Disorders - depressive disorders
Bonnar, D., Gradisar, M., Moseley, L., Coughlin, A. M., Cain, N., Short, M. A.
Objectives: Whilst the evidence for clinical interventions for adolescents 0 sleep is
good, application to a broader context (i.e., school settings) suggests limited efficacy. This may be due to adolescents perceiving barriers and lack
of support to change sleep behaviours. We present here a randomised controlled trial of a sleep education program (SEP) with adjunct bright light
therapy (BLT) and/or parental involvement (PI). Methods: 193 adolescents (age = 16.3 (plus or minus) 0.4 years, 79%f) were randomly assigned to SEP
+BLT, SEP+PI, SEP+BLT+PI, or classesas- usual (CAU; control). SEP involved 4 x 50-min classes (over 4 weeks) based on a Motivational Interviewing
(MI) framework (Cain, Gradisar and Moseley, 2011, Sleep Med). Groups with BLT attempted a weekend phase advance using portable green light LED
glasses (500 nm; Re-Timers). Parents of adolescents in the PI groups received weblinks to weekly YouTube videos (~2-3 min long) outlining what their
teen was learning and how they could assist. CAU adolescents continued their regular school classes (with no sleep information). Results: Consistent
effects were found for all intervention groups, including advanced sleep onset on school nights (d = 0.49-0.53) and weekends (d = 0.26-0.37),
increases in TST (School: d = 0.35- 0.58; Weekends: d = 0.24-0.27), and decreased depression (d = 0.32-0.34). No changes occurred for the CAU group
(d = 0.03-0.14). Surprisingly, weekend out of bedtime did not advance in all four groups (d = 0.02-0.09). Conclusions: This sleep education program
based on an MI framework produced some meaningful sleep benefits to adolescents. However, brief adjunct light therapy and parental involvement do not
confer additional benefits. Increased 'dosages' of bright light and parental involvement need to be tested.
Journal of Sleep Research, 23 : 50-51
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions, Bright light therapy
Chen, Y., Shen, W. W., Gao, K., Lam, C. S., Chang, W. C., Deng, H.
Objective: Many children who lost
parents in the 2008 earthquake in Sichuan Province China, experienced symptoms of posttraumatic stress disorder (PTSD) and depression. This
randomized controlled study compared the treatment effectiveness of short-termcognitivebehavioral therapy (CBT) with a general supportive
intervention and with a control group of nontreatment. Methods: Thirty-two Chinese adolescents were randomly assigned to three treatment groups.
Participants were compared for psychological resilience (Connor-Davidson Resilience Scale), symptoms of PTSD (Children's Revised Impact of Events
Scale), and depression (Center for Epidemiologic Studies Depression Scale) at baseline, after treatment, and three-month follow-up. Results: CBT was
effective in reducing PTSD and depressive symptoms and improved psychological resilience. General support was more effective than no intervention in
improving psychological resilience. Conclusions: Short-term CBT group intervention seems to be a robust intervention for natural disaster victims.
Shortterm CBT group intervention was more effective than the general supportive intervention and the notreatment group in enhancing psychological
resilience and reducing PTSD and depression among adolescents who had lost parents in the earthquake. The general supportive intervention was
effective only in improving psychological resilience.
Psychiatric
Services, 65(2) : 259-262
- Year: 2014
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Supportive
therapy
Arnberg, Alexandra., Ost, Lars-Goran.
Pediatric depression
entails a higher risk for psychiatric disorders, somatic complaints, suicide, and functional impairment later in life. Cognitive behavior therapy
(CBT) is recommended for the treatment of depression in children, yet research is based primarily on adolescents. The present meta-analysis
investigated the efficacy of CBT in children aged 8 - 12 years with regard to depressive symptoms. We included randomized controlled trials of CBT
with participants who had an average age of = 12 years and were diagnosed with either depression or reported elevated depressive symptoms. The search
resulted in 10 randomized controlled trials with 267 participants in intervention and 256 in comparison groups. The mean age of participants was 10.5
years. The weighted between-group effect size for CBT was moderate, Cohen's d = 0.66. CBT outperformed both attention placebo and wait-list,
although there was a significant heterogeneity among studies with regard to effect sizes. The weighted within-group effect size for CBT was large, d
= 1.02. Earlier publication year, older participants, and more treatment sessions were associated with a larger effect size. In conclusion, the
efficacy of CBT in the treatment of pediatric depression symptoms was supported. Differences in efficacy, methodological shortcomings, and lack of
follow-up data limit the present study and indicate areas in need of improvement. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
(journal abstract)
Cognitive Behaviour
Therapy, 43(4) : 275-288
- Year: 2014
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Arnberg, Filip. K., Linton, Steven. J., Hultcrantz, Monica., Heintz, Emelie., Jonsson, Ulf.
Background: Greater
access to evidence-based psychological treatments is needed. This review aimed to evaluate whether internet-delivered psychological treatments for
mood and anxiety disorders are efficacious, noninferior to established treatments, safe, and cost-effective for children, adolescents and adults.;
Methods: We searched the literature for studies published until March 2013. Randomized controlled trials (RCTs) were considered for the assessment of
short-term efficacy and safety and were pooled in meta-analyses. Other designs were also considered for long-term effect and cost-effectiveness.
Comparisons against established treatments were evaluated for noninferiority. Two reviewers independently assessed the relevant studies for risk of
bias. The quality of the evidence was graded using an international grading system.; Results: A total of 52 relevant RCTs were identified whereof 12
were excluded due to high risk of bias. Five cost-effectiveness studies were identified and three were excluded due to high risk of bias. The
included trials mainly evaluated internet-delivered cognitive behavioral therapy (I-CBT) against a waiting list in adult volunteers and 88% were
conducted in Sweden or Australia. One trial involved children. For adults, the quality of evidence was graded as moderate for the short-term efficacy
of I-CBT vs. waiting list for mild/moderate depression (d = 0.83; 95% CI 0.59, 1.07) and social phobia (d = 0.85; 95% CI 0.66, 1.05), and moderate
for no efficacy of internet-delivered attention bias modification vs. sham treatment for social phobia (d = ?-0.04; 95% CI -0.24, 0.35). The quality
of evidence was graded as low/very low for other disorders, interventions, children/adolescents, noninferiority, adverse events, and cost-
effectiveness.; Conclusions: I-CBT is a viable treatment option for adults with depression and some anxiety disorders who request this treatment
modality. Important questions remain before broad implementation can be supported. Future research would benefit from prioritizing adapting
treatments to children/adolescents and using noninferiority designs with established forms of treatment.;
PLoS ONE, 9(5) : e98118-e98118
- Year: 2014
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Technology, interventions delivered using technology (e.g. online, SMS)
Cooper, J. A., Gorlick, M. A., Denny, T., Worthy, D. A., Beevers, C. G., Maddox, W. T.
Depression is often characterized by attentional biases toward negative items and away from positive items, which likely affects reward
and punishment processing. Recent work has reported that training attention away from negative stimuli reduced this bias and reduced depressive
symptoms. However, the effect of attention training on subsequent learning has yet to be explored. In the present study, participants were required
to learn to maximize reward during decision making. Undergraduates with elevated self-reported depressive symptoms received attention training toward
positive stimuli prior to performing the decision-making task (n = 20; active training). The active-training group was compared to two other groups:
undergraduates with elevated self-reported depressive symptoms who received placebo training (n = 22; placebo training) and a control group with low
levels of depressive symptoms (n = 33; nondepressive control). The placebo-training depressive group performed worse and switched between options
more than did the nondepressive controls on the reward maximization task. However, depressives that received active training performed as well as the
nondepressive controls. Computational modeling indicated that the placebo-trained group learned more from negative than from positive prediction
errors, leading to more frequent switching. The nondepressive control and active-training depressive groups showed similar learning from positive and
negative prediction errors, leading to less-frequent switching and better performance. Our results indicate that individuals with elevated depressive
symptoms are impaired at reward maximization, but that the deficit can be improved with attention training toward positive stimuli.
Cognitive, Affective & Behavioral Neuroscience, 14(2) : 729-
741
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Dietz, L. J., Marshal, M. P., Burton, C. M., Bridge, J. A., Birmaher, B., Kolko, D., Duffy, J. N., Brent, D. A.
Objective: Changes in adolescent interpersonal behavior before and after an
acute course of psychotherapy were investigated as outcomes and mediators of remission status in a previously described treatment study of depressed
adolescents. Maternal depressive symptoms were examined as moderators of the association between psychotherapy condition and changes in adolescentsa
interpersonal behavior. Method: Adolescents (n = 63, mean age = 15.6 years, 77.8% female, 84.1% White) engaged in videotaped interactions with their
mothers before randomization to cognitive behavior therapy (CBT), systemic behavior family therapy (SBFT), or nondirective supportive therapy (NST)
and after 12-16 weeks of treatment. Adolescent involvement, problem solving, and dyadic conflict were examined. Results: Improvements in adolescent
problem solving were significantly associated with CBT and SBFT. Maternal depressive symptoms moderated the effect of CBT, but not SBFT, on
adolescentsa problem solving; adolescents experienced increases in problem solving only when their mothers had low or moderate levels of depressive
symptoms. Improvements in adolescentsa problem solving were associated with higher rates of remission across treatment conditions, but there were no
significant indirect effects of SBFT on remission status through problem solving. Exploratory analyses revealed a significant indirect effect of CBT
on remission status through changes in adolescent problem solving, but only when maternal depressive symptoms at study entry were low. Conclusions:
Findings provide preliminary support for problem solving as an active treatment component of structured psychotherapies for depressed adolescents and
suggest one pathway by which maternal depression may disrupt treatment efficacy for depressed adolescents treated with CBT. (PsycINFO Database Record
(c) 2014 APA, all rights reserved). (copyright) 2014 American Psychological Association.
Journal of Consulting & Clinical Psychology, 82(2) : 202-
211
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Family therapy, Supportive
therapy
Emslie, G. J., Prakash,
A., Zhang, Q., Pangallo, B. A., Bangs, M. E., March, J. S.
Objective: The purpose of this study was to evaluate the efficacy and safety of duloxetine fixed dose in the treatment of children (7-
11 years) and adolescents (12-17 years) with major depressive disorder (MDD). Methods: Patients (n=463) in this 36 week study (10 week acute and 26
week extension treatment) received duloxetine 60mg QD (n=108), duloxetine 30mg QD (n=116), fluoxetine 20mg QD (n=117, active control), or placebo
(n=122). Measures included: Children's Depression Rating Scale-Revised (CDRS-R), treatment-emergent adverse events (TEAEs), and Columbia-Suicide
Severity Rating Scale (C-SSRS). Results: Neither active drug (duloxetine or fluoxetine) separated significantly (p<0.05) from placebo on mean change
from baseline to end-point (10 weeks) on the CDRS-R total score. Total TEAEs and discontinuation for AEs were significantly (p<0.05) higher only for
the duloxetine 60mg group versus the placebo group during acute treatment. No clinically significant electrocardiogram (ECG) or laboratory
abnormalities were observed, and no completed suicides or deaths occurred during the study. A total of 7 (6.7%) duloxetine 60mg, 6 (5.2%) duloxetine
30mg, 9 (8.0%) fluoxetine, and 11 (9.4%) placebo patients had worsening of suicidal ideation from baseline during acute treatment. Of the patients
with suicidal ideation at baseline, 13/16 (81%) duloxetine 60mg, 16/17 (94%) duloxetine 30mg, 11/16 (69%) fluoxetine, and 13/15 (87%) placebo had
improvement in suicidal ideation at end-point during acute treatment. One fluoxetine, one placebo, and six duloxetine patients had treatment-emergent
suicidal behavior during the 36 week study. Conclusions: Trial results were inconclusive, as neither the investigational drug (duloxetine) nor the
active control (fluoxetine) separated from placebo on the CDRS-R at 10 weeks. No new duloxetine safety signals were identified relative to those seen
in adults.
Journal of Child & Adolescent Psychopharmacology, 24(4) : 170-
179
- Year: 2014
- 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)
Daches, S., Mor, N.
Although depression and rumination have
been associated with a difficulty ignoring irrelevant negative content, the causal direction of this relationship is unclear. The aim of this study
was to train individuals who engage in habitual brooding, a particularly maladaptive subtype of rumination, to inhibit or to attend to negative
stimuli. The effects of the training on rumination and depression were examined. Participants were randomly assigned to four sessions of training to
inhibit or to attend to negative stimuli or to a sham-training group, in a two-week span. At both pre and post training, participants completed
measures of depressive symptoms, rumination and inhibition bias. Compared with individuals in the sham training condition, those who were trained to
attend to negative stimuli exhibited a significant decrease in inhibition of irrelevant negative content whereas those who were trained to inhibit
negative stimuli, showed a trend toward improved inhibition of irrelevant negative content and a reduction in brooding, but not in depressive
symptoms. Our findings suggest that inhibition training may be beneficial for reducing brooding. (copyright) 2013 Springer Science+Business
Media.
Cognitive Therapy & Research, 38(2) : 160-171
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
DelBello, M. P., Hochadel, T. J., Portland, K. B., Azzaro, A. J., Katic,
A., Khan, A., Emslie, G.
Objective: A randomized, double-blind, placebo-controlled flexible-dose, parallel group trial was conducted at 26 clinical investigational
sites in the United States to examine the safety and efficacy of the selegiline transdermal system (STS) (EMSAM(registered trademark)) in adolescents
(ages 12-17 years) meeting American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for
moderate to severe major depressive disorder (MDD) without psychotic features. Methods: Adolescents (n=308) with moderate to severe MDD were
randomized to either STS (n=152) or placebo (n=156). Two hundred and fifteen (69.8%) subjects completed the study and 17 (5.5%) reported
discontinuation because of adverse events (AEs). The primary efficacy outcome measure was the mean change from baseline to end of study (week 12 last
observation carried forward [LOCF]) in the Children's Depression Rating Scale-Revised (CDRS-R) total score. Secondary outcome measures included
end-point Clinical Global Impressions - Severity (CGI-S) and Clinical Global Impressions - Improvement (CGI-I). Results: Patients on STS or placebo
had a significant decline from baseline (p<0.001) on their CDRS-R total score with mean reductions(plus or minus)SD as follows: STS 21.4(plus or
minus)16.6; placebo 21.5(plus or minus)16.5. Both groups had similar response rates (58.6% vs. 59.3%) defined as CGI-I of 1 or 2 at study end.
However, these between-group efficacy findings were without statistical significance. The overall incidence of reported AEs was 62.5% for STS-treated
patients and 57.7% for placebo-treated patients. Most commonly reported AEs in STS or placebo groups were application site reactions (STS=24.3%;
placebo=21.8%), headache (STS=17.1%; placebo=16.7%), and nausea (STS=7.2%; placebo=7.7%). Treatment groups did not differ on any laboratory
parameters, vital signs, or electrocardiogram (ECG) findings. No suspected hypertensive crises were reported in the trial. Conclusions: These data
demonstrated that the STS was safe and well tolerated in this adolescent sample. However, both STS-treated and placebo-treated subjects demonstrated
a decline from baseline in depressive symptoms (CDRS-R total score) over the length of the study, without statistical superiority by either group.
Copyright (copyright) 2014, Mary Ann Liebert, Inc.
Journal of Child & Adolescent Psychopharmacology, 24(6) : 311-
317
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Monoamine oxidase inhibitors (MAOIs) & ARIMAs, Other antidepressants
Dewald-Kaufmann, J. F., Oort, F. J., Meijer, A.
M.
OBJECTIVE: Sleep problems are common and persistent during adolescence and can have
negative effects on adolescents' mood. To date, studies that investigate the effects of sleep extension on adolescents' sleep and depressive
symptoms are still lacking. This study aims to investigate the effects of gradual sleep extension combined with sleep hygiene advice in adolescents
with chronic sleep reduction on objectively measured sleep, self-reported sleep problems and depressive symptoms.\rMETHODS: Fifty-five adolescents
with chronic sleep reduction (mean age: 15.44 years; 85.5% females) were included in the study. Participants were randomly assigned to either a sleep
extension group (gradual sleep extension by advancing bedtimes in the evening and receiving sleep hygiene advice) or to a control group (no
instruction). Sleep was measured with actigraphy during three weeks, the first week was the baseline week, and the last two weeks were the
experimental weeks during which sleep was extended. Other outcome variables were self-reported sleep problems (daytime sleepiness, symptoms of
insomnia and circadian rhythm sleep disorder) and depressive symptoms, which were assessed before and after the experimental manipulation.\rRESULTS:
During the third week of the experiment, adolescents in the sleep extension group had earlier bedtimes, earlier sleep onsets, spent more time in bed
and slept longer than adolescents in the control group. Their chronic sleep reduction, insomnia symptoms and depressive symptoms diminished
significantly. In addition, there was a trend of improved circadian rhythm sleep disorder symptoms and sleep quality.\rCONCLUSION: Gradual sleep
extension combined with sleep hygiene advice seems to have beneficial effects on sleep, self-reported sleep problems and depressive symptoms of
adolescents with chronic sleep reduction. Although we cannot distinguish between the effects of sleep extension and sleep hygiene advice, the results
suggest that advancing bedtimes can extend sleep and improve depressive symptoms.
Journal of Child Psychology & Psychiatry & Allied Disciplines, 55(3) : 273-
283
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions
De-Azevedo-Cardoso, T., Mondin, T. C., Spessato, B. C., De-Avila-Quevedo, L., De-Mattos-Souza, L. D., Da-Silva, R. A., Jansen, K.
Background Studies show high
comorbidity between anxiety disorder and depression. Little is known regarding how anxiety symptoms affect prognosis in depression treatment,
suggesting the importance of studying the impact of anxiety symptoms in the treatment of depression. We evaluated the impact of anxiety symptoms in
the remission of depressive symptoms after brief psychotherapies for depression. Methods This randomized clinical trial of 18-29-year-old adults
included individuals who met the diagnostic criteria for depression as assessed by the Structured Clinical Interview for DSM (SCID). Depressive
symptoms were assessed using the Hamilton Rating Scale for Depression (HRSD); anxiety symptoms were assessed using the Hamilton Anxiety Rating Scale
(HARS). The protocols of psychotherapy used were: Cognitive Narrative Psychotherapy (CNP) and Cognitive Behavioral Psychotherapy (CBP). Both
treatments included seven sessions. At the end of the treatment and six-month follow-up, an evaluation was made with the HRSD and HARS. The sample
included 97 patients divided between the protocols of psychotherapy. Results There was a significant, positive, moderate correlation between the
severity of anxiety symptoms at baseline and the remission of depressive symptoms at post-intervention (r=0.38 p<0.001) as well as a significant,
positive, low correlation at follow up (r=0.20 p=0.049). We found remission of anxiety symptoms and depressive symptoms after brief psychotherapies,
and the remission persisted at follow up. Limitation We did not evaluate the diagnosis of anxiety disorders. Conclusion The severity of anxiety
symptoms did not compromise the treatment focused primarily on depressive symptoms. (copyright) 2014 Published by Elsevier B.V.
Journal of Affective Disorders, 168 : 331-
336
- Year: 2014
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
De-Voogd, E. L., Wiers, R. W., Prins, P. J. M., Salemink, E.
Background and objectives An attentional bias for
negative information plays an important role in the development and maintenance of (social) anxiety and depression, which are highly prevalent in
adolescence. Attention Bias Modification (ABM) might be an interesting tool in the prevention of emotional disorders. The current study investigated
whether visual search ABM might affect attentional bias and emotional functioning in adolescents. Methods A visual search task was used as a training
paradigm; participants (n = 16 adolescents, aged 13-16) had to repeatedly identify the only smiling face in a 4 null 4 matrix of negative emotional
faces, while participants in the control condition (n = 16) were randomly allocated to one of three placebo training versions. An assessment version
of the task was developed to directly test whether attentional bias changed due to the training. Self-reported anxiety and depressive symptoms and
self-esteem were measured pre- and post-training. Results After two sessions of training, the ABM group showed a significant decrease in attentional
bias for negative information and self-reported social phobia, while the control group did not. There were no effects of training on depressive mood
or self-esteem. Limitations No correlation between attentional bias and social phobia was found, which raises questions about the validity of the
attentional bias assessment task. Also, the small sample size precludes strong conclusions. Conclusions Visual search ABM might be beneficial in
changing attentional bias and social phobia in adolescents, but further research with larger sample sizes and longer follow-up is needed. (copyright)
2013 Elsevier Ltd. All rights reserved.
Journal of Behavior Therapy & Experimental Psychiatry, 45(2) : 252-259
- Year: 2014
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification