disorders - Depressive Disorders
Horigian, Viviana E., Weems, Carl F., Robbins, Michael S., Feaster, Daniel J., Ucha, Jessica, Miller, Michael, Werstlein, Robert
Background and Objectives: Research shows that interventions for substance use disorders may be helpful in reducing internalizing disorders in adolescents. This paper examines the prevalence and reductions of anxiety and depression symptoms among youth receiving substance use treatment.; Methods: Four hundred eighty adolescents ages 12-17 who received treatment for substance abuse as part of the Brief Strategic Family Therapy effectiveness trial were screened for anxiety and depression using the Diagnostic Interview Schedule for Children-Predictive Scales (DISC-PS). Twelve-month post-randomization assessments were completed by 327 parents and 315 youth. Sixty-five percent of the sample was found to have probability of at least one anxiety disorder or depression diagnosis.; Results: Significant reduction of anxiety and depressive symptoms and significant reductions in probable anxiety and depression diagnoses were observed at follow-up. Few differences by treatment type and by ethnic group were noticed.; Conclusions and Scientific Significance: Findings indicate that substance use interventions might help reduce the prevalence of anxiety and depressive symptoms and the probability of these disorders.; Copyright © American Academy of Addiction Psychiatry.
American Journal on Addictions, 22(4) : 329-337
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy
Garcia, C., Pintor, J., Vazquez, G., Alvarez-Zumarraga, E.
The authors examined the feasibility and preliminary outcomes of Project Wings Girls' Groups, a school-based mental health promotion program designed to improve well-being in Latina adolescents, as observed in outcomes, including perceived stress, depressive symptoms, coping, and connectedness. This pilot randomized controlled trial compared outcomes over 9 months postintervention for 42 9th and 10th grade adolescents attending two urban high schools. Girls were randomized to Project Wings Girls' Groups, a 16-session facilitated curriculum, including sharing circles, mind-body exercises, and coping skills building or the attention control (i.e., similar format but focused on general health topics). Feasibility of retention and long-term follow-up data collection was demonstrated, with lessons learned for future study. Although not statistically powered, this trial demonstrated findings in the expected direction, including reduced perceived stress and depression and increased connectedness. A trial with sufficient power is warranted to examine Project Wings' effects on mental health problems among Latina adolescents. (copyright) The Author(s) 2011.
Western Journal of Nursing Research, 35(4) : 434-458
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Gerson, M. W., Fernandez, N.
We developed and tested a brief three‐session program to build resilience (protection from depressive symptoms) and thriving (positive growth) in undergraduates by teaching adaptive explanatory styles. In Study 1, a pretest - posttest waiting list control experiment with 28 undergraduates found that our Program for Accelerated Thriving and Health (PATH) significantly increased optimistic and personal control explanatory styles (Attributional Style Questionnaire), resilience (Beck Depression Inventory‐II), and thriving (Connor - Davidson Resilience Scale 10). In Study 2, a placebo control experiment with 63 undergraduates found a modified version of the program to significantly increase resilience. All effects were at least moderate in size. As predicted, a personal control explanatory style significantly predicted thriving in both studies. Predictors of resilience and thriving were discussed in terms of differentiating the constructs. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Journal of Applied Social Psychology, 43(11) : 2169-2184
- Year: 2013
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Findling, R. L., Robb, A., Bose, A.
Objective: The purpose of this study was to evaluate the extended efficacy, safety, and tolerability of escitalopram relative to placebo in adolescents with major depressive disorder (MDD). Methods: Adolescents (12-17 years) who completed an 8-week randomized, double-blind, flexible-dose, placebo-controlled, lead-in study of escitalopram 10-20 mg versus placebo could enroll in a 16-24-week, multisite extension trial; patients maintained the same lead-in randomization (escitalopram or placebo) and dosage (escitalopram 10 or 20 mg/day, or placebo) during the extension. The primary efficacy was Children's Depression Rating Scale-Revised (CDRS-R) change from the lead-in study baseline to treatment week 24 (8-week lead-in study plus 16-week extension); the secondary efficacy was Clinical Global Impressions-Improvement (CGI-I) score at week 24. All efficacy analyses used the last observation carried forward (LOCF) approach; sensitivity analyses used observed cases (OC) and mixed-effects model for repeated measures (MMRM). Safety was evaluated via adverse event (AE) reports and the clinician-rated Columbia-Suicide Severity Rating Scale (C-SSRS). Results: Following lead-in, 165 patients enrolled in the double-blind extension (82 placebo; 83 escitalopram); 40 (48.8%) placebo and 37 (44.6%) escitalopram patients completed treatment. CDRS-R total score improvement was significantly greater for escitalopram than for placebo (p=0.005, LOCF; p=0.014; MMRM). Response rates (CDRS-R (greater-than or equal to)40% reduction from baseline [adjusted and unadjusted] and CGI-I (less-than or equal to)2) were significantly higher for escitalopram than for placebo (LOCF); remission rates (CDRS-R (less-than or equal to)28) were 50.6% for escitalopram and 35.7% for placebo (p=0.002). OC analyses were not significantly different between groups. The most frequent escitalopram AEs ((greater-than or equal to)5% and more frequent than placebo) were headache, nausea, insomnia, vomiting, influenza-like symptoms, diarrhea, and urinary tract infection. Most AEs were mild/moderate and not related to the study drug. AEs suggestive of self-harm occurred in 5.7% and 7.1% of placebo and escitalopram patients. Occurrence of suicidal behavior and/or suicidal ideation assessed by C-SSRS was 10.9% (14/128) for placebo and 14.5% (19/131) for escitalopram. Conclusions: Extended use of escitalopram was generally safe and resulted in modest improvement in efficacy in adolescents with MDD. (copyright) Copyright 2013, Mary Ann Liebert, Inc. 2013.
Journal of Child & Adolescent Psychopharmacology, 23(7) : 468-480
- Year: 2013
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs)
DelBello, M., Welge, J., Strawn, J., Patino-Duran, L. R., Stahl, L., Blom, T., Strakowski, S., McNamara, R.
Background: Family studies demonstrate that offspring of bipolar parents have an elevated risk of developing mood disorders compared with the general population. When these offspring develop major depressive disorder, their risk of developing mania (and by definition bipolar I disorder) is increased further (ie, they are at ultra-high risk). Moreover, antidepressant medications that are commonly used to treat depressive symptoms may increase risk of developing manic symptoms. Therefore, studies of potential treatments for mood symptoms in ultra-high risk youth are urgently needed to establish early intervention, and ultimately prevention, strategies. The aim of our 12-week double-blind placebo-controlled study was to examine the efficacy and tolerability of long-chain omega-3 (LCn-3) fatty acids for the treatment of depressive symptoms in ultrahigh risk youth and to investigate predictors and mediators of treatment response. Methods: Sixty youth (ages 9-20 years) with a current DSMIV- TR diagnosis of Major Depressive Disorder or Depressive Disorder NOS, a Childhood Depression Rating Scale- Revised Version (CDRS-R) of score (greater-than or equal to) 28, and at least one biological parent with bipolar I disorder, were recruited to participate in this 12-week double-blind placebo-controlled study. Fifty-six subjects were randomized to LCn-3 fatty acid supplements (2100 mg/d) or placebo (olive oil). Symptom and tolerability ratings were performed weekly and red blood cell (RBC) LCn-3 fatty acid levels were obtained at baseline and endpoint from each participant. Results: The mean age of participants was 13.7 + 4.0 years, and a majority of participants were girls (82%) and White (67%). At baseline subjects displayed moderate symptoms of depression (mean CDRS-R: 47 + 8), and there was a trend for an inverse correlation between baseline CDRS scores and RBC LCn-3 fatty acid levels (R2=0.06, p=0.085). Among participants with post-baseline LCn-3 measurements, RBC LCn-3 fatty acid (EPA +DHA) levels increased and arachidonic acid (AA) to EPA +DHA (AA/EPA +DHA) ratios decreased, significantly from baseline to endpoint in the group treated with LCn-3 fatty acids (n=20) but not in the placebo group (n=20). There were statistically significant baseline to endpoint reductions in CDRS-R scores in both treatment groups (LCn-3 fatty acids: -21.1 + 8.9 and placebo: -18.9 + 8.4), although there was no significant group difference in improvement (p=0.42). The mean + SD percent reduction in CDRS-R score was 66 + 27% in the LCn-3 fatty acid group and 53 + 27% in the placebo group (p=0.11). The baseline AA/EPA +DHA ratio was inversely correlated with baseline to endpoint change in CDRS-R score (ie, smaller baseline ratios were associated with greater CDRS-R improvement, p=0.031), and larger baseline to endpoint decreases in the AA/DHA + EPA ratio were associated with smaller reductions in CDRS-R scores. In an ANCOVA model, this effect appeared to be similar in both treatment groups (p=0.044 for main effect of change in AA/EPA + DHA, and no significant interaction with treatment assignment, p=0.69). After adjusting for the baseline to endpoint change in the AA/EPA +DHA ratio, treatment with LCn-3 fatty acids was associated with greater reductions in CDRS-R scores than placebo (p=0.017). The most commonly reported adverse events were headache (Placebo: 83%, LCn-3: 77%) and drowsiness (Placebo: 72%, LCn-3: 77%). Reported gastrointestinal adverse events were nausea (Placebo: 52%, LCn-3: 54%), vomiting (Placebo: 38%, LCn- 3: 19%), diarrhea (Placebo: 17%, LCn-3: 27%), and heartburn (Placebo: 17%, LCn-3: 31%). Conclusions: This study provides preliminary evidence that LCn-3 fatty acid supplementation is well-tolerated and improves depressive symptoms in youth at high risk for developing mania. Additionally, we found that higher baseline LCn-3 fatty acid levels predicted greater improvement in depressive symptoms. Although the results suggest that supplementation may produce treatment benefits, in contrast to our expectation, larger decreases in A to DHA + EPA ratios were associated with less improvement in depressive symptoms. These findings indicate that the amount, duration, and/or rate of change in LCn-3 fatty acid levels may impact the therapeutic benefits of omega-3 fatty acid supplementation. Additional dose finding studies to identify a plausible biological mechanism for our findings and to determine whether omega-3 fatty acid supplementation is more effective and better tolerated than conventional antidepressant medications for the treatment of ultra-high risk youth are necessary.
Neuropsychopharmacology, 38 : S374-S375
- Year: 2013
- Problem: Bipolar Disorders, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Fish oil (Omega-3 fatty acids)
, Omega 3 fatty acids (e.g. fish oil, flax oil)
Donker, T., Batterham, P. J., Warmerdam, L., Bennett, K., Bennett, A., Cuijpers, P., Griffiths, K. M., Christensen, H.
Background: By identifying which predictors and moderators lead to beneficial outcomes, accurate selection of the best initial treatment will have significant benefits for depressed individuals. Method: An automated, fully self-guided randomized controlled internet-delivered noninferiority trial was conducted comparing two new interventions (Interpersonal Psychotherapy FIFT; n=6201 and Cognitive Behavioral Therapy FCBT; n=6101) to an active control intervention (M00dGYM; n=613) over a period of 4 weeks to spontaneous visitors of an internet-delivered therapy website (e-couch). A range of putative predictors and moderators (socio-demographic characteristics rage, gender, marital status, education levell, clinical characteristics Fdepression!anxiety symptoms, disability, quality of life, medication usel, skills Fmastery and dysfunctional attitudesi and treatment preference) were assessed using internet-delivered self-report measures at baseline and immediately following treatment and at six months follow-up. Analyses were conducted using Mixed Model Repeated Measures (MMRM). Resu Its: Female gender, lower mastery and lower dysfunctional attitudes predicted better outcome at post-test and!or follow-up regardless of intervention. No overall differential effects for condition on depression as a function of outcome were found. However, based on time-specific estimates, a significant interaction effect of age was found. For younger people, internet-delivered 1Ff may be the preferred treatment choice, whereas older participants derive more benefits from internet-delivered CBT programs. Limitations: Although the sample of participants was large, power to detect moderator effects was still lacking. Conclusions: Different e-mental health programs may be more beneficial for specific age groups. The findings raise important possibilities for increasing depression treatment effectiveness and improving clinical practice guidelines for depression treatment of different age groups. (copyright) 2013 Elsevier B.V. All rights reserved.
Journal of Affective Disorders, 151(1) : 343-351
- Year: 2013
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Interpersonal therapy (IPT)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Bertha, E. A., Balazs, J.
In adolescence, the number of depressive symptoms is rising notably. Individuals may have relevant depressive symptoms without meeting the full criteria of a major depressive episode (MDE), a condition referred to as subthreshold depression (sD). This article presents a review on adolescent sD examining the prevalence, the quality of life (QoL), the risk of developing MDE, and preventive programs available for adolescents living with sD. A systematic literature search from the year of the introduction of Diagnostic and Statistic Manual for Mental Disorders Fourth Edition (DSM-IV) until 2012 (18 years) was conducted with a special focus on adolescent sD. Data from 27 studies were included into this review. The results show high prevalence of sD among adolescents, with a negative impact on QoL, and provide evidence that sD is a significant risk indicator of later MDE; therefore, individuals with sD represent good targets for preventive interventions. Our review highlights the fact that sD is a significant health problem among adolescents indeed, and adolescents with sD could be a subgroup of youth, who need further help to reduce their clinically significant depressive symptoms for the successful prevention of a later MDE. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)
European Child & Adolescent Psychiatry, 22(10) : 589-603
- Year: 2013
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
Brown, H. E., Pearson, N., Braithwaite, R. E., Brown, W. J., Biddle, S. J. H.
Context: Evidence suggests chronic physical activity (PA) participation may be both protective against the onset of and beneficial for reducing depressive symptoms. Objective: The aim of this article is to assess the impact of PA interventions on depression in children and adolescents using meta-analysis. Data sources: Published English language studies were located from manual and computerized searches of the following databases: PsycInfo, The Cochrane Database of Systematic Reviews and The Cochrane Central Register of Controlled Trials, Trials Register of Promoting Health Interventions (TRoPHI; EPPI Centre), Web of Science and MEDLINE. Study selection: Studies meeting inclusion criteria (1) reported on interventions to promote or increase PA; (2) included children aged 5 - 11 years and/or adolescents aged 12 - 19 years; (3) reported on results using a quantitative measure of depression; (4) included a non-physical control or comparison group; and (5) were published in peer-reviewed journals written in English, up to and including May 2011 (when the search was conducted). Data extraction: Studies were coded for methodological, participant and study characteristics. Comprehensive Meta- Analysis version-2 software was used to compute effect sizes, with subgroup analyses to identify moderating characteristics. Study quality was assessed using the Delphi technique. Results: Nine studies were included (n = 581); most were school-based randomized controlled trials, randomized by individual. Studies used a variety of measurement tools to assess depressive symptoms. The summary treatment effect was small but significant (Hedges' g = -0.26, standard error = 0.09, 95% confidence intervals = -0.43, -0.08, p = 0.004). Subgroup analyses showed that methodological (e.g. studies with both education and PA intervention; those with a higher quality score; and less than 3 months in duration) and participant characteristics (e.g. single-gender studies; those targeting overweight or obese groups) contributed most to the reduction in depression. Conclusions: There was a small significant overall effect for PA on depression. More outcome-focused, high-quality trials are required to effectively inform the implementation of programmes to reduce depressive symptoms in children and adolescents. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)
Sports Medicine, 43(3) : 195-206
- Year: 2013
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Physical activity, exercise
Carnevale, T. D.
Although the subject of adolescent depression has gained significant attention, little is being done in the way of primary prevention. The purpose of this article is to conduct a review of the literature through the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. This review was conducted utilizing several online databases, as well as web and hand searches. Eleven studies were identified through a process of elimination and critically appraised by a two-tiered method. Results indicated cognitive-behavioral universal prevention interventions can be effective on decreasing depressive symptomalogy in adolescents. All reviewed studies were conducted in the school environment by professionals and/or school staff; however, only three of the programs implemented demonstrated adoption and sustainability. School nurses can be instrumental in bridging the gap between the planning and developing of prevention programs and translation into the real-world school environment. (copyright) The Author(s) 2012.
Journal of School Nursing, 29(3) : 181-195
- Year: 2013
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
Cavanagh, K., Strauss, C., Cicconi, F., Griffiths, N., Wyper, A., Jones, F.
Objectives: There is growing evidence that mindfulness has positive consequences for both psychological and physical health in both clinical and non-clinical populations. The potential benefits of mindfulness underpin a range of therapeutic intervention approaches designed to increase mindfulness in both clinical and community contexts. Self-guided mindfulness-based interventions may be a way to increase access to the benefits of mindfulness. This study explored whether a brief, online, mindfulness-based intervention can increase mindfulness and reduce perceived stress and anxiety/depression symptoms within a student population. Method: One hundred and four students were randomly allocated to either immediately start a two-week, self-guided, online, mindfulness-based intervention or a wait-list control. Measures of mindfulness, perceived stress and anxiety/depression were administered before and after the intervention period. Results: Intention to treat analysis identified significant group by time interactions for mindfulness skills, perceived stress and anxiety/depression symptoms. Participation in the intervention was associated with significant improvements in all measured domains, where no significant changes on these measures were found for the control group. Conclusions: This provides evidence in support of the feasibility and effectiveness of shorter self-guided mindfulness-based interventions. The limitations and implications of this study for clinical practice are discussed. (copyright) 2013 Elsevier Ltd.
Behaviour Research & Therapy, 51(9) : 573-578
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Mindfulness based therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Bernhardsdottir, J., Vilhjalmsson, R., Champion, J. D.
A study of a brief cognitive behavioral group therapy intervention for psychologically distressed Icelandic female university students was conducted using a pre-post test quasi-experimental design with intervention and control group conditions. Students were randomly allocated to control and intervention group conditions (n = 30). The intervention group received four sessions of cognitive behavioral group therapy, delivered by two advanced practice psychiatric nurses. Assessment of distress included self-reported depression and anxiety symptoms. Students in the intervention group experienced significantly lower levels of depression and anxiety symptoms compared to the control group post-test providing preliminary evidence concerning intervention effectiveness for Icelandic students. ;
Issues in Mental Health Nursing, 34(7) : 497-504
- Year: 2013
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Baum, E. S., Rude, S. S.
Traditional expressive writing (EW) and EW augmented by emotion-acceptance instructions (EWEA) were compared to non-emotional control writing for their ability to forestall depression symptoms in undergraduates with high or low initial levels of depression symptomatology. EWEA instructions encouraged participants to take a more accepting, "emotion friendly" approach toward expressive writing, stressing the importance of "staying present" with difficult emotional experiences non-judgmentally and with openness. Writing condition interacted significantly with initial depression such that at the 5-week posttest, EWEA was more beneficial than control writing for participants with low to mild initial depression symptoms (CESD <17) and EW was more beneficial than control writing for participants with very low initial depression symptoms (CESD <8). But for the EW condition, this effect was reversed such that participants in this condition with high initial depression (CESD >26) fared worse at posttest than those in the control group. (copyright) 2012 Springer Science+Business Media, LLC.
Cognitive Therapy & Research, 37(1) : 35-42
- Year: 2013
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art