disorders - depressive disorders
Van-Der-Wurff, I. S. M., Von-Schacky, C., Bergeland, T., Leontjevas, R., Zeegers, M. P., Kirschner, P. A., De-Groot, R. H. M.
Objective: Depressive feelings and/or low self-esteem are common in adolescents and are associated with long-term negative outcomes. Multiple studies have shown associations between long-chain polyunsaturated fatty acids (LCPUFA) and depression in adults, but adolescent studies are limited. This study investigated the association between blood LCPUFA status and mental well-being (depression and selfesteem) in adolescents attending lower general secondary education (LGSE) with a low baseline Omega-3 Index (O3I). Furthermore, the effect of one year of krill oil supplementation on mental well-being was investigated. Method(s): A double-blind, randomized controlled trial (RCT) in adolescents attending LGSE (n=267) with an O3I<=5%. Students received placebo or krill oil supplementation (520 mg eicosapentaenoic acid, 280 mg docosahexaenoic acid per day) for 1 year. Participants filled out the Centre for Epidemiologic Studies Depression (CES-D) scale and Rosenberg Self-Esteem Scale (RSE) at baseline, 6, and 12 months, and LCPUFA status was determined. Baseline data were analysed with the Bayesian statistical approach, RCT data with mixed models. Result(s): Baseline analyses showed associations of higher Osbond acid (ObA) status with lower depression and higher self-esteem. After one year, O3I remained low probably due to non-adherence. Both intention-to-treat and O3I analyses did not show effects on CES-D or RSE. Conclusion(s): The associations of higher ObA status with lower depression and higher self-esteem scores warrant more research. The RCT did not reveal evidence for less depressive feelings, or higher selfesteem after one year of krill oil, possibly due to low increase in the O3I. More research with higher LCPUFA doses and higher adherence is needed.
Nutritional Neuroscience, 21 (Supplement 1) : S26
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Fish oil (Omega-3 fatty acids)
, Omega 3 fatty acids (e.g. fish oil, flax oil)
Martinez, V., Rojas, G., Martinez, P., Zitko, P., Irarrazaval, M., Luttges, C., Araya, R.
BACKGROUND: Despite evidence on efficacious interventions, a great proportion of depressed adolescents do not receive evidence-based treatment and have no access to specialized mental health care. Remote collaborative depression care (RCDC) may help to reduce the gap between needs and specialized mental health services. OBJECTIVE(S): The objective of this study was to assess the feasibility, acceptability, and effectiveness of an RCDC intervention for adolescents with major depressive disorder (MDD) living in the Araucania Region, Chile. METHOD(S): A cluster randomized, assessor-blind trial was carried out at 16 primary care centers in the Araucania Region, Chile. Before randomization, all participating primary care teams were trained in clinical guidelines for the treatment of adolescent depression. Adolescents (N=143; 13-19 years) with MDD were recruited. The intervention group (RCDC, N=65) received a 3-month RCDC treatment that included continuous remote supervision by psychiatrists located in Santiago, Chile's capital city, through shared electronic health records (SEHR) and phone patient monitoring. The control group (enhanced usual care or EUC; N=78) received EUC by clinicians who were encouraged to follow clinical guidelines. Recruitment and response rates and the use of the SEHR system were registered; patient adherence and satisfaction with the treatment and clinician satisfaction with RCDC were assessed at 12-week follow-up; and depressive symptoms and health-related quality of life (HRQoL) were evaluated at baseline and 12-weeks follow-up. RESULT(S): More than 60.3% (143/237) of the original estimated sample size was recruited, and a response rate of 90.9% (130/143) was achieved at 12-week follow-up. A mean (SD) of 3.5 (4.0) messages per patient were written on the SEHR system by primary care teams. A third of the patients showed an optimal adherence to psychopharmacological treatment, and adolescents in the RCDC intervention group were more satisfied with psychological assistance than those in EUC group. Primary care clinicians were satisfied with the RCDC intervention, valuing its usefulness. There were no significant differences in depressive symptoms or HRQoL between groups. Satisfaction with psychological care, in both groups, was related to a significant change in depressive symptomatology at 12-weeks follow-up (beta=-4.3, 95% CI -7.2 to -1.3). CONCLUSION(S): This is the first trial of its kind in Latin America that includes adolescents from vulnerable backgrounds, with an intervention that proved to be feasible and well accepted by both patients and primary care clinicians. Design and implementation issues may explain similar effectiveness across arms. The effectiveness of the intervention seems to be comparable with an already nationwide established treatment program that proved to be highly efficacious under controlled conditions. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01860443; https://clinicaltrials.gov/ct2/show/NCT01860443 (Archived by WebCite at http://www.webcitation.org/6wafMKlTY). Copyright ©Vania Martinez, Graciela Rojas, Pablo Martinez, Pedro Zitko, Matias Irarrazaval, Carolina Luttges, Ricardo Araya. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 31.01.2018.
Journal of Medical Internet Research, 20(1) : e38
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement interventions
Bai, S., Zeledon, L.R., D'Amico, E.J., Shoptaw, S., Avina, C., LaBorde, A.P., Anderson, M., Fitzpatrick, O.M., Asarnow, J.R.
Objective: Primary care (PC) is a major service delivery setting that can provide preventive behavioral health care to youths. To explore the hypothesis that reducing health risk behaviors (HRBs) would lower depressive symptoms, and that health risk and depression can be efficiently targeted together in PC, this study (1) evaluates an intervention designed to reduce HRBs among adolescent PC patients with depressive symptoms and (2) examines prospective links between HRBs and depressive symptoms. Method: A Randomized controlled trial was conducted comparing a behavioral health intervention with enhanced Usual PC (UC+). Participants were 187 adolescents (ages 13-18 years) with past-year depression, assessed at baseline, 6 months, and 12 months. Primary outcome was the Health Risk Behavior Index (HRBI), a composite score indexing smoking, substance use, unsafe sex, and obesity risk. Secondary/exploratory outcomes were an index of the first three most correlated behaviors (HRBI-S), each HRB, depressive symptoms, and satisfaction with mental health care. Results: Outcomes were similar at 6 and 12 months, with no significant between-group differences. HRBI, HRBI-S, and depressive symptoms decreased, and satisfaction with mental health care increased across time in both groups. HRBI, HRBI-S, and smoking predicted later severe depression. Conversely, severe depression predicted later HRBI-S and substance use. Conclusions: UC+ and the behavioral health intervention yielded similar benefits in reducing HRBs and depressive symptoms. Findings underscore the bidirectional links between depression and HRBs, supporting the importance of monitoring for HRBs and depression in PC to allow for effective intervention in both areas. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Journal of Pediatric Psychology, 43(9) : 1004-1016
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Other service delivery and improvement interventions
Lindsey, M.A., Banks, A., Cota, C.F., Lawrence-Scott, M., Joe, S.
The objective was to qualitatively examine the treatment effects of depression interventions on young, Black males (YBM) across treatment providers and settings via a review. Randomized controlled trials (RCTs) seeking to ameliorate depressive symptomology in Black males ages 12-29 were eligible for inclusion. After review of 627 abstracts and 212 full-text articles, 12 studies were selected. These RCTs were organized into five categories based on the intervention method. We isolated only one study that targeted YBM exclusively. Additionally, only two treatment effect sizes for YBM were available from the data. While remaining RCTs did involve Black youth, disaggregated data based on race and gender were not reported. Overall, the lack of research specific to YBM prevented any strong conclusions about the treatment effects on depression for this population. Small sample size along with poor representation of YBM were trends in the selected studies that also posed an issue. Therefore, our review produced qualitative findings but failed to isolate any true effect size for YBM being treated for depression. Until more conclusive evidence exists, alternative strategies may need to be employed in order to find appropriate interventions for depressed YBM seeking mental health treatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Research on Social Work Practice, 28(3) : 320-329
- Year: 2018
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
Hur, J. W., Kim, B., Park, D., Choi, S. W.
INTRODUCTION: While self-administered mobile app-based cognitive behavioral therapy (CBT) has shown efficiency and effectiveness over the past decade, attempts to address automatic and negative beliefs have been lacking. The purpose of this study was to introduce and verify a mobile app that directly intervenes in dysfunctional thoughts. This app-based treatment includes recognizing automatic and negative thoughts of the protagonist of scenarios, writing advice directly to the main character, and sharing advice provided by other participants. MATERIALS AND METHODS: Thirty-four participants diagnosed with Other Specified Depressive Disorder were recruited and randomly allocated to a CBT-based mobile-app program, the Todac Todac (TT group), or a daily mood chart app program (control group). Participants were asked to use the software for 3 weeks. Assessments for autonomic thoughts and clinical symptoms were administered at baseline and at a follow-up evaluation. RESULT(S): After completing the 3-week program, Dysfunctional Attitude Scale (DAS) scores in TT group were lower than they were in the control group. In clinical measures, both TT group and control group showed reduced Beck Depression Inventory-II (BDI-II) scores and situation-dependent trait version of State-Trait Anxiety Inventory (STAI-X2) at follow-up. However, TT group showed significantly reduced STAI-X2 scores compared to control group. For all participants, changes in DAS scores were correlated with BDI-II and STAI-X2 scores. CONCLUSION(S): Our preliminary findings provide promising evidence that scenario-based CBT mobile apps can be used to deliver feasible and efficacious cognitive therapy. Long-term research is needed to determine the impact and effectiveness of this new treatment format.
Telemedicine Journal & e-health, 24(9) : 710-716
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Technology, interventions delivered using technology (e.g. online, SMS)
Devoe, D., Farris, M., Addington, J.
Youth at clinical high risk (CHR) for psychosis often present with symptoms of depression and anxiety, which can reduce quality of life. Therefore, the aim of this systematic review was to determine the impact of all interventions on symptoms of depression and anxiety in CHR samples. We systematically searched Embase, EBM, PsycINFO, CINAHL, and MEDLINE. Studies were selected if they reported changes in depression or anxiety symptoms in youth at CHR and included an intervention. Data was evaluated using pairwise metaanalyses, stratified by time, and reported as the standardized mean difference (SMD). Twenty-three studies met our inclusion criteria, including a total of 1,831 CHR participants. The mean age was 19.35 years and 49% were female. Interventions included family therapy, glycine, antipsychotics, cognitive remediation, however analysis could only be performed on cognitive behavioural therapy (CBT) and omega-3. CBT did not significantly improve depression at 6-months (SMD = 0.02; 95% CI = -0.25, 0.28), 12-months (SMD = -0.04; 95%CI = -0.23, 0.14), 18-months (SMD = -0.11; 95%CI = -0.41, 0.20), or at 24-48-month follow-up (SMD = -0.21; 95%CI = -0.50, 0.08). CBT did not significantly improve anxiety at 6-months (SMD = -0.10; 95% CI = -0.29, 0.08), 12-months (SMD = 0.05; 95%CI = -0.14, 0.23), 18-months (SMD = 0.09; 95%CI = -0.22, 0.39), or at 24-48-months (SMD = -0.06; 95%CI = -0.55, 0.43). Omega-3 did not significantly improve depression at 6-months (SMD = -0.46; 95CI = -1.15, 0.23) and 12-months (SMD = -0.29; 95%CI = -1.10, 0.51). In conclusion, no interventions significantly impacted symptoms of depression or anxiety in CHR samples. However, no trials in this review were designed to target and treat these symptoms and the CBT used was specifically designed to address attenuated psychotic symptoms.
Early Intervention in Psychiatry, 12 (Supplement 1) : 174
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders, Psychosis Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Other biological interventions, Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Cognitive remediation therapy, Family therapy, Fish oil (Omega-3 fatty acids)
, Omega 3 fatty acids (e.g. fish oil, flax oil)
Cardamone-Breen, M. C., Jorm, A. F., Lawrence, K. A., Rapee, R. M., Mackinnon, A. J., Yap, M. B. H.
BACKGROUND: Depression and anxiety disorders are significant contributors to burden of disease in young people, highlighting the need to focus preventive efforts early in life. Despite substantial evidence for the role of parents in the prevention of adolescent depression and anxiety disorders, there remains a need for translation of this evidence into preventive parenting interventions. To address this gap, we developed a single-session, Web-based, tailored psychoeducation intervention that aims to improve parenting practices known to influence the development of adolescent depression and anxiety disorders. OBJECTIVE(S): The aim of this study was to evaluate the short-term effects of the intervention on parenting risk and protective factors and symptoms of depression and anxiety in adolescent participants. METHOD(S): We conducted a single-blind, parallel group, superiority randomized controlled trial comparing the intervention with a 3-month waitlist control. The intervention is fully automated and consists of two components: (1) completion of an online self-assessment of current parenting practices against evidence-based parenting recommendations for the prevention of adolescent depression and anxiety disorders and (2) an individually tailored feedback report highlighting each parent's strengths and areas for improvement based on responses to the self-assessment. A community sample of 349 parents, together with 327 adolescents (aged 12-15 years), were randomized to either the intervention or waitlist control condition. Parents and adolescents completed online self-reported assessments of parenting and adolescent symptoms of depression and anxiety at baseline, 1-month (parent-report of parenting only), and 3-month follow-up. RESULT(S): Compared with controls, intervention group parents showed significantly greater improvement in parenting risk and protective factors from baseline to 1-month and 3-month follow-up (F2,331.22=16.36, P<.001), with a small to medium effect size at 3-month follow-up (d=0.33). There were no significant effects of the intervention on adolescent-report of parenting or symptoms of depression or anxiety in the adolescents (all P>.05). CONCLUSION(S): Findings suggest that a single-session, individually tailored, Web-based parenting intervention can improve parenting factors that are known to influence the development of depression and anxiety in adolescents. However, our results do not support the effectiveness of the intervention in improving adolescent depression or anxiety symptoms in the short-term. Long-term studies are required to adequately assess the relationship between improving parenting factors and adolescent depression and anxiety outcomes. Nonetheless, this is a promising avenue for the translation of research into a low-cost, sustainable, universal prevention approach. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12615000247572; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12615000247572 (Archived by WebCite at http://www.webcitation.org/6v1ha19XG) Copyright ©Mairead C Cardamone-Breen, Anthony F Jorm, Katherine A Lawrence, Ronald M Rapee, Andrew J Mackinnon, Marie Bee Hui Yap. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.04.2018.
Journal of Medical Internet Research, 20(4) : e148
- Year: 2018
- Problem: Anxiety Disorders (any), 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)
Yap, M. B. H., Mahtani, S., Rapee, R. M., Nicolas, C., Lawrence, K. A., Mackinnon, A., Jorm, A. F.
Background: Depression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. Objective: This study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms. Methods: A two-arm randomized controlled trial was conducted with 359 parent-adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents' risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent's strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on individually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent- and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent- and child-report Spence Children's Anxiety Scale (anxiety symptoms). Results: Parents in the intervention condition completed a mean of 73.7% of their intended personalized PiP program. A total of 318 parents (88.6%, 318/359) and 308 adolescents (92.8%, 308/332) completed the postintervention assessment. Attrition was handled using mixed model of repeated measures analysis of variance. As hypothesized, we found a significant condition-by-time interaction on the PRADAS, with a medium effect size, Cohen d = 0.57, 95% CI 0.34-0.79. No significant differences between conditions were found at postintervention on any of the secondary outcome measures, with adolescent depressive (parent-report only) and anxiety (both parent- and adolescent-report) symptoms decreasing significantly from baseline to postintervention in both conditions. Conclusions: The fully automated PiP intervention showed promising short-term effects on parenting behaviors that are associated with adolescents' risk for depression and anxiety. Long-term follow-up is required to ascertain whether these effects translate into reduced adolescent depression and anxiety problems. The intervention may be useful as a low-cost universal public health program to increase parenting practices believed to benefit adolescents' mental health. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of Medical Internet Research Vol 20(1), 2018, ArtID e17, 20(1) :
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Prathikanti, S.
Purpose: Conventional pharmacotherapies and psychotherapies for major depression are associated with limited adherence to care and relatively low remission rates. Yoga may offer an alternative treatment option, but rigorous studies are few. This randomized controlled trial with blinded outcome assessors examined an 8-week hatha yoga intervention as monotherapy for mild-to-moderate major depression. Result(s): In intent-to-treat analysis, yoga participants exhibited significantly greater 8-week decline in Beck's Depression Inventory (BDI) scores than controls (P value=.034). In subanalyses of participants completing final 8-week measures, yoga participants were more likely to achieve remission, defined per final BDI score <=9 (P value=.018). Effect size of yoga in reducing BDI scores was large, per Cohen's d=-0.96 (95% confidence interval, -1.81 to -0.12). Intervention groups did not differ significantly in 8-week change scores for either the, the Generalized Self-efficacy Scale or Rosenberg's Self-esteem Scale. Conclusion(s): In adults with mild-to-moderate major depression, an 8-week hatha yoga intervention resulted in statistically and clinically significant reductions in depression severity.
Global Advances in Health and Medicine, 7 : 159
- Year: 2018
- 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)
, Mind-body exercises (e.g. yoga, tai chi, qigong)
, Physical activity, exercise
Weisz, J. R., Ugueto, A. M., Herren, J., Marchette, L. K., Bearman, S. K., Lee, E. H., Thomassin, K., Alleyne, A., Cheron, D. M., Tweed, J. L., Hersh, J., Raftery-Helmer, J. N., Weissman, A. S., Jensen-Doss, A.
OBJECTIVE: We assessed sustainability of an empirically supported, transdiagnostic youth psychotherapy program when therapist supervision was shifted from external experts to internal clinic staff.
METHOD: One hundred sixty-eight youths, aged 6-15 years, 59.5% male, 85.1% Caucasian, were treated for anxiety, depression, traumatic stress, or conduct problems by clinicians employed in community mental health clinics. In Phase 1 (2.7 years), 1 group of clinicians, the Sustain group, received training in Child STEPs (a modular transdiagnostic treatment + weekly feedback on youth response) and treated clinic-referred youths, guided by weekly supervision from external STEPs experts. In Phase 2 (2.9 years), Sustain clinicians treated additional youths but with supervision by clinic staff who had been trained to supervise STEPs. Also in Phase 2, a new group, External Supervision clinicians, received training and supervision from external STEPs experts and treated referred youths. Phase 2 youths were randomized to Sustain or External Supervision clinicians. Groups were compared on 3 therapist fidelity measures and 14 clinical outcome measures.
RESULTS: Sustain clinicians maintained their previous levels of fidelity and youth outcomes after switching from external to internal supervision; and in Phase 2, the Sustain and External Supervision groups also did not differ on fidelity or youth outcomes. Whereas all 34 group comparisons were nonsignificant, trends with the largest effect sizes showed better clinical outcomes for internal than external supervision.
CONCLUSIONS: Implementation of empirically supported transdiagnostic treatment may be sustained when supervision is transferred from external experts to trained clinic staff, potentially enhancing cost-effectiveness and staying power in clinical practice. (PsycINFO Database Record
Journal of Consulting & Clinical Psychology, 86(9) : 726-737
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement interventions
Breedvelt, J., Kandola, A., Kousoulis, A., Brouwer, M., Karyotaki, E., Bockting, C., Cuijpers, P.
Background: Depression is a prevalent disorder with a peak rate of onset in young adulthood from 18 to 25 years. To date, no review has systematically assessed the effectiveness of programs that aim to reduce depressive symptoms or diagnosis of depression in young adults. Method: A systematic search was performed in Cochrane, PubMed, PsycINFO and EMBASE. We performed a random-effects meta-analysis of the randomized controlled studies that compared an intervention for young adults (aged 18-25) without a diagnosis or history of depression and a control condition. Comparisons between intervention and control group outcomes were carried out at the post-intervention time point. We also compared intervention and control group outcomes at later follow-up time points where data were available. Results: Twenty-six randomized controlled trials among 2865 young adults were included in the analysis. The pooled effect size of the interventions versus control at post-intervention was g = 0.37 (95% CI: 0.28-0.47, NNT = 9) and heterogeneity was moderate I2 = 36 (95% CI: 11-64). There were no significant effects in terms of the type of delivery, focus of study, type of control, or type of support within the interventions. Limitations: The authors were unable to assess the effects of interventions on the onset of depression as none of the included studies measured incidence. The risk of bias was high in most studies (81%). Only one study included a follow-up of more than a year. Demographic factors were inconsistently reported in the included articles. Conclusion: While it was not possible to investigate the effects of interventions on depression incidence, some evidence was found for the effectiveness of preventative interventions in reducing depressive symptoms in young adults. Future research should address limitations of the current evidence base to allow stronger conclusions to be drawn. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Journal of Affective Disorders, 239 : 18-29
- Year: 2018
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
Ignaszewski, M. J., Waslick, B.
Objectives: Antidepressant treatment for major depressive disorder (MDD) has been a topic of continued interest with a number of placebo randomized-controlled trials (RCTs) being published in the past decade. We review the updated literature since the 2007 Bridge meta-analysis, and reassess safety data looking at signals of treatment-emergent suicidality with the Columbia Suicide Severity Rating Scale (CSSR-S). Method(s): PubMed literature review was performed searching for RCTs published since the 2007 article and supplemented with manual search. Result(s): Findings from seven trials (five industry sponsored, one NIMH funded, and one other) were included in this systematic review, which showed high medication and placebo response rates, with only fluoxetine and escitalopram treatment reaching statistical significance. Fluoxetine was also shown to prevent relapse of MDD with continued treatment with an odds ratio of 3.2 for prevention of relapse compared with placebo. There were no increases in treatment-emergent suicidality associated with antidepressant medication in any trial measuring suicidality systematically using the CSSR-S. Conclusion(s): Depressed pediatric patients respond similarly in these trials to antidepressant intervention and placebo, with recent studies showing that newer agents did not clearly demonstrate benefit above placebo. The evidence continues to support fluoxetine and escitalopram as first-line treatment and demonstrated effect to prevent relapse. Use of newer rating scales reveals similar rates of treatment-emergent suicidality in patients on antidepressants as placebo, in contrast to increased suicide signal suggested by past research using adverse events data. Antidepressant treatment is generally safe and well tolerated in this age group. Copyright © 2018 Mary Ann Liebert, Inc., publishers.
Journal of Child and Adolescent Psychopharmacology, 28(10) : 668-675
- Year: 2018
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
, Relapse prevention
-
Treatment and intervention: Biological Interventions (any)
, Antidepressants (any)