Disorders - Depressive Disorders
Feehan, Catherine J., Vostanis, Panos
Conducted a randomized trial of cognitive-behavioral therapy (CBT) and a nonfocused intervention for 57 children and adolescents aged 8-16 yrs with depression referred to 4 child and adolescent psychiatry units. Ss in both groups showed similar rates of recovery from depression at the end of treatment. This paper addresses the question of how cognitive-behavioral therapy was perceived and used by the 29 depressed Ss in clinical settings. Only 7 Ss (24%) kept a diary for all 9 sessions of the CBT programme. Ss who had been rated as compliant with CBT tasks were more likely to recover at the end of treatment. Analysis of the content of each cognitive-behavioral session showed that all Ss received advice on self-monitoring, positive self-statementing, and social problem-solving, but only 50% actually received advice on cognitive restructuring, since this was scheduled late in the treatment package and most Ss had recovered by this stage. The Ss, their parents, and therapists had a high degree of agreement on the helpfulness of CBT. The Ss identified several helpful CBT elements, the majority being related to social problem-solving. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Behavioural & Cognitive Psychotherapy, 24(2) : 171-183
- Year: 1996
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Field, Tiffany M., Grizzle, Nancy, Scafidi, Frank, Schanberg, Saul
Thirty-two depressed adolescent mothers (mean age 18.1 yrs) received ten 30-minute sessions of massage therapy or relaxation therapy over a five-week period. Subjects were randomly assigned to each group. Although both groups reported lower anxiety following their first and last therapy sessions, only the massage therapy group showed behavioral and stress hormone changes including a decrease in anxious behavior, pulse, and salivary cortisol levels. A decrease in urine cortisol levels suggested lower stress following the five-week period for the massage therapy group. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Adolescence, 31(124) : 903-911
- Year: 1996
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Massage
, Relaxation
Kye, C. H., Waterman, G. S., Ryan, N. D., Birmaher, B., Williamson, D. E., Iyengar, S., Dachille, S.
OBJECTIVE: To determine amitriptyline's (AMI) efficacy in the acute treatment of adolescent major depressive disorder (MDD). METHOD: Subjects aged 12 through 17 years meeting Research Diagnostic Criteria for MDD, diagnosed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS), participated in a 2-week placebo-washout followed by an 8-week, randomized, double-blind, parallel-design, placebo-controlled trial of AMI, 5 mg/kg per day. The K-SADS nine-item scale, the Hamilton Depression Rating Scale, and the Clinical Global Impressions rating scale were used as outcome measures. RESULTS: Thirty-one subjects were randomized (18 AMI, 13 placebo). Twenty-two subjects were study completers (12 AMI, 10 placebo). AMI's efficacy was suggested by the Clinical Global Impressions but not the K-SADS-derived data. Perhaps the primary limitation of the current study is its small sample size. CONCLUSION: No definitive recommendation can be made regarding the efficacy of tricyclic antidepressants in the treatment of adolescent MDD.
Journal of the American Academy of Child & Adolescent Psychiatry, 35(9) : 1139-44
- Year: 1996
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Tricyclic antidepressants
Hazell, P., O'Connell, D., Heathcote, D., Robertson, J., Henry, D.
OBJECTIVE--To examine whether tricyclic antidepressants are superior to placebo in the treatment of child and adolescent depression. DESIGN--Meta-analysis of 12 randomised controlled trials comparing the efficacy of tricyclic antidepressants with placebo in depressed subjects aged 6-18 years. MAIN OUTCOME MEASURES--Most studies employed several depression rating scales. For each study the "best available" measure was chosen by using objective criteria, and individual and pooled effect sizes were calculated as the number of standard deviations by which the change scores for the treatment groups exceeded those for the control groups. Where authors had reported numbers "responding" to treatment we calculated individual and pooled ratios for the odds of improvement in treated compared with control subjects. RESULTS--From the six studies presenting data which enabled an estimation of effect size the pooled effect size was 0.35 standard deviations (95% confidence interval of -0.16 to 0.86) indicating no significant benefit of treatment. From the five studies presenting data on the number of "responders" in each group, the ratio of the odds of a response in the treated compared with the control subjects was calculated and the pooled odds ratio was 1.08 (95% confidence interval of 0.53 to 2.17); again indicating no significant benefit of treatment. The pooled sample had more than an 80% chance of detecting a treatment effect of 0.5 standard deviations or greater. There was an inverse relation between study quality and estimated treatment effect. CONCLUSIONS--Tricyclic antidepressants appear to be no more effective than placebo in the treatment of depression in children and adolescents.
British Medical Journal, 310(6984) : 897-901
- Year: 1995
- Problem: Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Tricyclic antidepressants
Gillham, Jane E., Reivich, Karen J., Jaycox, Lisa H., Seligman, Martin E. P.
Examines the follow-up study in school children after teaching cognitive and social-problem-solving techniques to prevent depressive symptoms. Comparison of the children with no-treatment control group; Effects of prevention program on children after the program ended; Suggestions of psychological immunization against depression.
Psychological Science, 6(6) : 343-351
- Year: 1995
- 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., Hawkins, Wesley, Murphy, Mary, Sheeber, Lisa B., et-al.,
Assessed a targeted prevention program for 150 adolescents (mean age 15.3 yrs) at risk for future depressive disorder by virtue of having elevated depressive symptomatology. Ss were screened for depression and were randomized to either a 15-session cognitive group prevention intervention or a "usual care" control condition. Ss were assessed initially, after the intervention, and at 6- and 12-mo follow-ups by the Center for Epidemiologic Studies Depression Scale, the Schedule for Affective Disorders and Schizophrenia for School-Age Children--Epidemiologic Version, the Longitudinal Interval Follow-up Evaluation, and the Hamilton Rating Scale for Depression. Survival analyses indicate a significant 12-mo advantage for the prevention program, with affective disorder total incidence rates of 14.5% for intervention Ss vs 25.7% for controls. No differences were detected for nonaffective disorders across the study period. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Journal of the American Academy of Child & Adolescent Psychiatry, 34(3) : 312-321
- Year: 1995
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Ralph, A., Nicholson, L.
The prevalence of depressive symptoms in Year 10 students in two metropolitan high schools, and the implication of a short-term, school-based group intervention to assist students in coping with depression are described. A total of 260 students were screened using a multistage, multimethod procedure that resulted in 16% and 20% of students in each school meeting criteria for depression. Nine students identified as depressed from one school formed an initial treatment group and a matched wait-list control group was formed from students in the second school. Dependent measures included self-report measures of depression and self-concept, teacher ratings of classroom participation and demeanour, and school records of academic performance and absenteeism. Clinical improvements that maintained were noted for just over half of those in the initial treatment group, whereas no such changes occurred in the control group. Differences at follow-up were statistically significant, although not immediately posttreatment. Some improvements were also recorded for participation and demeanour in class. A subsequent, less intensive intervention with 12 students with more severe depressive symptoms from the second school was less effective. The results are discussed in relation to variations in delivery of the intervention program, and the severity and nature of problems experienced by the students who participated in each intervention.
Behaviour Change, 12(4) : 175-190
- Year: 1995
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Skills training
Reed, M. K.
The efficacy of Structured Learning Therapy (SLT) in treating adolescent depression was evaluated. SLT treatment focuses on developing social competencies, self-evaluation skills, and appropriate affective expression. Eighteen adolescents, aged 14-19 years, prescreened for depression were randomly assigned to the SLT treatment or control group. All subjects participated in six biweekly 60-minute sessions. Pre-, post, and follow-up assessments on depression, self-esteem, and personality measures were conducted. Results suggest that SLT reliably reduced depression in males (p < .05) and maintained their improved level of functioning (p < .02). Female treatment subjects did not improve significantly. Results suggest differential effectiveness of treatment across gender.
Adolescence, 29(114) : 293-302
- Year: 1994
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Skills training
Hains, A., Ellman, S.
This study examined the effectiveness of a school-based prevention intervention to reduce the incidence of negative emotional arousal and other psychological problems in adolescents in response to stress. The prevention program was modeled after a stress inoculation training program and included a variety of cognitive behavioral interventions (i.e., cognitive restructuring, problem solving, anxiety management training). Reductions on anxiety, depression, and anger self-report scales were noted after training, especially in youths who were classified as being high in emotional arousal, and these gains were maintained at follow-up. The waiting list control group showed similar improvements after they received training. Improvements in grade point average, school attendance, physical health problems, and self-reports of total, daily, and major negative stress events were not found, except for some within-group improvements at follow-up
Journal of Cognitive Psychotherapy, 8(3) : 219-232
- Year: 1994
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Jaycox, L. H., Reivich, K. J., Gillham, J., Seligman, M. E. P.
This paper describes the development and preliminary efficacy of a program designed to prevent depressive symptoms in at-risk 10-13 year-olds, and relates the findings to the current understanding of childhood depression. The treatment targets depressive symptoms and related difficulties such as conduct problems, low academic achievement, low social competence, and poor peer relations, by proactively teaching cognitive techniques. Children were identified as 'at-risk' based on depressive symptoms and their reports of parental conflict. Sixty-nine children participated in treatment groups and were compared to 73 children in control groups. Depressive symptoms were significantly reduced and classroom behavior was significantly improved in the treatment group as compared to controls at post-test. Six-month follow-up showed continued reduction in depressive symptoms, as well as significantly fewer externalizing conduct problems, as compared to controls. The reduction in symptoms was most pronounced in the children who were most at risk.
Behaviour Research & Therapy., 32(8) : 801-816
- Year: 1994
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Kutcher, Stan, Boulos, Carolyn, Ward, Bridgette, Marton, Peter, et-al.,
Studied the efficacy and the tolerability of the tricyclic antidepressant desipramine (DMI) in the treatment of 60 adolescents (aged 15-19 yrs) with major depressive disorder. Ss were randomized to receive DMI (200 mg daily in divided doses) or placebo for 6 consecutive weeks following a 1-wk placebo period. Treatment outcome was determined using the Hamilton Rating Scale for Depression and the Beck Depression Inventory. Tolerability was determined using a symptom side effects scale. In addition, laboratory and cardiovascular monitoring was performed. No significant differences in treatment outcome between DMI- and placebo-treated groups were determined. Neither DMI, nor its metabolite 2-hydroxy-DMI, nor their ratio, was positively correlated to treatment outcome. The DMI group endorsed more side effects but the only significant between-group difference in side effects was increased heart rate in the DMI-treated group. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Journal of the American Academy of Child & Adolescent Psychiatry, 33(5) : 686-694
- Year: 1994
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Tricyclic antidepressants
Clarke, Gregory N., Hawkins, Wesley, Murphy, Mary, Sheeber, Lisa
Examined 2 school-based primary prevention interventions for adolescent depressive symptomatology and disorder in separate studies with high school samples of 9th-10th graders. In Study 1, with 513 Ss, a 3-session educational intervention was associated with a short-term reduction in extreme-scoring cases of depressive symptoms among boys, but not girls, when compared to a randomly assigned control condition. However, this effect was not sustained over a 12-wk follow-up. In Study 2, with 300 Ss, a 5-session behavioral skills training intervention failed to demonstrate any differences compared to a random control condition. Neither of the 2 interventions had any effect on depression knowledge, attitudes toward treatment, or actual treatment seeking. It is suggested that depression may be best prevented with a competency-based intervention targeting several disorders. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Journal of Adolescent Research, 8(2) : 183-204
- Year: 1993
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training