Disorders - Depressive Disorders
Durgam, S., Chen, C., Migliore, R., Prakash, C., Edwards, J., Findling, R. L.
Background: Major depressive disorder (MDD) is a serious illness in children and adolescents. Vilazodone is a selective serotonin reuptake inhibitor approved for MDD in adults. This study evaluated the efficacy, safety, and tolerability of vilazodone in adolescent patients, ages 12-17 years, with MDD (NCT01878292). Methods: This double-blind, randomized, placebo-controlled, parallel-group, fixed-dose study was conducted at 56 study centers in the United States and was 10 weeks in duration (a 1-week screening period, an 8-week double-blind treatment period, and a 1-week double-blind down-taper period). Outpatients with an MDD diagnosis based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria were included in the study. Clinical inclusion criteria required a Children's Depression Rating Scale-Revised (CDRS-R) total score of >= 40 and Clinical Global Impressions-Severity (CGI-S) score of >= 4. Patients were randomized 1:1:1 to 8 weeks of double-blind treatment with placebo (n = 174), vilazodone 15 mg/day (n = 175), or vilazodone 30 mg/day (n = 180). The primary and secondary efficacy parameters were change from baseline to week 8 in CDRS-R total score and CGI-S score, respectively. Safety parameters included adverse events (AEs); clinical laboratory, vital sign, and electrocardiogram parameters; and the Columbia-Suicide Severity Rating Scale. Results: Approximately 86% of patients completed double-blind treatment. There was no statistically significant difference between vilazodone 15 mg/day or 30 mg/day and placebo in change from baseline in CDRS-R score. Change in CGI-S score was not significant after adjustment for multiple comparisons. The most common treatment-emergent AEs were nausea, upper abdominal pain, vomiting, diarrhea, nasopharyngitis, headache, and dizziness. Reports of suicidal ideation (placebo, 33.3%; vilazodone 15 mg/day, 36.0%; vilazodone 30 mg/day, 31.1%) and suicidal behavior (placebo, 1.8%; vilazodone 15 mg/day, 1.1%; vilazodone 30 mg/day, 1.1%) were similar between treatment groups. There were no deaths in the study. Conclusions: The efficacy of vilazodone for the treatment of MDD in adolescent patients could not be confirmed in this study. Vilazodone was generally safe and well tolerated, with treatment-emergent AEs similar to those in adult patients. Clinical Trial Registration: NCT01878292. Copyright © 2018 The Author(s)
Pediatric Drugs, : 1-11
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Antidepressants (any)
Ismayilova, L., Karimli, L., Sanson, J., Gaveras, E., Nanema, R., To-Camier, A., Chaffin, J.
Rationale: There is limited evidence about interventions improving child mental health in francophone West Africa. Behavioral mental health interventions alone may have limited effects on children's emotional well-being in families living in abject poverty, especially in low-income countries. Objective: This study tests the effects of economic intervention, alone and in combination with a family-focused component, on the mental health of children from ultra-poor households in rural Burkina Faso. Methods: The three-arm cluster randomized trial included children in the age range of 10-15 years old (N = 360), from twelve villages in Nord region of Burkina Faso (ClinicalTrial.gov ID: NCT02415933). Villages were randomized (4 villages/120 households per arm) to the waitlist arm, the economic intervention utilizing the Graduation approach (Trickle Up/TU arm), or to the economic strengthening plus family coaching component (TU + arm). Intervention effects were tested using repeated-measures mixed-effects regressions that account for the clustered nature of the data. Results: Children from the TU + arm showed a reduction in depressive symptoms at 12 months (medium effect size Cohen's d = -0.41, p =.001) and 24 months (d = -0.39, p =.025), compared to the control condition and the economic intervention alone (at 12 months d = -0.22, p =.020). Small effect size improvements in self-esteem were detected in the TU + group, compared to the control arm at 12 months (d = 0.21) and to the TU arm at 24 months (d = 0.21). Trauma symptoms significantly reduced in the TU + group at 12 months (Incidence Risk Ratio/IRR = 0.62, 95% CI = 0.41, 0.92, p =.042), compared to the control group. Conclusion: Integrating psychosocial intervention involving all family members with economic empowerment strategies may be an innovative approach for improving emotional well-being among children living in extreme poverty. Copyright © 2018 Elsevier Ltd
Social Science and Medicine, 208 : 180-189
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement interventions
Kirschbaum, I., Straub, J., Gest, S., Holtmann, M., Legenbauer, T.,
Chronotherapeutics are well established for the treatment of depression and associated sleeping problems in adults. However, effects are still understudied in adolescents. Two pilot studies highlighted the crucial role of sleep when it comes to the treatment of depression, by means of chronotherapeutics, in adolescents. The aim of the present study was to investigate the role of adjunctive wake therapy (WT) in addition to bright light therapy (BLT) with respect to sleep behaviors. In the present study, 62 depressed inpatients (aged 13-18 years; diagnosed with Beck Depression Inventory Revision) were randomly assigned to two groups: BLT only (BLT-group) and a combination of BLT and WT (COMB-group). After one night of WT adolescents in the COMB-group revealed longer sleep durations, time in bed, advanced sleep onset, less wakes during night and an improved sleep efficiency. However, one night of WT plus BLT had no additional effect on sleep parameters compared with BLT-group in the long run. Therefore, future studies should assess whether more nights of WT might lead to more sustainable effects. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Chronobiology International, 35(1) : 101-110
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Bright light therapy
, Other complementary & alternative interventions
Komulainen, E., Heikkila, R., Nummenmaa, L., Raij, T. T., Harmer, C. J., Isometsa, E., Ekelund, J.
Background: Increased self-focus and negative self-concept play an important role in depression. Antidepressants influence self-referential processing in healthy volunteers, but their function in self-processing of depressed patients remains unknown. Methods: Thirty-two depressed patients were randomly allocated to receive either escitalopram 10 mg or placebo for one week. After one week, neural responses to positive and negative self-referential adjectives and neutral control stimuli were assessed with functional magnetic resonance imaging. A group of matched healthy volunteers served as a control group. Results: Escitalopram decreased responses of medial fronto-parietal regions to self-referential words relative to non-emotional control stimuli, driven by increased responses to the control condition. Escitalopram also increased responses in the pre-defined region of the medial prefrontal cortex (MPFC) and the anterior cingulate cortex (ACC) to positive relative to negative words. Importantly, the changes in neural responses occurred before any effect on depressive symptoms, implying a direct effect of escitalopram. Furthermore, the placebo group had decreased responses of the MPFC and the ACC to positive self-referential processing relative to the matched healthy controls. However, neural responses of the escitalopram group and the healthy unmedicated controls were similar. Limitations: Differences between the groups in self-reported depression symptoms and personality traits may have influenced the results. Conclusion: One-week treatment with escitalopram normalized aberrant self-referential processing in depressed patients, shifting the focus from the self to the external environment and potentiating positive self-referential processing. This may be an important factor in mechanism of action of antidepressants. Copyright © 2018 Elsevier B.V.
Journal of Affective Disorders, 236 : 222-229
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Antidepressants (any)
Hogberg, G., Hallstrom, T.
Suicide attempts and suicidal ideation in adolescence are considered to be related to suicide and psychiatric adversity later in life. Secondary prevention by improving the treatment of suicidal youth is a distinct possibility. In this study, treatment with a systematised mood-regulation focused cognitive behavioural therapy (MR-CBT) (n = 15) was compared with treatment as usual (TAU) (n = 12) in a group of depressed adolescents in a clinical setting. MR-CBT focuses on mood regulation by means of counter conditioning with memory reconsolidation being the proposed mechanism of change. Subjects practice keeping emotionally positive memories to diminish the emotional impact of negative memories. Symptoms of depression were tested with a short version of the Mood and Feelings Questionnaire (SMFQ), and wellbeing with the World Health Organization 5 Wellbeing Index (WHO-5). Suicidal events were rated according to the clinical interview Columbia Suicide Severity Rating Scale (C-SSRS). Suicidal events at the end of treatment were significantly reduced in the MR-CBT group, but not in the TAU group. Depression and wellbeing improved significantly in both treatment groups. While far from conclusive, the results are encouraging enough to suggest that further studies should be undertaken to examine whether psychotherapy focusing on mood regulation for young individuals at risk might enhance secondary prevention of suicide. Copyright © 2018 by the authors. Licensee MDPI, Basel, Switzerland.
International Journal of Environmental Research and Public Health, 15 (5) (no pagination)(921) :
- Year: 2018
- Problem: Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
, Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Lopresti, A. L., Drummond, P. D., Inarejos-Garcia, A. M., Prodanov, M.
Background: Saffron has antidepressant and anxiolytic effects in adults with mild-to-moderate depression. However, this is the first study examining its mood-related effects in teenagers. Methods: In this 8-week, randomised, double-blind, placebo-controlled study, youth aged 12-16 years, with mild-to-moderate anxiety or depressive symptoms were given tablets containing placebo or a saffron extract (affron, 14 mg b.i.d). The youth and parent versions of the Revised Child Anxiety and Depression Scale (RCADS) were used as outcome measures. Results: 80 participants were enrolled and 68 completed the study. Based on youth self-reports, affron was associated with greater improvements in overall internalising symptoms (p = 0.049), separation anxiety (p = 0.003), social phobia (p = 0.023), and depression (p = 0.016). Total internalising scores decreased by an average of 33% compared to 17% in the placebo group (p = 0.029). However, parental reports of improvements were inconsistent as mean improvements in RCADS scores were greater in the saffron group (40% vs 26%) (p = 0.026), although no other significant differences were identified. affron was well-tolerated and there was a trend of reduced headaches in participants on the active treatment. Limitations: The use of a self-report instrument, limited study duration, single treatment dose, and non-clinical sample used in this study limit the generalisability of study findings. Conclusion: The administration of a standardised saffron extract (affron) for 8 weeks improved anxiety and depressive symptoms in youth with mild-to-moderate symptoms, at least from the perspective of the adolescent. However, these beneficial effects were inconsistently corroborated by parents. Copyright © 2018
Journal of Affective Disorders, 232 : 349-357
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Homeopathic, plant-based medicines
Mascaro, J. S., Kelley, S., Darcher, A., Negi, L. T., Worthman, C., Miller, A., Raison, C.
Increasing data suggest that for medical school students the stress of academic and psychological demands can impair social emotions that are a core aspect of compassion and ultimately physician competence. Few interventions have proven successful for enhancing physician compassion in ways that persist in the face of suffering and that enable sustained caretaker well-being. To address this issue, the current study was designed to (1) investigate the feasibility of cognitively-based compassion training (CBCT) for second-year medical students, and (2) test whether CBCT decreases depression, enhances compassion, and improves daily functioning in medical students. Compared to the wait-list group, students randomized to CBCT reported increased compassion, and decreased loneliness and depression. Changes in compassion were most robust in individuals reporting high levels of depression at baseline, suggesting that CBCT may benefit those most in need by breaking the link between personal suffering and a concomitant drop in compassion. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
The Journal of Positive Psychology, 13(2) : 133-142
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
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Stage: Universal prevention
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Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Meditation
Mobius, M., Ferrari, G. R., van-den-Bergh, R., Becker, E. S., Rinck, M.
To address shortcomings of purely reaction-time based attention bias modification (ABM) paradigms, a novel eye-tracking based ABM training (ET-ABM) was developed. This training targets the late disengagement from negative stimuli and the lack of attention for positive information, which are characteristics of depression. In the present study, 75 dysphoric students (BDI >= 9) were randomly assigned to either this positive training (PT), or a sham-training (ST) that did not train any valence-specific gaze pattern (positive and negative pictures had to be disengaged from and attended to equally often). Results showed that the PT induced a positive attentional bias (longer fixations of positive than negative pictures). Although the ST group showed an increase in positive attentional bias as well, this increase was not as strong as in the PT group. Compared to the ST, the PT specifically induced faster disengagement from negative pictures. No differential training effects were found on stress responses or state rumination. These results show that the ET-ABM successfully modifies attentional processes, specifically late disengagement from negative stimuli, in dysphoric students, and hence might be a promising alternative to existing ABM paradigms. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Cognitive Therapy and Research, 42(4) : 408-420
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Paolucci, E. M., Loukov, D., Bowdish, D. M. E., Heisz, J. J.
Background: Exercise may help to mitigate symptoms of depression by reducing inflammation; however, little is known about the influence of exercise intensity on depressed mood. Methods: In the present study, sixty-one university students were assigned to six weeks of high-intensity interval training (HIT), moderate continuous training (MCT), or no exercise (CON) during their academic term. We measured changes in depression, anxiety and perceived stress along with pro-inflammatory cytokines tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), interleukin-1 beta (IL-1beta), and C-reactive protein (CRP). Results: Depression increased for CON, demonstrating how quickly mental health can decline for students during their academic term. In contrast, MCT decreased depression and pro-inflammatory cytokine TNF-alpha levels. Although HIT decreased depressive symptoms, it also increased perceived stress, TNF-alpha and IL-6 relative to MCT. This may be due to the higher level of physical stress evoked by the more strenuous exercise protocol. Conclusions: Taken together, the results suggest that moderate-intensity exercise may be an optimal intensity of exercise for the promotion of mental health by decreasing TNF-alpha. This is critical for informing the use of exercise as medicine for mental health. Copyright © 2018
Biological Psychology, 133 : 79-84
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Physical activity, exercise
Nematolahi, P., Mehrabani, M., Karami-Mohajeri, S., Dabaghzadeh, F.
OBJECTIVE: To evaluate the effects of oral rosemary on memory performance, anxiety, depression, and sleep quality in university students.
METHODS: In this double-blinded randomized controlled trial, the 68 participating students randomly received 500 mg rosemary and placebo twice daily for one month. Prospective and retrospective memory performance, depression, anxiety and sleep quality of the students were measured using Prospective and Retrospective Memory Questionnaire, Hospital Anxiety and Depression Scale, and Pittsburgh Sleep Quality Inventory at baseline and after one month.
RESULTS: The scores of all the scales and subscales except the sleep latency and sleep duration components of Pittsburgh Sleep Quality Inventory were significantly decreased in the rosemary group in comparison with the control group after one month.
CONCLUSIONS: Rosemary as a traditional herb could be used to boost prospective and retrospective memory, reduce anxiety and depression, and improve sleep quality in university students.
Complementary Therapies in Clinical Practice, 30 : 24-28
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Homeopathic, plant-based medicines
Poole, L. A., Knight, T., Toumbourou, J. W., Lubman, D. I., Bertino, M. D., Lewis, A. J.
This paper presents findings from a multi-centre, double-blind, randomized controlled trial that tested the hypothesis that parent and youth mental health improvements would be superior in a family-based intervention for adolescent depression (BEST MOOD) compared to a treatment-as-usual supportive parenting program (PAST). Eligible participants were families with a young person aged between 12 and 18 years who met diagnostic criteria for a depressive disorder (major, minor or dysthymic). Participating families (N = 64; 73.4% of youth were female) were recruited in Victoria, Australia and allocated to treatment condition using a block randomization procedure (parallel design) with two levels of blinding. This paper reports on the trial's secondary outcomes on youth and parent mental health. General linear mixed models were used to examine the longitudinal effect of treatment group on outcome. Data were analyzed according to intention-to-treat; 31 families were analyzed in BEST MOOD, and 33 families in PAST. Parents in the BEST MOOD group experienced significantly greater reductions in stress and depressive symptoms than parents in the PAST group at 3-month follow-up. A greater reduction in parental anxiety was observed in the BEST MOOD group (d = 0.35) compared with PAST (d = 0.02), although the between-group difference was not significant. Both groups of youth showed similar levels of improvement in depressive symptoms at post-treatment (d = 0.83 and 0.80 respectively), which were largely sustained at a 3-month follow-up. The family-based BEST MOOD intervention appeared superior to treatment-as-usual (PAST) in demonstrating greater reductions in parental stress and depression. Both interventions produced large reductions in youth depressive symptoms. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of Abnormal Child Psychology, 46(1) : 169-181
- Year: 2018
- Problem: Depressive Disorders
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Family therapy, Psychoeducation, Supportive therapy
Sang, H., Tan, D.
The primary aim of this study was to evaluate the effectiveness of a social skills training program for Chinese students' internalizing behavior disorders symptoms reduction. Additionally, the study aimed to clarify whether the use of social skills training program would lead to better outcome than the use of daily usual program. Our RCT study randomly assigned 29 students who were suspected of internalizing behavior disorders to an intervention group in which students received a cognitive-behavioral approach-based social skills training program (n = 16) or to a control group with daily usual program during the period (n = 13). The analyses suggest that students receiving the social skills training program reported a significantly decrease of anxiety, depression and withdrawal symptoms during the end of the intervention and follow-up interval than did students in the control group. Cognitive-behavioral approach-based social skills interventions may help increase the sustainability of outcome after treatment for internalizing behavior disorders symptoms. Copyright © 2018, Anka Publishers. All rights reserved.
NeuroQuantology, 16(5) : 104-109
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Skills training