Disorders - Depressive Disorders
Balchin, R., Linde, J., Blackhurst, D., Rauch, H. L., Schonbachler, G.
Background: In periods of prolonged stress and pain the body produces endorphins to help endure pain. The PANIC system is built on the same pathways as the pain system and is characterized by behaviour that looks like depression. The term 'mental pain' in the context of feelings of loss is arguably justified in light of this relationship between the physical pain and social loss systems. It is reasonable to expect that endorphin release ameliorates depression. Methods: Moderately depressed males (n=30) were randomly assigned to one of three groups of varying exercise intensity. Each underwent a six-week exercise programme for three days per week, one hour per day. The HAM-D, MADRS, and ANPS were administered weekly and β-endorphin levels measured. Results Moderate- and high-intensity exercise improved depression levels, while very-low intensity exercise did not have as beneficial an effect. β-endorphin results were inconclusive. Participants showed a slight decrease in PANIC and FEAR, and increased SEEKING. Limitations: The potential insensitivity of the assays that were utilized, and the known problems with measuring β-endorphins, may have contributed to the findings. The lack of a state measure of the basic emotion systems is problematic, as a trait measure has to be relied upon, and this likely affected the ability to accurately detect changes over time. Conclusions: The demonstrated improvements in depressive symptoms have important implications for the clinical treatment of patients despite the hypothesis that the PANIC system is involved in the genesis and maintenance of depression not having been conclusively confirmed.
Journal of Affective Disorders, 200 : 218-221
- Year: 2016
- 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)
, Physical activity, exercise
Bluth, K., Campo, R. A., Pruteanu-Malinici, S., Reams, A., Mullarkey, M., & Broderick, P. C
Mindfulness, 7(1) : 90-104
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy
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.
Copyright © 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