assess the
degree to which current evidence supports broad implementation, and outline additional steps needed to close the gap between effectiveness and
dissemination. We used the Society for Prevention Research's Standards of Evidence (Flay et al., 2005) to evaluate the degree to which existing
depression prevention programs have established intervention efficacy, effectiveness, and readiness for dissemination. We reviewed all depression
prevention programs for youth that have been evaluated in at least two published, randomized controlled trials in which the intervention was compared
to a no-intervention control group. A total of 37 studies evaluating 11 different programs were reviewed with regard to depressive symptoms and
diagnoses at postintervention and follow-up (at least 6 months). Eight programs demonstrated significant main effects on depressive symptoms relative
to controls in multiple randomized controlled trials; 5 programs had at least 1 trial with significant main effects present at least 1 year
postintervention. Two programs demonstrated efficacy for both depressive symptoms and depressive episodes across multiple independent trials.
Regarding effectiveness, 6 programs had at least 1 study showing significant effects when delivered by endogenous service providers; 4 programs had
significant effects in studies conducted independently of the program developers. Several programs have demonstrated promise in terms of efficacy,
but no depression prevention program for children or adolescents as yet has garnered sufficient evidence of effectiveness under real-world conditions
to warrant widespread dissemination at this time. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Clinical Child & Adolescent
Psychology, 45(6) : 763-783
- Year: 2016
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Bunge, E. L., Dickter, B., Jones, M. K., Alie, G., Spear, A., Perales, R.
The dominant model of delivering psychological interventions is face-to-face (F2F) in oneto- one psychotherapy. Behavioral
Intervention Technologies (BITs) may have the capacity to expand delivery models and/or increase the outcomes of therapy. This article is a
systematic review of the available literature on BITs for children and adolescents with DSM-5 mental health diagnoses. All articles on EBSCOhost
published between 1st January 2000 and 31st December 2014 referencing terms related to youth, BITs, and therapy were collected
for analysis (n=7179). After inclusion/exclusion criteria were applied, 53 articles were included in the review, discussing BIT interventions for
Anxiety, Depression, Obsessive-Compulsive Disorder, Attention-Deficit/Hyperactivity Disorder, Conduct Disorder, and Oppositional Defiant Disorder.
The review found general support for BITs as interventions for child and adolescent disorders. Limitations of the current research and suggestions
for future directions are discussed. Copyright © 2016 Bentham Science Publishers.
Current
Psychiatry Reviews, 12(1) : 14-28
- Year: 2016
- Problem: Anxiety Disorders (any), 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), Cognitive & behavioural therapies (CBT), Exposure therapy, Exposure
and response prevention, Attention/cognitive bias
modification, Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
Carter, T., Morres, I. D., Meade, O., Callaghan, P.
Objective The purpose of this review was
to examine the treatment effect of physical exercise on depressive symptoms for adolescents aged 13 to 17 years. Method A systematic search of 7
electronic databases identified relevant randomized controlled trials. Following removal of duplicates, 543 texts were screened for eligibility.
Screening, data extraction, and trial methodological quality assessment (using the Delphi list) were undertaken by 2 independent researchers.
Standardized mean differences were used for pooling postintervention depressive symptom scores. Results Eleven trials met the inclusion criteria, 8
of which provided the necessary data for calculation of standardized effect size. Exercise showed a statistically significant moderate overall effect
on depressive symptom reduction (standardized mean difference [SMD] = -0.48, 95% CI = -0.87, -0.10, p =.01, I2 = 67%). Among trials with
higher methodological scoring, a nonsignificant moderate effect was recorded (SMD = -0.41, 95% CI = -0.86, 0.05, p =.08). In trials with exclusively
clinical samples, exercise showed a statistically significant moderate effect on depressive symptoms with lower levels of heterogeneity (SMD = -0.43,
95% CI = -0.84, -0.02, p =.04, I2 = 44%). Conclusion Physical exercise appears to improve depressive symptoms in adolescents, especially
in clinical samples in which the moderate antidepressant effect, higher methodological quality, and lowered statistical heterogeneity suggest that
exercise may be a useful treatment strategy for depression. Larger trials with clinical samples that adequately minimize the risk of bias are
required for firmer conclusions on the effectiveness of exercise as an antidepressant treatment. Copyright © 2016 American Academy of Child and
Adolescent Psychiatry
Journal of the American Academy of Child & Adolescent Psychiatry, 55(7) : 580-
590
- Year: 2016
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Cheng, F. K.
Childhood mental health problems not only incur a financial burden but more importantly
damages individual and family well-being, which compels mental care practitioners to search for solutions, among which meditation is a more
economical method. This integrative review investigates the effectiveness of meditation on psychological problems for adolescents under age of 20
through different types of meditation, though mainly mindfulness-based modes. The 36 reviewed publications include quantitative, qualitative and
mixed methods research, conducted in North America, Europe, and the Asia Pacific region, related to developmental disabilities, emotional problems,
and mental illnesses. Outcomes indicate a decrease in self-harm thoughts, disruptive behaviour, stress, anxiety, impulsivity, and psychological
distress; and improvements in self-control, quality of sleep, emotional regulation, executive function, anger management, and social competence,
resulting in better academic performance, quality of life, mental wellness, and child-parent relationships. This review suggests the integration of
meditation into physical activities, and music and art therapies, as well as randomised controlled trials to examine such synthesis of these
disciplines. In conclusion, meditation is a potential curative and preventive measure, both low cost and non-intrusive, for the promotion of
adolescent mental wellness. This sheds light on nurses who look after children with mental health. Copyright © 2016 The Author.
International Journal of Africa Nursing Sciences, 4 : 7-
19
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders, Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Mindfulness based
therapy, Meditation
Cipriani, A., Zhou, X., DelGiovane, C., Hetrick, S. E., Qin, B., Whittington, C., Coghill, D., Zhang, Y., Hazell, P., Leucht, S., Cuijpers, P., Pu, J., Cohen, D., Ravindran, A. V., Liu, Y., Michael, K. D., Yang, L., Liu, L., Xie, P.
BACKGROUND: Major depressive disorder is one of the most common mental disorders in children
and adolescents. However, whether to use pharmacological interventions in this population and which drug should be preferred are still matters of
controversy. Consequently, we aimed to compare and rank antidepressants and placebo for major depressive disorder in young people.\rMETHODS: We did a
network meta-analysis to identify both direct and indirect evidence from relevant trials. We searched PubMed, the Cochrane Library, Web of Science,
Embase, CINAHL, PsycINFO, LiLACS, regulatory agencies' websites, and international registers for published and unpublished, double-blind randomised
controlled trials up to May 31, 2015, for the acute treatment of major depressive disorder in children and adolescents. We included trials of
amitriptyline, citalopram, clomipramine, desipramine, duloxetine, escitalopram, fluoxetine, imipramine, mirtazapine, nefazodone, nortriptyline,
paroxetine, sertraline, and venlafaxine. Trials recruiting participants with treatment-resistant depression, treatment duration of less than 4 weeks,
or an overall sample size of less than ten patients were excluded. We extracted the relevant information from the published reports with a predefined
data extraction sheet, and assessed the risk of bias with the Cochrane risk of bias tool. The primary outcomes were efficacy (change in depressive
symptoms) and tolerability (discontinuations due to adverse events). We did pair-wise meta-analyses using the random-effects model and then did a
random-effects network meta-analysis within a Bayesian framework. We assessed the quality of evidence contributing to each network estimate using the
GRADE framework. This study is registered with PROSPERO, number CRD42015016023.\rFINDINGS: We deemed 34 trials eligible, including 5260 participants
and 14 antidepressant treatments. The quality of evidence was rated as very low in most comparisons. For efficacy, only fluoxetine was statistically
significantly more effective than placebo (standardised mean difference -0.51, 95% credible interval [CrI] -0.99 to -0.03). In terms of tolerability,
fluoxetine was also better than duloxetine (odds ratio [OR] 0.31, 95% CrI 0.13 to 0.95) and imipramine (0.23, 0.04 to 0.78). Patients given
imipramine, venlafaxine, and duloxetine had more discontinuations due to adverse events than did those given placebo (5.49, 1.96 to 20.86; 3.19, 1.01
to 18.70; and 2.80, 1.20 to 9.42, respectively). In terms of heterogeneity, the global I(2) values were 33.21% for efficacy and 0% for tolerability.
\rINTERPRETATION: When considering the risk-benefit profile of antidepressants in the acute treatment of major depressive disorder, these drugs do
not seem to offer a clear advantage for children and adolescents. Fluoxetine is probably the best option to consider when a pharmacological treatment
is indicated.\rFUNDING: National Basic Research Program of China (973 Program).\rCopyright © 2016 Elsevier Ltd. All rights reserved.
Lancet, 388(10047) : 881
-90
- Year: 2016
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Tricyclic antidepressants, Tetracyclic antidepressants (TECA/NSSAs), Serotonin-norepinephrine reuptake inhibitors
(SNRIs), Antidepressants
(any)