Disorders - Depressive Disorders
Yu, David Lei, Seligman, Martin E.
Posted 5/8/2002. Three studies reported on depressive symptoms (DSs) in mainland Chinese children. Study 1 showed that DSs were widely present in Chinese children. There were more symptoms in boys, in younger children, in children of less educated and less wealthy parents, in children from multi-child families, in children from single-parent families, in children from families in turmoil, and in children with lower academic achievement and conduct problems. In Study 2, 185 Chinese children in Beijing were followed for 8 months. A pessimistic explanatory style was associated with higher concurrent levels of DSs and higher levels at subsequent tests as well. There was strong evidence that the interaction of a pessimistic explanatory style and negative life events predicted higher levels of future DSs. In Study 3, we implemented an "optimistic child" type intervention program for 220 Chinese children who were selected from 1,425 students based on DSs and family conflict and were randomly assigned to the intervention group or the control group. At the post-test and the 3- and 6-month follow-ups, children who participated in the intervention program showed significantly fewer DSs. A more optimistic explanatory style mediated the prevention of depressive symptoms. . . . (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Prevention & Treatment, 5(1) :
- Year: 2002
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Cardemil, E. V., Reivich, K. J., Seligman, M.
We present data on the efficacy of the Penn Resiliency Program (PRP) with low income minority children. This school-based depression prevention program teaches cognitive and social problem-solving skills to groups of middle-school students who might be at-risk for developing depressive symptoms by virtue of their low-income status. Our previous research had established the effectiveness of the original PRP with predominately middle-income Caucasian children. We administered the PRP to 2 cohorts of low-income minority children: African American and Latino 5th and 6th
graders. We found a clearly beneficial effect for the Latino children up to 6 months after the conclusion of the depression prevention program, but no clear effect for the African American children.
Prevention & Treatment, 5(Article 8) :
- Year: 2002
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Clarke, Gregory N., Hornbrook, Mark, Lynch, Frances, Polen, Michael, Gale, John, O'Connor, Elizabeth, Seeley, John R., Debar, Lynn
OBJECTIVE: A randomized, controlled effectiveness trial of group cognitive-behavioral therapy (CBT) for depressed adolescent offspring of depressed parents in a health maintenance organization (HMO) was conducted. METHOD: Potential adult cases were found by reviewing antidepressant medication prescriptions, mental health appointments, and medical charts. Introductory study letters signed by each parent's treating physician were mailed to the appropriate adults. Eligible offspring aged 13 to 18 who met current DSM-III-R criteria for major depression and/or dysthymia were randomly assigned to either usual HMO care (n = 47) or usual care plus a 16-session group CBT program (n = 41). Assessments were conducted at baseline, after treatment, and at 12- and 24-month follow-up. RESULTS: Using intent-to-treat analyses, the authors were unable to detect any significant advantage of the CBT program over usual care, either for depression diagnoses, continuous depression measures, nonaffective measures, or functioning outcomes. CONCLUSIONS: Group CBT does not appear to be incrementally beneficial for depressed offspring of depressed parents who are receiving other mental health care. However, given that many other studies have found positive effects of CBT for youth depression, this single study should not be viewed as evidence that CBT is ineffective overall.
Journal of the American Academy of Child & Adolescent Psychiatry, 41(3) : 305-13
- Year: 2002
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Baldwin, David S.
Escitalopram is a new antidepressant drug, available for clinical use in many countries. This review describes the properties of escitalopram, summarizes the results of randomized controlled trials, and suggests that escitalopram has advantages over citalopram in the treatment of depression. [References: 15]
Hospital Medicine, 63(11) : 668-71
- Year: 2002
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs)
Pfeffer, C. R., Jiang, H., Kakuma, T., Hwang, J., Metsch, M.
Objective
This study evaluated efficacy of a manual-based bereavement group intervention for children who suffered suicide of a parent or sibling.
Method
Seventy-five families (102 children) were screened from medical examiners' lists of suicide victims. Fifty-two families (75 children) were eligible and assigned in alternating order to receive (27 families, 39 children) or not to receive (25 families, 36 children) the intervention. Intervention efficacy was evaluated as change in children's symptoms of anxiety, depression, posttraumatic stress, social adjustment, and parents' depressive symptoms from initial to outcome assessments.
Results
Changes in anxiety and depressive symptoms were significantly greater among children who received the intervention than in those who did not. A greater dropout of children assigned not to receive (75%) than to receive (18%) intervention led to an imbalance in retention of intervention and nonintervention participants.
Conclusions
A bereavement group intervention focusing on reactions to death and suicide and strengthening coping skills can lessen distress of children bereaved after parental or sibling suicide. Such intervention may prevent future morbidities.
Journal of the American Academy of Child & Adolescent Psychiatry, 41(5) : 505-513
- Year: 2002
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Michael, Kurt D., Crowley, Susan L.
We located a comprehensive sample of studies (1980-1999) on the psychosocial and pharmacological treatment of child and adolescent depression through an extensive literature search. Articles that met the inclusionary criteria were subsequently analyzed. The outcome data from 38 studies were extracted and converted into effect sizes (ESs). Comparisons of main effects, demographic, and quality of study variables were conducted. The overall findings of this meta-analysis indicate that several different psychosocial interventions for child and adolescent depression produced moderate to large treatment gains that were clinically meaningful for many afflicted youth. However, in general, the vast majority of pharmacological interventions were not effective in treating depressed children and adolescents. Nonetheless, there is recent evidence that selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine are efficacious, and will likely play an increased role in the management of affective illness in youngsters. The clinical implications and limitations of these data are discussed and suggestions for future research are provided. [References: 112]
Clinical Psychology Review, 22(2) : 247-69
- Year: 2002
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
, At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
Emslie, Graham J., Heiligenstein, John H., Wagner, Karen Dineen, Hoog, Sharon L., Ernest, Daniel E., Brown, Eileen, Nilsson, Mary, Jacobsen, Jennie G.
Presents results from the acute treatment phase of a clinical trial designed to confirm efficacy of a fixed dose of 20 mg of fluoxetine in 122 children and 97 adolescents with major depressive disorder (MDD). After a 1-week placebo lead-in, fluoxetine-treated patients received fluoxetine 10 mg/day for 1 week, then fluoxetine 20 mg/day for 8 weeks. Fluoxetine was associated with greater mean improvement in Children's Depression Rating Scale-Revised (CDRS-R) score than placebo after 1 week and throughout the study period. Significantly more fluoxetine-treated patients (41%) met the prospectively defined criteria for remission than did placebo-treated patients (20%). More fluoxetine- (65%) than placebo-treated (53%) patients met the prospectively defined response criterion of >=30% decrease in CDRS-R score, but this difference was not significant. Significantly more fluoxetine- than placebo-treated patients completed acute treatment. There were no significant differences between treatment groups in discontinuations due to adverse events. Fluoxetine 20 mg daily appears to be well tolerated and effective for acute treatment of MDD in child and adolescent outpatients. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Journal of the American Academy of Child & Adolescent Psychiatry, 41(10) : 1205-1214
- Year: 2002
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs)
Diamond, Guy S., Reis, Brendali F., Diamond, Gary M., Siqueland, Lynne, Isaacs, Lisa
OBJECTIVE: To design a treatment manual and adherence measure for attachment-based family therapy (ABFT) for adolescent depression and to collect pilot data on the treatment's efficacy. METHOD: Over a period of 2 years, 32 adolescents meeting criteria for major depressive disorder (MDD) were randomly assigned to 12 weeks of ABFT or a 6-week, minimal-contact, waitlist control group. The sample was 78% female and 69% African American; 69% were from low-income, inner-city communities. RESULTS: At post-treatment, 81% of the patients treated with ABFT no longer met criteria for MDD, in contrast with 47% of patients in the waitlist group. Mixed factorial analyses of variance revealed that, compared with the waitlist group, patients treated with ABFT showed a significantly greater reduction in both depressive and anxiety symptoms and family conflict. Of the 15 treated cases assessed at the follow-up, 13 patients (87%) continued to not meet criteria for MDD 6 months after treatment ended. CONCLUSIONS: ABFT appears to be a promising treatment and worthy of further development.
Journal of the American Academy of Child & Adolescent Psychiatry, 41(10) : 1190-6
- Year: 2002
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy
Lowry-Webster, H. M., Barrett, P. M., Dadds, M. R.
This paper describes the development and preliminary findings of a program designed to prevent the development of anxiety and depressive symptoms in children aged 10 to 13 years. Using a universal prevention approach, a total of 594 children were randomly assigned on a class-by-class basis to either a 10-session family group CBT program (FRIENDS) routinely implemented as part of the school curriculum, or to a comparison group. Pre-post intervention changes were examined universally, and for children who scored above the clinical cut-off for anxiety at pretest. Results revealed that children in the FRIENDS intervention group reported fewer anxiety symptoms, regardless of their risk status, than the comparison group at posttest. In terms of reported levels of depression, only the high anxiety group who completed the FRIENDS intervention evidenced improvements at posttest. Overall, these preliminary results appear to support the benefits of a school-based universal cognitive-behavioural intervention program. Implications of this study are discussed, and long-term follow-up measures are currently underway.
Behaviour Change., 18(1) : 36-50
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Keller, M. B., Ryan, N. D., Strober, M., Klein, R. G., Kutcher, S. P., Birmaher, B., Hagino, O. R., et-al
Objective: To compare paroxetine with placebo and imipramine with placebo for the treatment of adolescent depression. Method: After a 7- to 14-day screening period, 275 adolescents with major depression began 8 weeks of double-blind paroxetine (20-40 mg), imipramine (gradual upward titration to 200-300 mg), or placebo. The two primary outcome measures were endpoint response (Hamilton Rating Scale for Depression [HAM-D] score [less-than or equal to]8 or [greater-than or equal to]50% reduction in baseline HAM-D) and change from baseline HAM-D score. Other depression-related variables were (1) HAM-D depressed mood item; (2) depression item of the Schedule for Affective Disorders and Schizophrenia for Adolescents-Lifetime version (K-SADS-L); (3) Clinical Global Impression (CGI) improvement scores of 1 or 2; (4) nine-item depression subscale of K-SADS-L; and (5) mean CGI improvement scores. Results: Paroxetine demonstrated significantly greater improvement compared with placebo in HAM-D total score [less-than or equal to]8, HAM-D depressed mood item, K-SADS-L depressed mood item, and CGI score of 1 or 2. The response to imipramine was not significantly different from placebo for any measure. Neither paroxetine nor imipramine differed significantly from placebo on parent- or self-rating measures. Withdrawal rates for adverse effects were 9.7% and 6.9% for paroxetine and placebo, respectively. Of 31.5% of subjects stopping imipramine therapy because of adverse effects, nearly one third did so because of adverse cardiovascular effects. Conclusions: Paroxetine is generally well tolerated and effective for major depression in adolescents.
Journal of the American Academy of Child & Adolescent Psychiatry, 40(7) : 762-772
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Tricyclic antidepressants
Joiner-Jr, Thomas E., Voelz, Zachary R., Rudd, M.
Practicing psychologists face many complexities and challenges in caring for suicidal patients who have comorbid mood and anxiety disorders. Not only must suicidal crises be addressed, but co-occurring depressive and anxiety symptoms compete for attention as well and are associated with relatively poor clinical prognosis in usual treatments. The current study compared problem-solving treatment to treatment as usual among depression-anxiety comorbid versus noncomorbid clinically suicidal young adults. Suicidal patients with mood and anxiety disorders were randomized to the 2 treatments and followed over time. Comorbid suicidal patients, in particular, experienced notable symptom improvements from the problem-solving treatment. Features of the problem-solving treatment are described for use in clinical practice. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Professional Psychology: Research & Practice, 32(3) : 278-282
- Year: 2001
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
, Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Problem solving therapy (PST)
Clarke, G. N., Hornbrook, M., Lynch, F., Polen, M., Gale, J., Beardslee, W., O'Connor, E., Seeley, J.
BACKGROUND: Adolescent offspring of depressed parents are at high risk for development of depression. Cognitive restructuring therapy holds promise for preventing progression to depressive episodes. METHODS: A randomized, controlled trial was conducted to prevent depressive episodes in at-risk offspring (aged 13-18 years) of adults treated for depression in a health maintenance organization (HMO). Potential adult cases were found by reviewing the HMO pharmacy records for dispensation of antidepressant medication and the mental health appointment system. Medical charts were reviewed for a depression diagnosis. Recruitment letters signed by treating physicians were mailed to adults. Eligible offspring had subdiagnostic depressive symptoms insufficient to meet full DSM-III-R criteria for affective disorder and/or a past mood disorder. These youth were randomized to usual HMO care (n = 49) or usual care plus a 15-session group cognitive therapy prevention program (n = 45). RESULTS: We detected significant treatment-by-time (program) effects for the Center for Epidemiological Studies Depression Scale (P=.005) and the Global Assessment of Functioning scores (P =.04). Survival analysis of incident major depressive episodes during a median 15-month follow-up found a significant advantage (P =.003) for the experimental condition (9.3% cumulative major depression incidence) compared with the usual-care control condition (28.8%). CONCLUSION: A brief, group cognitive therapy prevention program can reduce the risk for depression in the adolescent offspring of parents with a history of depression.
Archives of General Psychiatry, 58(12) : 1127-34
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)