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Schukking N, Scheepstra KWF, Bergfeld IO, van Waarde JA, Tendolkar I, Spaans HP, Hegeman AJM, Scheepens DS, Lok A. A Multicenter Retrospective Chart Review on the Effectiveness and Tolerability of Electroconvulsive Therapy in Adolescents and Young Adults With Major Depressive Disorder or Bipolar Depression. J ECT 2024; 40:145-153. [PMID: 37984354 DOI: 10.1097/yct.0000000000000978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
BACKGROUND Major depressive disorder and bipolar depression in adolescents and young adults are prevalent and major contributors to the global burden of disease, whereas effective interventions are limited. Available evidence is insufficient to assess effectiveness and tolerability of electroconvulsive therapy in depressed adolescents and young adults. METHODS A retrospective chart review was conducted in patients with major depressive disorder or bipolar depression who underwent electroconvulsive therapy from 2001 to 2021 in 12 centers in the Netherlands. Patients were classified as young (15-25 years) and older adults (26-80 years). Primary outcome was effectiveness, expressed as response (≥50% reduction in rating scale score compared with baseline) and remission. Rating scale scores were cross-sectionally assessed at baseline and at the end of the index course. Outcomes of remitters were included in responders. Secondary outcome was occurrence of subjective cognitive impairment and adverse events. Long-term outcomes were not available. RESULTS In the young (n = 57) and older adult (n = 41) group, 40.4% and 56.1% ( P = 0.153) of patients achieved response and 28.1% and 39.0% ( P = 0.281) remission, respectively. Subjective cognitive impairment (80.5% vs 56.3%; P = 0.001) and transient cardiac arrhythmia (14.6% vs 2.8%; P = 0.020) were reported significantly more frequently in the older adult group. CONCLUSIONS Despite significantly more comorbidity of personality disorders, autism spectrum disorders, and anxiety disorders, effectiveness in the young was similar to the older adults. Tolerability was even superior in the young, despite significantly more bilateral treatment. Electroconvulsive therapy could be considered a viable treatment option in depressed adolescents and young adults.
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Affiliation(s)
- Nout Schukking
- From the Department of Adult Psychiatry, Amsterdam UMC, University of Amsterdam
| | | | | | | | - Indira Tendolkar
- Department of Psychiatry, Donders Institute for Brain, Cognition, and Behavior, Nijmegen
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Willems L, Rasing SPA, Heijs DAM, Vermulst AA, Huvenaars MJ, Onrust SA, Creemers DHM. Mental health app boost my mood (BMM) as preventive early intervention for adolescents with (sub)clinical depressive symptoms. BMC Public Health 2024; 24:2118. [PMID: 39103796 DOI: 10.1186/s12889-024-19666-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 07/31/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Depression is a common mental disorder. Detecting (sub)clinical depressive symptoms in adolescents at an early stage and offering a low-threshold early intervention can minimize the risk of serious and/or long-term depression. As such, a digital intervention can be a low-threshold preventive and early intervention. This study aims to examine whether the Boost My Mood (BMM)-app is a suitable preventive early intervention for adolescents with (sub)clinical depressive symptoms. METHODS This naturalistic single-arm evaluation study (N = 50) was conducted in adolescents aged 16-21 with (sub)clinical depressive symptoms. Furthermore, the BMM-app was studied in relation to anxiety, worrying, stress, and sleeping problems. An exploratory objective was to determine whether positive expectations and social support are related to app use. RESULTS The study showed a significant decrease in not only depressive symptoms, but also anxiety, worrying and stress while using the BMM-app. Sleeping problems did not significantly decrease over time while using the BMM-app. The degree of use of the BMM-app and telling significant others about using the BMM-app were both not related to a decrease in depressive symptoms. The BMM-app was used significantly more when the adolescent had told relatives about their depressive symptoms. CONCLUSIONS A digital intervention, such as the BMM-app, can be a low-threshold preventive and early intervention for adolescents with (sub)clinical depressive symptoms. Beneficial effects of the BMM-app were reported on depressive symptoms as well as other aspects of quality of life, such as anxiety, worrying, and stress. Whereas several factors may have played a role in the current findings on depressive symptoms, there are reasons to assume that part of the reduction in symptoms could be attributed to the BMM-app. Although no causality can be assumed, this study is a first step in the implementation of preventive apps in mental health care.
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Affiliation(s)
- Linda Willems
- GGZ Oost Brabant, P.O. Box 3, Boekel, 5427 ZG, The Netherlands.
| | - Sanne P A Rasing
- GGZ Oost Brabant, P.O. Box 3, Boekel, 5427 ZG, The Netherlands
- Behavioural Science Institute, Radboud University, P.O. Box 9104, Nijmegen, 6500 HE, The Netherlands
| | - Dewi A M Heijs
- GGZ Oost Brabant, P.O. Box 3, Boekel, 5427 ZG, The Netherlands
| | - Ad A Vermulst
- GGZ Oost Brabant, P.O. Box 3, Boekel, 5427 ZG, The Netherlands
| | | | - Simone A Onrust
- Trimbos-Instituut, P.O. Box 725, Utrecht, 3500 AS, The Netherlands
| | - Daan H M Creemers
- GGZ Oost Brabant, P.O. Box 3, Boekel, 5427 ZG, The Netherlands
- Behavioural Science Institute, Radboud University, P.O. Box 9104, Nijmegen, 6500 HE, The Netherlands
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Yu T, Hu J, Zhao J. Childhood emotional abuse and depression symptoms among Chinese adolescents: The sequential masking effect of ruminative thinking and deliberate rumination. CHILD ABUSE & NEGLECT 2024; 154:106854. [PMID: 38823333 DOI: 10.1016/j.chiabu.2024.106854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND This study delves into the relationship between childhood trauma and adolescent depression symptoms, specifically examining the distinct roles of ruminative thinking and deliberate rumination in mediating this connection. The focus is on exploring whether these cognitive processes, namely ruminative thinking and deliberate rumination, operate differently and sequentially in mediating the impact of childhood emotional abuse (CEA) on the development of depression symptoms among Chinese adolescents. METHODS The study involved gathering data from 489 adolescents, with a relatively balanced gender distribution (44.79 % males and 55.21 % females). The average age of the participants was 16.92 years, with a standard deviation of 0.67. Data collection took place in two Chinese high schools, and participants were tasked with completing assessments related to CEA, ruminative thinking, deliberate rumination, and depression symptoms. The interplay among these variables was then examined using a serial mediation model. RESULTS The findings of the study indicate that CEA not only exhibited a direct association with adolescent depression symptoms but also exerted indirect effects through distinct mediating mechanisms involving ruminative thinking and deliberate rumination. Specifically, ruminative thinking was identified as a mediator, whereas deliberate rumination emerged as a buffer in the relationship between CEA and depression. Additionally, ruminative thinking and deliberate rumination partially masked the effect of CEA on adolescent depression symptoms in a sequential pattern. CONCLUSIONS Regarding the link from CEA to adolescent depression symptoms, ruminative thinking is an adverse mediator while deliberate rumination appears to play a benign role. Consequently, the promotion of a shift from ruminative thinking to deliberate rumination is proposed as a promising strategy for alleviating the detrimental effects of CEA on adolescent depression.
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Affiliation(s)
- Tengxu Yu
- Department of Psychology, Liaoning Normal University, Dalian City 116029, China.
| | - Jinsheng Hu
- Department of Psychology, Liaoning Normal University, Dalian City 116029, China.
| | - Jiayin Zhao
- Department of Psychology, Liaoning Normal University, Dalian City 116029, China.
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Li Y, Ye Y, Zhou X. Parent-child relationship, parenting behaviors, and adolescents' depressive symptoms after an earthquake: unraveling within-adolescent associations from between-adolescent differences. Eur Child Adolesc Psychiatry 2024; 33:2301-2318. [PMID: 37924379 DOI: 10.1007/s00787-023-02319-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/15/2023] [Indexed: 11/06/2023]
Abstract
This study assessed temporal associations between parent-child relationship, parenting behaviors (i.e., warmth, rejection, and overprotection), and adolescents' depressive symptoms after trauma, using random-intercept cross-lagged panel models to distinguish between- and within-adolescent differences. We surveyed Chinese adolescents 12 (Aug 2018; T1), 21 (May 2019; T2), 27 (Nov 2019; T3) months after the Jiuzhaigou earthquake that occurred in August 2017. Of the 585 adolescents who participated in at least two waves of the study, mean age at T1 was 15.50 years old (SD = 1.58 years) and 57.8% were girls. Controlling adolescents' gender, age, ethnicity, trauma exposure at T1, and parents' marital status, between-adolescent results showed that parent-child relationship and parenting behaviors, parent-child relationship and depressive symptoms were correlated across models of parental warmth, rejection, and overprotection, whereas depressive symptoms were only correlated with parental rejection and overprotection. Within-adolescent results indicated that parent-child relationship and adolescents' depressive symptoms had bidirectional associations via the mediation of parental warmth from T1 to T3. Over the longer term following the earthquake, we found that parental rejection was bidirectionally associated with adolescents' depressive symptoms, whereas parental overprotection was unidirectionally influenced by adolescents' depressive symptoms from T2 to T3. In addition, more depressive symptoms in adolescents were associated with worsening parent-child relationship from T2 to T3. In conclusion, shortly after trauma, interventions should focus on improving parent-child relationship and relieving adolescents' depressive symptoms. Over the longer term after trauma, relieving adolescents' depressive symptoms should be prioritized to avoid its eroding effects on parent-child relationship and parenting behaviors, and to break the "vicious cycle".
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Affiliation(s)
- Yifan Li
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China
| | - Yingying Ye
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China.
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Pardossi S, Fagiolini A, Scheggi S, Cuomo A. A Systematic Review on Ketamine and Esketamine for Treatment-Resistant Depression and Suicidality in Adolescents: A New Hope? CHILDREN (BASEL, SWITZERLAND) 2024; 11:801. [PMID: 39062250 PMCID: PMC11274655 DOI: 10.3390/children11070801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024]
Abstract
Treating depression in adolescents is a significant challenge, and major depressive disorder (MDD) with suicidal ideation and treatment-resistant depression (TRD) are common and potentially devastating to optimal psychological and physical development in this age group. Suicide is among the leading causes of youth mortality, and TRD occurs in up to 40% of adolescents with MDD. TRD involves severe, persistent symptoms that are hard to treat, significantly reducing functioning and quality of life. We conducted a literature search focusing on key terms related to ketamine and esketamine for MDD with suicidal ideation and TRD in adolescents, aiming to review the potential utility of these molecules in adolescents for these conditions. Ketamine has shown efficacy in reducing depressive symptoms in adolescents with TRD. Esketamine has shown efficacy in reducing depressive symptoms and treating suicidal ideation in adolescents. Both ketamine and esketamine have demonstrated favorable safety and tolerability profiles. Using these drugs for serious conditions like adolescent MDD with suicidal thoughts and TRD can effectively treat symptoms, reduce self-harm and suicide risks, and provide a window for longer-term therapeutic interventions. The prompt and effective treatment of TRD could improve adolescents' quality of life. However, more research is needed to optimize treatment protocols and evaluate long-term effects.
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Affiliation(s)
- Simone Pardossi
- Department of Molecular Medicine, University of Siena School of Medicine, 53100 Siena, Italy; (A.F.); (S.S.); (A.C.)
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Tsujii N, Okazaki K, Kihara H, Usami M, Fujita J, Horiuchi F, Okada T, Negoro H. Is there evidence for the use of noninvasive brain stimulation techniques for children and adolescents with mental illness? PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2024; 3:e190. [PMID: 38868088 PMCID: PMC11114260 DOI: 10.1002/pcn5.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 06/14/2024]
Affiliation(s)
- Noa Tsujii
- Department of Child Mental Health and DevelopmentToyama University HospitalToyamaToyamaJapan
| | - Kosuke Okazaki
- Shigisan HospitalHerarland ShigisanIkomaNaraJapan
- Department of PsychiatryNara Medical UniversityKashiharaNaraJapan
| | - Hiroaki Kihara
- Department of NeuropsychiatryKanazawa Medical UniversityUchinadaIshikawaJapan
| | - Masahide Usami
- Department of Child and Adolescent Psychiatry, Kohnodai HospitalNational Center for Global Health and MedicineChibaJapan
| | - Junichi Fujita
- Department of Child PsychiatryYokohama City University HospitalYokohamaKanagawaJapan
| | - Fumie Horiuchi
- Department of Child PsychiatryEhime University Graduate School of MedicineToon CityJapan
| | - Takashi Okada
- Department of PsychiatryNara Medical UniversityKashiharaNaraJapan
- Department of Developmental Disorders, National Institute of Mental HealthNational Center of Neurology and PsychiatryKodairaTokyoJapan
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Palatine E, Phillips ML, Soehner AM. The effect of slow wave sleep deprivation on mood in adolescents with depressive symptoms: A pilot study. J Affect Disord 2024; 354:347-355. [PMID: 38479512 DOI: 10.1016/j.jad.2024.03.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/13/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND There is an urgent need for safe, rapid-acting treatment strategies for adolescent depression. In depressed adults, slow wave sleep deprivation (SWSD) improved next-day mood without disrupting sleep duration, but SWSD has not been tested in adolescents. In a pilot study, the aim was to assess the effect of SWSD on sleep physiology and mood outcomes (depression, rumination, anhedonia) among adolescents with depressive symptoms. METHODS Sixteen adolescents (17.44 ± 1.46 yr, 12 female) completed three nights of polysomnographic sleep recording: Baseline, SWSD, and Recovery nights. Acoustic stimulation (tones of random pitch, duration, and volume) suppressed slow wave sleep (SWS) in real-time during SWSD. After each night, depression, rumination, and anhedonia severity were assessed. RESULTS SWSD successfully suppressed SWS, increased N2, and had minimal impact on Rapid Eye Movement (REM), nocturnal awakenings, and total sleep time. While SWSD did not improve depression or anhedonia severity overall, lower baseline non-REM alpha activity and greater SWS rebound during recovery sleep correlated with SWSD-related reduction in clinician-rated depression severity. Next-day rumination severity decreased after SWSD, with sustained improvements following recovery sleep. However, rumination improvement was not associated with SWS suppression, but rather reduction in total sleep time and REM in exploratory correlation models. LIMITATIONS Small sample size and large proportion of females. CONCLUSION SWSD did not improve depression in adolescents overall but a subset with low non-REM alpha activity and intact homeostatic sleep regulation may benefit from this approach. Findings from this pilot study also suggest that partial sleep deprivation may be a beneficial therapeutic strategy for rumination in adolescents.
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Affiliation(s)
- Elise Palatine
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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8
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Courtney DB, Barwick M, Amani B, Greenblatt AT, Aitken M, Krause KR, Andrade BF, Bennett K, Cleverley K, Uliaszek AA, de Oliveira C, Hawke LD, Henderson J, Wang W, Watson P, Gajaria A, Newton AS, Ameis S, Relihan J, Prebeg M, Chen S, Szatmari P. An Integrated Care Pathway for depression in adolescents: protocol for a Type 1 Hybrid Effectiveness-implementation, Non-randomized, Cluster Controlled Trial. BMC Psychiatry 2024; 24:193. [PMID: 38459453 PMCID: PMC10921633 DOI: 10.1186/s12888-023-05297-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/22/2023] [Indexed: 03/10/2024] Open
Abstract
INTRODUCTION Our group developed an Integrated Care Pathway to facilitate the delivery of evidence-based care for adolescents experiencing depression called CARIBOU-2 (Care for Adolescents who Receive Information 'Bout OUtcomes, 2nd iteration). The core pathway components are assessment, psychoeducation, psychotherapy options, medication options, caregiver support, measurement-based care team reviews and graduation. We aim to test the clinical and implementation effectiveness of the CARIBOU-2 pathway relative to treatment-as-usual (TAU) in community mental health settings. METHODS AND ANALYSIS We will use a Type 1 Hybrid Effectiveness-Implementation, Non-randomized Cluster Controlled Trial Design. Primary participants will be adolescents (planned n = 300, aged 13-18 years) with depressive symptoms, presenting to one of six community mental health agencies. All sites will begin in the TAU condition and transition to the CARIBOU-2 intervention after enrolling 25 adolescents. The primary clinical outcome is the rate of change of depressive symptoms from baseline to the 24-week endpoint using the Childhood Depression Rating Scale-Revised (CDRS-R). Generalized mixed effects modelling will be conducted to compare this outcome between intervention types. Our primary hypothesis is that there will be a greater rate of reduction in depressive symptoms in the group receiving the CARIBOU-2 intervention relative to TAU over 24 weeks as per the CDRS-R. Implementation outcomes will also be examined, including clinician fidelity to the pathway and its components, and cost-effectiveness. ETHICS AND DISSEMINATION Research ethics board approvals have been obtained. Should our results support our hypotheses, systematic implementation of the CARIBOU-2 intervention in other community mental health agencies would be indicated.
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Affiliation(s)
- Darren B Courtney
- Centre for Addiction and Mental Health, Toronto, ON, Canada.
- University of Toronto, Toronto, ON, Canada.
- Cundill Centre for Child and Youth Depression, Toronto, ON, Canada.
| | - Melanie Barwick
- University of Toronto, Toronto, ON, Canada
- Hospital for Sick Children, Toronto, ON, Canada
| | - Bahar Amani
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression, Toronto, ON, Canada
| | - Andrea T Greenblatt
- University of Toronto, Toronto, ON, Canada
- Hospital for Sick Children, Toronto, ON, Canada
| | - Madison Aitken
- Cundill Centre for Child and Youth Depression, Toronto, ON, Canada
| | - Karolin R Krause
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression, Toronto, ON, Canada
| | - Brendan F Andrade
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Kathryn Bennett
- Department of Health Research Methods, Evidence, and Impact (Formerly Clinical Epidemiology and Biostatistics), McMaster University, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
| | - Kristin Cleverley
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | | | | | - Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Jo Henderson
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Priya Watson
- Cundill Centre for Child and Youth Depression, Toronto, ON, Canada
| | - Amy Gajaria
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Amanda S Newton
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Stephanie Ameis
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression, Toronto, ON, Canada
| | - Jacqueline Relihan
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression, Toronto, ON, Canada
| | - Matthew Prebeg
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression, Toronto, ON, Canada
- Hospital for Sick Children, Toronto, ON, Canada
| | - Sheng Chen
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression, Toronto, ON, Canada
- Hospital for Sick Children, Toronto, ON, Canada
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Coury SM, López V, Bajwa Z, Garcia JM, Teresi GI, Kuhlman KR, Li Y, Cole S, Miklowitz DJ, Pappas I, Ho TC. Protocol for teen inflammation glutamate emotion research (TIGER): Toward predictors of treatment response and clinical course in depressed adolescents. Brain Behav Immun Health 2024; 35:100718. [PMID: 38235411 PMCID: PMC10792689 DOI: 10.1016/j.bbih.2023.100718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/04/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Abstract
Adolescent-onset depression is a prevalent and debilitating condition commonly associated with treatment refractory depression and non-response to first-line antidepressants. There are, however, no objective tests to determine who may or may not respond to antidepressants. As depressed adolescents are especially vulnerable to the lifelong consequences of ineffectively-treated depression, it is critical to identify neurobiological predictors of treatment non-response in this population. Here, we describe the scientific rationale and protocol for the Teen Inflammation Glutamate Emotion Research (TIGER) study, a prospective 18-month investigation of 160 depressed adolescents who will be assessed before and after treatment with selective serotonin reuptake inhibitors. TIGER will be using ultra-high field imaging to test the effects of acute stress and antidepressant treatment on inflammatory and glutamatergic processes hypothesized to underlie depression maintenance. Results from this work will motivate future studies testing alternative therapeutics for depressed adolescents at risk for treatment resistant depression. ClinicalTrials.gov Identifier: NCT05329441.
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Affiliation(s)
- Saché M. Coury
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Vanessa López
- Department of Neuroscience, Columbia University, New York, NY, USA
| | - Zia Bajwa
- Department of Psychiatry, Columnia University, New York, NY, USA
| | - Jordan M. Garcia
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Giana I. Teresi
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Kate R. Kuhlman
- Department of Psychological Science, School of Social Ecology, University of California Irvine, Irvine, CA, USA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Steve Cole
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA
- Departments of Psychiatry and Biobehavioral Sciences and Medicine, Division of Hematology-Oncology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - David J. Miklowitz
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ioannis Pappas
- Laboratory of NeuroImaging, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Tiffany C. Ho
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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Zhao M, Huang Y, Wang J, Feng J, Zhou B. Internet addiction and depression among Chinese adolescents: anxiety as a mediator and social support as a moderator. PSYCHOL HEALTH MED 2023; 28:2315-2328. [PMID: 37317485 DOI: 10.1080/13548506.2023.2224041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
This study constructed a moderated mediation model to investigate the mediating effect of anxiety and the moderating effect of social support between Internet addiction and depression. A sample of 17 058 middle school students in one district of Chengdu were selected. The Internet Addiction Test (IAT), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Social Support Scale for adolescents were used to investigate their Internet addiction, anxiety, depression and social support. The descriptive statistics and Spearman correlation analysis were performed with SPSS 25.0. An SPSS macro process was used to analyze the data from complex models that contained mediators and moderators. The results show that adolescents with Internet addiction are more likely to suffer from depression. Anxiety partially mediated the relations between Internet addiction and depression. Social support moderated both direct and indirect pathways leading from Internet addiction to depression, and these two effects were stronger for adolescents with low social support than for those with high social support. It will be possible for researchers to gain a better understanding of the conditions, pathways, and effects of Internet addiction on depression in adolescents through the results of this study.
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Affiliation(s)
- Meng Zhao
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yulan Huang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Jinyu Wang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Jie Feng
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Bo Zhou
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
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11
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Chang JC, Hai-Ti-Lin, Wang YC, Gau SSF. Treatment-resistant depression in children and adolescents. PROGRESS IN BRAIN RESEARCH 2023; 281:1-24. [PMID: 37806711 DOI: 10.1016/bs.pbr.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Major depressive disorder (MDD) in children and adolescents is a significant health problem, causing profound impairments in social, academic, and family functioning and substantial morbidity and mortality. Up to 15% of children and adolescents suffer from MDD, and a proportion, around 30 to 40% of them, failed to respond to initial selective serotonin reuptake inhibitor (SSRI) treatment. The only evidence-based recommendation is medication switching to another SSRI and augmentation with cognitive behavioral therapy. Newly developing treatment, including ketamine, transcranial magnetic stimulation, psychotherapy other than cognitive behavioral therapy, and combined pharmacotherapy with other interventions, requires further longitudinal controlled trials regarding efficacy and safety in this vulnerable population.
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Affiliation(s)
- Jung-Chi Chang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hai-Ti-Lin
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Ching Wang
- Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Huber RS, Boxer D, Smith CJ, Renshaw PF, Yurgelun-Todd DA, Kondo DG. Detailed assessment of suicidal ideation in youth with bipolar disorder versus major depressive disorder. Bipolar Disord 2023; 25:200-208. [PMID: 36606348 PMCID: PMC10525907 DOI: 10.1111/bdi.13294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES There is a critical need to better understand the factors underlying the increased suicide risk for youth with bipolar disorder (BD) in order to develop targeted prevention efforts. This study aimed to examine differences in characteristics of suicide ideation (SI) in youth with BD compared to youth with major depressive disorder (MDD) that may be associated with increased suicide risk. METHODS One hundred and fifty-one participants (92 MDD and 59 BD), ages 13-21, completed a diagnostic interview and clinical assessments. Lifetime symptoms of SI and SA were assessed using the Columbia Suicide Severity Rating Scale. Ordinal logistic regression models were used to investigate whether the diagnostic group predicted the severity and intensity of the most severe or most common SI with the age of onset, age, and gender as covariates. RESULTS Compared to MDD youth, BD youth were more likely to report experiencing more severe SI, p = 0.039, experiencing the most severe SI more frequently, p = 0.002, having less control of the most severe SI, p = 0.012, and that deterrents were less likely to stop them from acting on the most severe SI, p = 0.006. CONCLUSION This study highlights differences in the severity and intensity of SI in youth with BD and suggests that youth with BD have greater difficulty inhibiting thoughts of SI which may lead to less resistance to suicide action. Findings underscore the need for a more detailed assessment of SI in youth with BD to better understand SI as a proximal risk factor for future SA and a potential target for intervention.
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Affiliation(s)
- Rebekah S. Huber
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Danielle Boxer
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Calen J. Smith
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Perry F. Renshaw
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
- U.S. Department of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah, USA
| | - Deborah A. Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
- U.S. Department of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah, USA
| | - Douglas G. Kondo
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
- U.S. Department of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah, USA
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13
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Malkki VK, Rosenström TH, Jokela MM, Saarni SE. Associations between specific depressive symptoms and psychosocial functioning in psychotherapy. J Affect Disord 2023; 328:29-38. [PMID: 36773764 DOI: 10.1016/j.jad.2023.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/21/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Psychotherapy for depression aims to reduce symptoms and to improve psychosocial functioning. We examined whether some symptoms are more important than others in the association between depression and functioning over the course of psychotherapy treatment. METHODS We studied associations between specific symptoms of depression (PHQ-9) and change in social and occupational functioning (SOFAS), both with structural equation models (considering liabilities of depression and each specific symptom) and with logistic regression models (considering the risk for individual patients). The study sample consisted of adult patients (n = 771) from the Finnish Psychotherapy Quality Registry (FPQR) who completed psychotherapy treatment between September 2018 and September 2021. RESULTS Based on our results of logistic regression analyses and SEM models, the baseline measures of depression symptoms were not associated with changes in functioning. Changes in depressed mood or hopelessness, problems with sleep, feeling tired, and feeling little interest or pleasure were associated with improved functioning during psychotherapy. The strongest evidence for symptom-specific effects was found for the symptom of depressed mood or hopelessness. LIMITATIONS Due to our naturalistic study design containing only two measurement points, we were unable to study the causal relationship between symptoms and functioning. CONCLUSIONS Changes in certain symptoms during psychotherapy may affect functioning independently of underlying depression. Knowledge about the dynamics between symptoms and functioning could be used in treatment planning or implementation. Depressed mood or hopelessness appears to have a role in the dynamic relationship between depression and functioning.
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Affiliation(s)
- Veera K Malkki
- Psychiatry, Helsinki University Hospital and University of Helsinki, Finland.
| | - Tom H Rosenström
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Markus M Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Suoma E Saarni
- Psychiatry, Helsinki University Hospital and University of Helsinki, Finland
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14
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Xu G, Xue M, Zhao J. The Association between Artificial Intelligence Awareness and Employee Depression: The Mediating Role of Emotional Exhaustion and the Moderating Role of Perceived Organizational Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5147. [PMID: 36982055 PMCID: PMC10049037 DOI: 10.3390/ijerph20065147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
The combination of artificial intelligence (AI) technology with the real economy has dramatically improved the efficiency of enterprises. However, the replacement of AI for employment also significantly impacts employees' cognition and psychological state. Based on the Conservation of Resources Theory, the relationship between AI awareness and employee depression is explored in this article while examining the mediating role of emotional exhaustion, as well as the moderating role of perceived organizational support. Based on a sample of 321 respondents, the empirical results show that (1) AI awareness is significantly positively correlated with depression; (2) emotional exhaustion plays a mediating role between AI awareness and depression; (3) perceived organizational support negatively moderates the relationship between emotional exhaustion and depression; (4) perceived organizational support negatively moderates the mediating role of emotional exhaustion between AI awareness and depression. The research conclusions provide a theoretical basis for organizations to take measures to intervene in the negative impact of changes in AI technology on employees' mental health.
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Affiliation(s)
- Guanglu Xu
- School of Business, Nanjing University of Information Science & Technology, Nanjing 210044, China
| | - Ming Xue
- School of Business Administration, Shanghai Lixin University of Accounting and Finance, Shanghai 201620, China
| | - Jidi Zhao
- School of Public Administration, College of Economics and Management, East China Normal University, Shanghai 200062, China
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15
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Mehta A, Dykiert D, Midgley N. Understanding treatment non-responders: A qualitative study of depressed adolescents' experiences of 'unsuccessful' psychotherapy. Psychol Psychother 2023; 96:448-463. [PMID: 36748831 DOI: 10.1111/papt.12448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/30/2022] [Accepted: 01/22/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This paper aimed to explore the experiences of depressed adolescents who completed but did not 'respond' to standard psychotherapy, based on a lack of improvement in pre-post symptoms scores. DESIGN This was a qualitative study employing interpretative phenomenological analysis (IPA). METHOD Seventy-seven adolescents with moderate to severe depression were interviewed as part of a qualitative arm of a randomised controlled trial. Five adolescents' post-treatment interviews were purposively sampled, based on lack of improvement on pre-post symptom scores, and adolescents still scoring above the clinical threshold for depression. The interviews were analysed using IPA. RESULTS Adolescents made sense of their depression as part of their identity and held negative expectations of therapy. Some aspects of therapy brought up intolerable feelings that contributed to disengagement in the therapeutic process and culminated in disappointing and hopeless endings. On the other hand, where a stronger therapeutic relationship was developed, some participants experienced certain improvements. CONCLUSIONS Findings highlight how actively exploring the adolescent's therapy expectations, developing a strong early therapeutic relationship and being mindful of the potential impact of endings are important in therapeutic work with adolescents with depression, especially where they may have a strong sense of hopelessness and self-criticism. Moreover, the finding that adolescents experienced improvements in other domains despite a lack of symptom reduction highlights the need to review how treatment outcomes are currently defined. Integrating individual perspectives of therapy with quantitative outcome measures can provide a more nuanced insight of treatment effects.
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Affiliation(s)
- Alisha Mehta
- Clinical, Educational and Health Psychology, University College London (UCL), London, UK
| | - Dominika Dykiert
- Clinical, Educational and Health Psychology, University College London (UCL), London, UK.,The Anna Freud National Centre for Children and Families, London, UK
| | - Nick Midgley
- Clinical, Educational and Health Psychology, University College London (UCL), London, UK.,The Anna Freud National Centre for Children and Families, London, UK
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16
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Yu T, Hu J, Zhang W, Zhang L, Zhao J. Psychological maltreatment and depression symptoms among Chinese adolescents: A multiple mediation model. CHILD ABUSE & NEGLECT 2022; 134:105940. [PMID: 36368166 DOI: 10.1016/j.chiabu.2022.105940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Adolescents are at risk of depression, and recent studies also found a high prevalence of depression among Chinese adolescents. Therefore, it is necessary to explore the risk and protective factors of depression among Chinese adolescents. OBJECTIVE This study examined the direct effect of psychological maltreatment on depression symptoms in adolescents and the mediating roles of emotion regulation and social support in their relationship. METHOD Data were collected from Chinese senior high school students (N = 687, 36.5 % males and 63.5 % females, Mage = 16.44 years, SD = 0.78) who completed the measures of psychological maltreatment, depression symptoms, perceived social support, and emotion regulation strategies, including cognitive reappraisal and expressive suppression. RESULTS The results indicated that: (a) psychological maltreatment was positively correlated with depression symptoms; (b) the two emotion regulation strategies and perceived social support partially mediated the link between psychological maltreatment and depression symptoms separately; (c) the two emotion regulation strategies and perceived social support partially mediated the link between psychological maltreatment and depression symptoms in a sequential pattern. CONCLUSION Psychological maltreatment was positively associated with depression symptoms in adolescents. Emotion regulation and perceived social support both significantly mediated the relationship between psychological maltreatment and depression symptoms.
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Affiliation(s)
- Tengxu Yu
- Department of Psychology, Liaoning Normal University, Dalian city 116029, Liaoning Province, China
| | - Jinsheng Hu
- Department of Psychology, Liaoning Normal University, Dalian city 116029, Liaoning Province, China.
| | - Wei Zhang
- Department of Psychology, Liaoning Normal University, Dalian city 116029, Liaoning Province, China
| | - Longfei Zhang
- Department of Psychology, Liaoning Normal University, Dalian city 116029, Liaoning Province, China
| | - Jiayin Zhao
- Department of Psychology, Liaoning Normal University, Dalian city 116029, Liaoning Province, China
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17
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Wallman EJ, Melvin GA. Parent preferences for adolescent depression treatment: The role of past treatment experience and biological etiological beliefs. J Affect Disord 2022; 316:17-25. [PMID: 35907482 DOI: 10.1016/j.jad.2022.07.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 07/08/2022] [Accepted: 07/22/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Parents play a crucial role in facilitating depression treatment for adolescents, yet parental preferences for adolescent treatments are ill-understood. Past treatment experience and belief in a biological model of depression may impact preferences, and warrant investigation. METHODS Parents (N = 143) of teens (12-18 years) completed a survey assessing preference for adolescent depression treatments, treatment knowledge, and beliefs about the biological etiology of depression. Details about parents' and adolescents' past mental health concerns and treatment were obtained. Parents indicated degree of preference from 0 (Not at all preferable) - 10 (Highly preferable) for six treatment options (counselling, antidepressant medication, repetitive transcranial magnetic stimulation, electroconvulsive therapy, exercise, no treatment) for three adolescents vignettes depicting varying depression severity (Mild/Moderate, Severe, and Treatment-Resistant). RESULTS Mean preference ratings across all vignette severities were high for counselling (range: 8.57-9.38) and exercise (range: 9.04-9.25). Multiple regression revealed parental past experience of psychopharmacological treatment was significantly associated with current preference for adolescent antidepressant medication, with increased helpfulness and milder/fewer adverse events associated with stronger preference. Greater perceived helpfulness of past teen psychopharmacological treatment was significantly associated with greater current parental preference for adolescent antidepressant medication. Strength of biological beliefs and counselling preference were significantly positively associated. LIMITATIONS Sample was highly educated, predominately female, and majority treatment-utilizing limiting the generalizability of findings. CONCLUSIONS Parents' own past medication experiences and degree of biological etiological beliefs appear to be associated with current teen depression treatment preferences. Counselling and exercise were highly preferred across depression severity.
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Affiliation(s)
- Emily Jean Wallman
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
| | - Glenn Alexander Melvin
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia; Centre for Educational Development, Appraisal & Research, University of Warwick, Coventry, UK
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18
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A retrospective examination of adjunctive L-methylfolate in children and adolescents with unipolar depression. J Affect Disord 2022; 312:315-321. [PMID: 35753502 DOI: 10.1016/j.jad.2022.06.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/18/2022] [Accepted: 06/20/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Adjunctive l-methylfolate is commonly prescribed for children and adolescents with treatment-resistant mood disorders; however, the relationship between l-methylfolate augmentation across methylenetetrahydrofolate reductase (MTHFR) genotypes in youths with depressive symptoms is unclear. METHODS We retrospectively examined the electronic health records of patients (N = 412) with depressive symptoms associated with unipolar depressive disorders and their MTHFR C677T genotypes from 2013 to 2019. Patients were ≤18 years of age at the time of MTHFR pharmacogenetic testing. Treatment response was assessed with Clinical Global Impression-Improvement (CGI-I) score reported in the medical record. RESULTS Patients with an MTHFR C677T C/T or T/T genotype were more likely to be prescribed l-methylfolate when the clinician knew their MTHFR genotype (p < 0.0001, OR: 15.1, 95 % CI: [5.1, 44.2]), but not when the clinician did not know their genotype (p = 0.4, OR: 2.1, 95 % CI: [0.4, 11.4]). Change in baseline and endpoint CGI-I scores between patients with an MTHFR C677T variant who were prescribed and not prescribed l-methylfolate did not significantly differ (p = 0.39). Response rate was not associated with l-methylfolate prescription (p = 0.17) or l-methylfolate dose (p = 0.69). LIMITATIONS This was a retrospective study, which yielded a heterogeneous patient population and limited data availability (e.g., adherence). Patients are severely ill and may have a refractory illness that limits response to adjunctive l-methylfolate. CONCLUSION Clinicians prescribe l-methylfolate to children and adolescents with depressive symptoms associated with unipolar depressive disorders who have an MTHFR C677T variant, although augmentation may not be associated with treatment response, regardless of MTHFR genotype or dose.
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19
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Wu W, Chen Y, Shi X, Lv H, Bai R, Guo Z, Yu L, Liu Y, Liu J, Chen Y, Zeng Y. The Mobile Phone Addiction and Depression Among High School Students: The Roles of Cyberbullying Victimization, Perpetration, and Gender. Front Psychol 2022; 13:845355. [PMID: 35572285 PMCID: PMC9095501 DOI: 10.3389/fpsyg.2022.845355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/04/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To examine the relation between mobile phone addiction and high school students' depression, and its inner mechanism-the sequential mediating roles of the cyberbullying victimization and the cyberbullying perpetration in this relationship. Methods 1297 high school students were recruited to complete the Smartphone Addiction Scale, European Cyberbullying Intervention Project Questionnaire and the Center for Epidemiological Studies Depression Scale. Results (1) Mobile phone addiction was positively correlated with and high school students' depression; (2) cyberbullying victimization and the cyberbullying perpetration significantly mediated the relation between mobile phone addiction and high school students' depression, which contained tow mediating paths-the independent mediating effects of cyberbullying victimization and the sequential mediating effect of cyberbullying victimization and the cyberbullying perpetration; (3) there are gender differences in the sequential mediation model, and boys who are victims of cyberbullying are more likely to develop into cyberbullying perpetrators than girls. Conclusion The results of this study indicate that depression among high school students with mobile phone addiction can be eliminated through the development of cyberbullying victimization and the cyberbullying perpetration.
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Affiliation(s)
- Wenzhi Wu
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | | | - Xiuying Shi
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Hua Lv
- Yuxi Third Middle School, Yuxi, China
| | - Rui Bai
- Yuxi Nationalities High School, Yuxi, China
| | - Zhichao Guo
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Lei Yu
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Yilin Liu
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Jianping Liu
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Yatang Chen
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Yong Zeng
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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20
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Online Social Support and Depressive Symptoms: Mediating Effect of Self-esteem and Gender Differences. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00818-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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21
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Yu T, Hu J. Extraversion and Neuroticism on College Freshmen's Depressive Symptoms During the COVID-19 Pandemic: The Mediating Role of Social Support. Front Psychiatry 2022; 13:822699. [PMID: 35340897 PMCID: PMC8942765 DOI: 10.3389/fpsyt.2022.822699] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study aims to explore the direct effects of extraversion and neuroticism on college freshmen's depressive symptoms and their indirect effects via social support under the background of COVID-19. METHOD A total of 3,563 college freshmen were surveyed using the extraversion and neuroticism scales of the Chinese version of the Eysenck Personality Questionnaire (EPQ), the Chinese version of the Beck Depression Inventory-II (BDI-II), and the Social Support Rating Scale (SSRS). Partial correlation analyses and regression analyses were used. RESULTS (1) Extraversion had a significant and negative predictive effect on depressive symptoms, while neuroticism positively predicted depressive symptoms. The interaction effect between extraversion and neuroticism on depressive symptoms was also significant. Neuroticism had a greater impact on depressive symptoms in college freshmen with low levels of extraversion. (2) Furthermore, social support partially mediated the relationships between extraversion and depressive symptoms, and neuroticism and depressive symptoms. CONCLUSIONS Extraversion and neuroticism can directly affect college freshmen' s depressive symptoms, and have indirect effects via the mediating role of social support. Additionally, extraversion interacts with neuroticism, and extraversion plays a protective role in the effect of neuroticism on depressive symptoms. These findings help identify college freshmen at high risk of depression and design effective prevention or intervention measures for them.
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Affiliation(s)
- Tengxu Yu
- Liaoning Normal University, Dalian, China
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22
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Parise EM, Parise LF, Sial OK, Cardona-Acosta AM, Gyles TM, Juarez B, Chaudhury D, Han MH, Nestler EJ, Bolaños-Guzmán CA. The Resilient Phenotype Induced by Prophylactic Ketamine Exposure During Adolescence Is Mediated by the Ventral Tegmental Area-Nucleus Accumbens Pathway. Biol Psychiatry 2021; 90:482-493. [PMID: 34247781 PMCID: PMC8761260 DOI: 10.1016/j.biopsych.2021.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 04/12/2021] [Accepted: 05/01/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Major depressive disorder is prevalent in children and adolescents and is associated with a high degree of morbidity throughout life, with potentially devastating personal consequences and public health impact. The efficacy of ketamine (KET) as an antidepressant has been demonstrated in adolescent rodents; however, the neurobiological mechanisms underlying these effects are unknown. Recent evidence showed that KET reverses stress-induced (i.e., depressive-like) deficits within major mesocorticolimbic regions, such as the prefrontal cortex, nucleus accumbens (NAc), and hippocampus, in adult rodents. However, little is known about KET's effect in the ventral tegmental area (VTA), which provides the majority of dopaminergic input to these brain regions. METHODS We characterized behavioral, biochemical, and electrophysiological effects produced by KET treatment in C57BL/6J male mice during adolescence (n = 7-10 per condition) within the VTA and its major projection regions, namely, the NAc and prefrontal cortex. Subsequently, molecular targets within the VTA-NAc projection were identified for viral gene transfer manipulations to recapitulate the effects of stress or KET treatment. RESULTS Repeated KET treatment produced a robust proresilient response to chronic social defeat stress. This effect was largely driven by Akt signaling activity within the VTA and NAc, and it could be blocked or recapitulated through direct Akt-viral-mediated manipulation. Additionally, we found that the KET-induced resilient phenotype is dependent on VTA-NAc, but not VTA-prefrontal cortex, pathway activity. CONCLUSIONS These findings indicate that KET exposure during adolescence produces a proresilient phenotype mediated by changes in Akt intracellular signaling and altered neuronal activity within the VTA-NAc pathway.
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Affiliation(s)
- Eric M Parise
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lyonna F Parise
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Omar K Sial
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas; Institute for Neuroscience, Texas A&M University, College Station, Texas
| | - Astrid M Cardona-Acosta
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas
| | - Trevonn M Gyles
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Barbara Juarez
- Department of Pharmacological Sciences, Institute for Systems Biomedicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Pharmacology, University of Washington, Seattle, Washington
| | - Dipesh Chaudhury
- Department of Pharmacological Sciences, Institute for Systems Biomedicine, Icahn School of Medicine at Mount Sinai, New York, New York; Division of Science, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Ming-Hu Han
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Center for Affective Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Pharmacological Sciences, Institute for Systems Biomedicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Eric J Nestler
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Carlos A Bolaños-Guzmán
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas; Institute for Neuroscience, Texas A&M University, College Station, Texas.
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23
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Døssing E, Pagsberg AK. Electroconvulsive Therapy in Children and Adolescents: A Systematic Review of Current Literature and Guidelines. J ECT 2021; 37:158-170. [PMID: 34424874 DOI: 10.1097/yct.0000000000000761] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
ABSTRACT There is a lack of studies regarding the efficacy of electroconvulsive therapy (ECT) in children and adolescents. In this study, we aimed to assess benefits and harms of ECT in children and adolescents with major psychiatric diseases. We conducted a systematic search in PubMed, EMBASE, and PsycINFO for peer-reviewed articles written in English regarding the use of ECT as treatment for major psychiatric diseases in children and adolescents. This study consists of 192 articles, mostly case studies (n = 50), reviews and overview articles (n = 52), and retrospective studies (n = 30). We present an overview of evidence for ECT in children and adolescents with mood disorders, catatonia, schizophrenia, intellectual disability, self-injurious behavior, and other indications. This article is also a summary of international guidelines regarding the use of ECT in children and adolescents. We evaluated the overall quality of evidence by using Grading of Recommendations, Assessment, Development and Evaluations and found the overall level of evidence to be of low quality. There are no absolute contra indications for ECT in children and adolescents. Fears regarding cognitive dysfunction have not been reproduced in studies. Electroconvulsive therapy should be considered in severe, treatment-resistant mood disorders, catatonia, and schizophrenia, especially in older adolescents. High-quality studies are warranted to assess the efficacy of ECT, especially in these potentially life-threatening diseases.
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Affiliation(s)
- Erik Døssing
- From the Child and Adolescent Mental Health Centre, Mental Health Services, Zealand Region, Roskilde
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24
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Sial OK, Gnecco T, Cardona-Acosta AM, Vieregg E, Cardoso EA, Parise LF, Bolaños-Guzmán CA. Exposure to Vicarious Social Defeat Stress and Western-Style Diets During Adolescence Leads to Physiological Dysregulation, Decreases in Reward Sensitivity, and Reduced Antidepressant Efficacy in Adulthood. Front Neurosci 2021; 15:701919. [PMID: 34408623 PMCID: PMC8366028 DOI: 10.3389/fnins.2021.701919] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/05/2021] [Indexed: 01/14/2023] Open
Abstract
A dramatic increase in the prevalence of major depression and diet-related disorders in adolescents has been observed over several decades, yet the mechanisms underlying this comorbidity have only recently begun to be elucidated. Exposure to western-style diet (WSD), high in both fats (45% kcal) and carbohydrates (35% kcal): e.g., high fat diet (HFD), has been linked to the development of metabolic syndrome-like symptoms and behavioral dysregulation in rodents, as similarly observed in the human condition. Because adolescence is a developmental period highlighted by vulnerability to both stress and poor diet, understanding the mechanism(s) underlying the combined negative effects of WSDs and stress on mood and reward regulation is critical. To this end, adolescent male C57 mice were exposed to vicarious social defeat stress (VSDS), a stress paradigm capable of separating physical (PS) versus psychological/emotional (ES) stress, followed by normal chow (NC), HFD, or a separate control diet high in carbohydrates (same sucrose content as HFD) and low in fat (LFD), while measuring body weight and food intake. Non-stressed control mice exposed to 5 weeks of NC or HFD showed no significant differences in body weight or social interaction. Mice exposed to VSDS (both ES and PS) gain weight rapidly 1 week after initiation of HFD, with the ES-exposed mice showing significantly higher weight gain as compared to the HFD-exposed control mice. These mice also exhibited a reduction in saccharin preference, indicative of anhedonic-like behavior. To further delineate whether high fat was the major contributing factor to these deficits, LFD was introduced. The mice in the VSDS + HFD gained weight more rapidly than the VSDS + LFD group, and though the LFD-exposed mice did not gain weight as rapidly as the HFD-exposed mice, both the VSDS + LFD- and VSDS + HFD-exposed mice exhibited attenuated response to the antidepressant fluoxetine. These data show that diets high in both fats and carbohydrates are responsible for rapid weight gain and reduced reward sensitivity; and that while consumption of diet high in carbohydrate and low in fat does not lead to rapid weight gain, both HFD and LFD exposure after stress leads to reduced responsiveness to antidepressant treatment.
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Affiliation(s)
- Omar K Sial
- Department of Psychological and Brain Sciences, and Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Tamara Gnecco
- Department of Psychological and Brain Sciences, and Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Astrid M Cardona-Acosta
- Department of Psychological and Brain Sciences, and Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Emily Vieregg
- Department of Psychological and Brain Sciences, and Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Ernesto A Cardoso
- Department of Psychological and Brain Sciences, and Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - Lyonna F Parise
- Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Carlos A Bolaños-Guzmán
- Department of Psychological and Brain Sciences, and Institute for Neuroscience, Texas A&M University, College Station, TX, United States
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25
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Roy AV, Thai M, Klimes-Dougan B, Schreiner MW, Mueller BA, Albott CS, Lim KO, Fiecas M, Tye SJ, Cullen KR. Brain entropy and neurotrophic molecular markers accompanying clinical improvement after ketamine: Preliminary evidence in adolescents with treatment-resistant depression. J Psychopharmacol 2021; 35:168-177. [PMID: 32643995 PMCID: PMC8569740 DOI: 10.1177/0269881120928203] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Current theory suggests that treatment-resistant depression (TRD) involves impaired neuroplasticity resulting in cognitive and neural rigidity, and that clinical improvement may require increasing brain flexibility and adaptability. AIMS In this hypothesis-generating study, we sought to identify preliminary evidence of brain flexibility correlates of clinical change within the context of an open-label ketamine trial in adolescents with TRD, focusing on two promising candidate markers of neural flexibility: (a) entropy of resting-state functional magnetic resonance imaging (fMRI) signals; and (b) insulin-stimulated phosphorylation of mammalian target of rapamycin (mTOR) and glycogen synthase-3-beta (GSK3β) in peripheral blood mononuclear cells. METHODS We collected resting-state functional magnetic resonance imaging data and blood samples from 13 adolescents with TRD before and after a series of six ketamine infusions over 2 weeks. Usable pre/post ketamine data were available from 11 adolescents for imaging and from 10 adolescents for molecular signaling. We examined correlations between treatment response and changes in the central and peripheral flexibility markers. RESULTS Depression reduction correlated with increased nucleus accumbens entropy. Follow-up analyses suggested that physiological changes were associated with treatment response. In contrast to treatment non-responders (n=6), responders (n=5) showed greater increase in nucleus accumbens entropy after ketamine, together with greater post-treatment insulin/mTOR/GSK3β signaling. CONCLUSIONS These data provide preliminary evidence that changes in neural flexibility may underlie symptom relief in adolescents with TRD following ketamine. Future research with adequately powered samples is needed to confirm resting-state entropy and insulin-stimulated mTOR and GSK3β as brain flexibility markers and candidate targets for future clinical trials. CLINICAL TRIAL NAME Ketamine in adolescents with treatment-resistant depressionURL: https://clinicaltrials.gov/ct2/show/NCT02078817Registration number: NCT02078817.
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Affiliation(s)
- Abhrajeet V Roy
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Michelle Thai
- Department of Psychology, College of Liberal Arts, University of Minnesota, Minneapolis, USA
| | - Bonnie Klimes-Dougan
- Department of Psychology, College of Liberal Arts, University of Minnesota, Minneapolis, USA
| | | | - Bryon A Mueller
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Christina Sophia Albott
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
| | - Mark Fiecas
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, USA
| | - Susannah J Tye
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Kathryn R Cullen
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, USA
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26
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Ye B, Zhou X, Im H, Liu M, Wang XQ, Yang Q. Epidemic Rumination and Resilience on College Students' Depressive Symptoms During the COVID-19 Pandemic: The Mediating Role of Fatigue. Front Public Health 2020; 8:560983. [PMID: 33363075 PMCID: PMC7755644 DOI: 10.3389/fpubh.2020.560983] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022] Open
Abstract
The restriction of numerous sectors of society and the uncertainty surrounding the development of the COVID-19 pandemic have resulted in adverse psychological states to college students isolated at home. In this study, we explored the mediating role of fatigue in the effects of epidemic rumination and resilience on depressive symptoms as well as how epidemic rumination and resilience may interact with one another. A large sample of Chinese college students (N = 1,293) completed measures on epidemic rumination, resilience, fatigue, and depressive symptoms. Results indicated depressive symptomology was positively predicted by epidemic rumination while negatively predicted by resilience. In both cases, fatigue partially mediated these effects and positively predicted depressive symptoms. Unexpectedly, epidemic rumination and resilience interacted in a manner where the effect of rumination on fatigue became stronger as resiliency increased. Theoretical and practical implications are provided to further interpret the results.
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Affiliation(s)
- Baojuan Ye
- Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Xiuxiu Zhou
- Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Hohjin Im
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Mingfan Liu
- Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Xin Qiang Wang
- Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Qiang Yang
- School of Education, Jiangxi Normal University, Nanchang, China
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27
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Courtney D, Bennett K, Henderson J, Darnay K, Battaglia M, Strauss J, Watson P, Szatmari P. A Way through the woods: Development of an integrated care pathway for adolescents with depression. Early Interv Psychiatry 2020; 14:486-494. [PMID: 31883210 DOI: 10.1111/eip.12918] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/14/2019] [Indexed: 01/02/2023]
Abstract
AIMS Depression in adolescents is common and debilitating. Treatment approaches vary widely across clinics and may not reflect evidence-based care. Integrated care pathways (ICPs) are implementation tools to facilitate bridging the gap between rigorous but often complex clinical practice guidelines and what is actually practiced. We describe the development of an ICP for the treatment of Adolescents with Major Depressive Disorder (MDD-A) based on the best-available clinical practice guidelines and derived in collaboration with clinicians, administrators, youth partners and caregivers. METHODS With clinician and health service manager input, we took the recommendations from a high quality clinical practice guideline (the National Institute of Health and Care Excellence Clinical Practice Guideline for Depression in Children and Young People) and translated them into an ICP. Feedback from youth partners and clinicians was iteratively incorporated into the current version of the pathway using a collaborative approach. RESULTS The current iteration of the pathway at a Canadian tertiary care teaching hospital is described. All youth (and caregivers, if applicable) are offered a multi-family psychoeducation session, a 16-session Group Cognitive Behaviour Therapy and team reviews every 4 weeks that include measurement-based care. Conditional branches of the pathway include a medication algorithm and an 8-session group for caregivers. CONCLUSIONS The resulting ICP provides a tool to facilitate bridging the gap between evidence and clinical practice.
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Affiliation(s)
- Darren Courtney
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Kathryn Bennett
- McMaster University, Department of Health Research Methods, Evidence and Impact. Hamilton, Ontario, Canada
| | - Joanna Henderson
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Karleigh Darnay
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Marco Battaglia
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - John Strauss
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Priya Watson
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Peter Szatmari
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
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Courtney D, Watson P, Chan BWC, Bennett KJ, Neprily K, Zentner T, Rodak T, Narrandes R, Szatmari P. How have predictors, moderators, mediators, treatment response, remission and resistance been defined and measured in randomised controlled trials for adolescent depression? A scoping review protocol. BMJ Open 2020; 10:e036171. [PMID: 32571862 PMCID: PMC7311009 DOI: 10.1136/bmjopen-2019-036171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Among randomised controlled trials for depressed adolescents, the extent of variation in how depressive symptom outcomes are defined is unknown. The variability in which potential predictors of these outcomes are tested is also unclear. This paper is a protocol describing the methods of a planned scoping review. The scoping review will examine and summarise how change in depressive symptoms have been described in RCT treatment studies to date. This review will report the measures used to describe change in depressive symptoms and whether the measure was used as a continuous or binary outcome or both. This review will describe how dichotomous outcome terms are defined to describe change in depression severity. This review will also examine predictors, moderators and mediators of change in depressive symptoms within RCTs. METHODS AND ANALYSIS In this paper, we describe the protocol for our scoping review. Following the format outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews, a research librarian will develop an operationalised search strategy, which we will apply to the MEDLINE, Embase, PsycINFO and Cumulative Index to Nursing and Allied Health Literature databases. We will search for papers from inception to 6 February 2020. A hand search for key citations will also be conducted. Investigator-raters will screen articles, first via the titles and abstracts and then through full-text reviews. We will include articles with randomised control design which assess the treatment of adolescents with major depressive disorder. We will systematically extract and synthesise prespecified data which includes: definition of depression used for participant inclusion, measures used to evaluate changes in depression, type of outcome used (continuous, binary or both), definitions of dichotomous terms to denote change in depression (eg, response, remission, recovery, etc) and reported predictors/moderators/mediators of change. ETHICS AND DISSEMINATION Ethics approval is not required. Findings will be presented in journal publications and at conferences.
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Affiliation(s)
- Darren Courtney
- Child, Youth and Family Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Priya Watson
- Child, Youth and Family Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Kathryn J Bennett
- Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | | | - Tabitha Zentner
- Child, Youth and Family Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Terri Rodak
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Renira Narrandes
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Sial OK, Parise EM, Parise LF, Gnecco T, Bolaños-Guzmán CA. Ketamine: The final frontier or another depressing end? Behav Brain Res 2020; 383:112508. [PMID: 32017978 PMCID: PMC7127859 DOI: 10.1016/j.bbr.2020.112508] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/15/2020] [Accepted: 01/23/2020] [Indexed: 12/12/2022]
Abstract
Two decades ago, the observation of a rapid and sustained antidepressant response after ketamine administration provided an exciting new avenue in the search for more effective therapeutics for the treatment of clinical depression. Research elucidating the mechanism(s) underlying ketamine's antidepressant properties has led to the development of several hypotheses, including that of disinhibition of excitatory glutamate neurons via blockade of N-methyl-d-aspartate (NMDA) receptors. Although the prominent understanding has been that ketamine's mode of action is mediated solely via the NMDA receptor, this view has been challenged by reports implicating other glutamate receptors such as AMPA, and other neurotransmitter systems such as serotonin and opioids in the antidepressant response. The recent approval of esketamine (Spravato™) for the treatment of depression has sparked a resurgence of interest for a deeper understanding of the mechanism(s) underlying ketamine's actions and safe therapeutic use. This review aims to present our current knowledge on both NMDA and non-NMDA mechanisms implicated in ketamine's response, and addresses the controversy surrounding the antidepressant role and potency of its stereoisomers and metabolites. There is much that remains to be known about our understanding of ketamine's antidepressant properties; and although the arrival of esketamine has been received with great enthusiasm, it is now more important than ever that its mechanisms of action be fully delineated, and both the short- and long-term neurobiological/functional consequences of its treatment be thoroughly characterized.
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MESH Headings
- Antidepressive Agents/pharmacology
- Antidepressive Agents/therapeutic use
- Depressive Disorder, Major/drug therapy
- Depressive Disorder, Treatment-Resistant/drug therapy
- Dopamine Plasma Membrane Transport Proteins/drug effects
- Excitatory Amino Acid Antagonists/pharmacology
- Excitatory Amino Acid Antagonists/therapeutic use
- Humans
- Ketamine/pharmacology
- Ketamine/therapeutic use
- Norepinephrine Plasma Membrane Transport Proteins/drug effects
- Receptor, Muscarinic M1/drug effects
- Receptors, AMPA/drug effects
- Receptors, Dopamine D2/drug effects
- Receptors, N-Methyl-D-Aspartate/drug effects
- Receptors, Opioid, delta/drug effects
- Receptors, Opioid, kappa/drug effects
- Receptors, Opioid, mu/drug effects
- Receptors, Serotonin, 5-HT3/drug effects
- Receptors, sigma/drug effects
- Serotonin Plasma Membrane Transport Proteins/drug effects
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Affiliation(s)
- Omar K Sial
- Texas A&M University: Department of Psychological and Brain Sciences, 4325 TAMU, College Station, TX, 77843, USA
| | - Eric M Parise
- Fishberg Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA
| | - Lyonna F Parise
- Fishberg Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA
| | - Tamara Gnecco
- Texas A&M University: Department of Psychological and Brain Sciences, 4325 TAMU, College Station, TX, 77843, USA
| | - Carlos A Bolaños-Guzmán
- Texas A&M University: Department of Psychological and Brain Sciences, 4325 TAMU, College Station, TX, 77843, USA.
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30
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Dwyer JB, Stringaris A, Brent DA, Bloch MH. Annual Research Review: Defining and treating pediatric treatment-resistant depression. J Child Psychol Psychiatry 2020; 61:312-332. [PMID: 32020643 PMCID: PMC8314167 DOI: 10.1111/jcpp.13202] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/31/2019] [Accepted: 01/03/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Adolescent major depressive disorder (MDD) is a significant health problem, associated with substantial morbidity, cost, and mortality. Depression is a significant risk factor for suicide, which is now the second leading cause of death in young people. Up to twenty per cent of adolescents will experience MDD before adulthood, and while a substantial proportion will improve with standard-of-care treatments (psychotherapy and medication), roughly one third will not. METHODS Here, we have reviewed the literature in order to discuss the concept of treatment-resistant depression (TRD) in adolescence, examine risk factors, diagnostic difficulties, and challenges in evaluating symptom improvement, and providing guidance on how to define adequate medication and psychotherapy treatment trials. RESULTS We propose a staging model for adolescent TRD and review the treatment literature. The evidence base for first- and second-line treatments primarily derives from four large pediatric clinical trials (TADS, TORDIA, ADAPT, and IMPACT). After two medications and a trial of evidence-based psychotherapy have failed to alleviate depressive symptoms, the evidence becomes quite thin for subsequent treatments. Here, we review the evidence for the effectiveness of medication switches, medication augmentation, psychotherapy augmentation, and interventional treatments (i.e., transcranial magnetic stimulation, electroconvulsive therapy, and ketamine) for adolescent TRD. Comparisons are drawn to the adult TRD literature, and areas for future pediatric depression research are highlighted. CONCLUSIONS As evidence is limited for treatments in this population, a careful consideration of the known risks and side effects of escalated treatments (e.g., mood stabilizers and atypical antipsychotics) is warranted and weighed against potential, but often untested, benefits.
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Affiliation(s)
- Jennifer B. Dwyer
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA,Yale Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Argyris Stringaris
- Mood Brain and Development Unit, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - David A. Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,University of Pittsburgh Medical Center Western Psychiatric Hospital, Pittsburgh, PA, USA
| | - Michael H. Bloch
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA,Yale Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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31
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Mei C, Fitzsimons J, Allen N, Alvarez-Jimenez M, Amminger GP, Browne V, Cannon M, Davis M, Dooley B, Hickie IB, Iyer S, Killackey E, Malla A, Manion I, Mathias S, Pennell K, Purcell R, Rickwood D, Singh SP, Wood SJ, Yung A, McGorry PD. Global research priorities for youth mental health. Early Interv Psychiatry 2020; 14:3-13. [PMID: 31960595 DOI: 10.1111/eip.12878] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/16/2019] [Accepted: 09/12/2019] [Indexed: 12/11/2022]
Abstract
AIM Over the past two decades, the youth mental health field has expanded and advanced considerably. Yet, mental disorders continue to disproportionately affect adolescents and young adults. Their prevalence and associated morbidity and mortality in young people have not substantially reduced, with high levels of unmet need and poor access to evidence-based treatments even in high-income countries. Despite the potential return on investment, youth mental disorders receive insufficient funding. Motivated by these continual disparities, we propose a strategic agenda for youth mental health research. METHOD Youth mental health experts and funders convened to develop youth mental health research priorities, via thematic roundtable discussions, that address critical evidence-based gaps. RESULTS Twenty-one global youth mental health research priorities were developed, including population health, neuroscience, clinical staging, novel interventions, technology, socio-cultural factors, service delivery, translation and implementation. CONCLUSIONS These priorities will focus attention on, and provide a basis for, a systematic and collaborative strategy to globally improve youth mental health outcomes.
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Affiliation(s)
- Cristina Mei
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Joanna Fitzsimons
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Nicholas Allen
- Department of Psychology, University of Oregon, Eugene, Oregon
| | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Günter Paul Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Vivienne Browne
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Maryann Davis
- Transitions to Adulthood Center for Research, Systems and Psychosocial Advances Research Center, Department of Psychiatry, University of Massachusetts Medical School, Shrewsbury, Massachusetts
| | - Barbara Dooley
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Ian B Hickie
- Youth Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Srividya Iyer
- Department of Psychiatry, McGill University, Montreal, Canada.,Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada.,ACCESS Open Minds (Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Canada.,Frayme, International Knowledge Translation Platform, Ottawa, Canada
| | - Eóin Killackey
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Ashok Malla
- Department of Psychiatry, McGill University, Montreal, Canada.,Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada.,ACCESS Open Minds (Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Canada
| | - Ian Manion
- Frayme, International Knowledge Translation Platform, Ottawa, Canada.,Royal Ottawa Hospital, Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Steve Mathias
- Frayme, International Knowledge Translation Platform, Ottawa, Canada.,Foundry, Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Kerryn Pennell
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Rosemary Purcell
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.,Frayme, International Knowledge Translation Platform, Ottawa, Canada
| | - Debra Rickwood
- Headspace National Youth Mental Health Foundation, Melbourne, Australia.,Faculty of Health, University of Canberra, Canberra, Australia
| | - Swaran P Singh
- Centre for Mental Health and Wellbeing Research, University of Warwick, Coventry, UK
| | - Stephen J Wood
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.,School of Psychology, University of Birmingham, Birmingham, UK
| | - Alison Yung
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
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Cullen KR, Padilla LE, Papke VN, Klimes-Dougan B. New Somatic Treatments for Child and Adolescent Depression. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2019; 6:380-400. [PMID: 33312841 PMCID: PMC7732147 DOI: 10.1007/s40501-019-00194-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Depression is a common clinical problem in youth, with prevalence increasing significantly during the adolescent period. Although several evidence-based treatments are currently available for treating depression in adults, only a subset of these have been investigated in a pediatric sample. Unfortunately, even well-established, first-line interventions do not lead to sufficient treatment response for many children and adolescents suffering from depression. However, recent research has been conducted in the area of somatic treatments for youth with depression. This review focuses on current (past three years, including published results and ongoing studies) research on somatic treatments for adolescent depression in the following categories: psychopharmacology, nutraceuticals, interventions implicating motor and sensory systems, and neuromodulation. FINDINGS Results from recent randomized, controlled trials testing psychopharmacological options suggest that while antidepressants that have been recently approved for adult patients are safe and tolerable in children and adolescents, none have yet outperformed performed placebo in efficacy. Nutraceuticals, motor-sensory interventions, and neuromodulation techniques, present safe and promising results, but few have been tested against controls to support effectiveness over current treatment options. SUMMARY This review of research on pediatric depression treatment from the past 3 years highlights some disappointments (negative results following some of the well-designed clinical trials) and gaps (preliminary studies in need of follow up with robust methodology) but also some promising directions in research of the efficacyof these treatments in a pediatric sample. We offer suggestions for future research including consideration of treatment timing, sequencing, the role of symptom severity in directing treatment selection, the potential value of combined treatments, consideration of how to best account for high placebo response rates, and the incorporation of neurobiological assessments to examine mechanisms and biomarker predictors of treatment response.
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Affiliation(s)
- Kathryn R Cullen
- Department of Psychiatry, University of Minnesota, F282/2A West Building 2450, Riverside Avenue South, Minneapolis, MN 55454, USA
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Robillard R, Chase T, Courtney D, Ward M, De Koninck J, Lee EK. Sleep-related breathing disturbances in adolescents with treatment resistant depression. Sleep Med 2019; 56:47-51. [DOI: 10.1016/j.sleep.2018.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/14/2018] [Accepted: 12/03/2018] [Indexed: 12/30/2022]
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Chi X, Liu X, Guo T, Wu M, Chen X. Internet Addiction and Depression in Chinese Adolescents: A Moderated Mediation Model. Front Psychiatry 2019; 10:816. [PMID: 31798471 PMCID: PMC6865207 DOI: 10.3389/fpsyt.2019.00816] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 10/16/2019] [Indexed: 12/13/2022] Open
Abstract
Research has revealed that Internet addiction is a risk factor for adolescents' development of depressive symptoms, although the underlying mechanisms are largely unknown. The present study examines the mediating role of positive youth development and the moderating role of mindfulness to determine the association between Internet addiction and depression. A sample of 522 Chinese adolescents completed measures related to Internet addiction, positive youth development, mindfulness, depression, and their background information, for which the results reveal that positive youth development mediates the relation between Internet addiction and depression. Moreover, the associations between both Internet addiction and depression as well as positive youth development and depression are moderated by mindfulness. These two effects were stronger for adolescents with low mindfulness than for those with high mindfulness. The present study contributes to a more thorough understanding of how and when Internet addiction increases the risk of depression in adolescents, suggesting that Internet addiction may affect adolescent depression through positive youth development and that mindfulness can alleviate the negative effect of Internet addiction or a low level of psychological resources on depression. The implications for research and practice are finally discussed.
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Affiliation(s)
- Xinli Chi
- College of Psychology, Shenzhen University, Shenzhen, China.,The Department of Psychology, Renmin University of China, Beijing, China.,The Laboratory of the Department of Psychology, Renmin University of China, Beijing, China.,Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China
| | - Xiaofeng Liu
- College of Psychology, Shenzhen University, Shenzhen, China.,Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China
| | - Tianyou Guo
- College of Psychology, Shenzhen University, Shenzhen, China.,Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China
| | - Mingxia Wu
- Southwest University Faculty of Psychology, Research Center of Mental Health Education in Southwest University, Chongqing, China
| | - Xiaochen Chen
- The Department of Psychology, Renmin University of China, Beijing, China.,The Laboratory of the Department of Psychology, Renmin University of China, Beijing, China
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Wang P, Wang X, Wu Y, Xie X, Wang X, Zhao F, Ouyang M, Lei L. Social networking sites addiction and adolescent depression: A moderated mediation model of rumination and self-esteem. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.02.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Higher Risk for Obstructive Sleep Apnea in Chronic Treatment-Resistant Depression. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2018. [DOI: 10.5812/ijpbs.10718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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37
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Can Social Networking Sites Alleviate Depression? The Relation between Authentic Online Self-Presentation and Adolescent Depression: a Mediation Model of Perceived Social Support and Rumination. CURRENT PSYCHOLOGY 2017. [DOI: 10.1007/s12144-017-9711-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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38
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Abstract
We review the evidence that antidepressants either increase or decrease the risk for suicidal ideation and behavior in adolescents. Meta-analyses of randomized clinical trials (RCTs) indicate a small increased risk for suicidal events in adolescents and young adults, but a protective effect in older adults. In contrast, pharmacoepidemiologic studies show a protective effect across the life span. Explanations for occurrence of suicidal events in younger patients and for the apparent contradiction between RCT and pharmacoepidemiologic studies are offered. Guidance for clinicians is provided on explaining the risk-benefit ratio of antidepressants and how to monitor and attenuate for suicidal risk.
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Affiliation(s)
- David A Brent
- Western Psychiatric Institute & Clinic, 3811 O'Hara Street, BFT 311, Pittsburgh, PA 15213, USA.
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Cullen KR, Jasberg S, Nelson B, Klimes-Dougan B, Lim KO, Croarkin PE. Seizure Induced by Deep Transcranial Magnetic Stimulation in an Adolescent with Depression. J Child Adolesc Psychopharmacol 2016; 26:637-41. [PMID: 27447245 PMCID: PMC5118961 DOI: 10.1089/cap.2016.0070] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Deep transcranial magnetic stimulation (TMS) with an H-1 coil was recently approved by the U.S. Food and Drug Administration (U.S. FDA) for treatment-resistant depression (TRD) in adults. Studies assessing the safety and effectiveness of deep TMS in adolescent TRD are lacking. The purpose of this brief report is to provide a case history of an adolescent enrolled in an investigational deep TMS protocol. METHODS A case history is described of the first participant of a sham-controlled clinical trial who had a seizure in the course of deep TMS with parameter settings extrapolated from the adult studies that led to US FDA approval (H-1 coil, 120% target stimulation intensity, 18 Hz, 55 trains of 2-second duration, total 1980 pulses). RESULTS The participant was a 17-year-old unmedicated female, with no significant medical history and no history of seizures or of drug or alcohol use. Brain magnetic resonance imaging showed no structural abnormalities. She initially received sham, which was well tolerated. During active treatment sessions, titration began at 85% of motor threshold (MT) and increased by 5% per day. Her weekly MT measurements were stable. On her first day of 120% MT (8th active treatment), during the 48th train, the participant had a generalized, tonic-clonic seizure that lasted 90 seconds and resolved spontaneously. She had an emergency medicine evaluation and was discharged home without anticonvulsant medications. There were no further seizures reported at a 6-month follow-up. CONCLUSIONS We report a deep TMS-induced generalized tonic-clonic seizure in an adolescent with TRD participating in a clinical trial. Given the demonstrated benefits of deep TMS for adult TRD, research investigating its use in adolescents with TRD is an important area. However, in light of this experience, additional precautions for adolescents should be considered. We propose that further dose-finding investigations are needed to refine adolescent-specific parameters that may be safe and effective for treating adolescents with TRD with deep TMS.
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Affiliation(s)
- Kathryn R. Cullen
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Suzanne Jasberg
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Brent Nelson
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | | | - Kelvin O. Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Paul E. Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
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Zhou X, Michael KD, Liu Y, Del Giovane C, Qin B, Cohen D, Gentile S, Xie P. Systematic review of management for treatment-resistant depression in adolescents. BMC Psychiatry 2014; 14:340. [PMID: 25433401 PMCID: PMC4254264 DOI: 10.1186/s12888-014-0340-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 11/17/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Current guidelines for treatment-resistant depression in adolescents remain inadequate. This study aimed to systematically review the management of treatment-resistant depression in adolescent patients. METHODS We conducted an electronic database search of PUBMED, EMBASE, Cochrane, Web of Science and PsycINFO for studies with adolescent treatment-resistant depression published up to January 2014. Treatment-resistant depression was defined as failure to respond to at least one course of psychological or pharmacological treatment for depression with an adequate dosage, duration, and appropriate compliance during the current illness episode. The Cochrane risk-of-bias method was used to assess the quality of randomized controlled trials. A meta-analysis of all active treatments was conducted. RESULTS Eight studies with 411 depressed adolescents that fit predetermined criteria investigated pharmacological treatments and psychotherapies. Six were open-label studies, and two were randomized controlled trials. The overall response rate for all active treatments investigated was 46% (95% CI 33 to 59; N = 411) with a moderately high degree of heterogeneity (I2 = 76.1%, 95% CI = 47%-86%). When only the two randomized trials were included, the overall response rate of active treatment was 53% (95% CI = 38-67; N = 347). In these randomized trials, SSRI therapy plus CBT was significantly more effective than SSRI therapy alone, while amitriptyline was not more effective than placebo. CONCLUSIONS Approximately half of the adolescents who presented with treatment-refractory depression responded to active treatment, which suggests that practitioners should remain persistent in managing these challenging cases. The combination of antidepressant medication and psychotherapy should be recommended for adolescents who present with treatment-resistant depression.
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Affiliation(s)
- Xinyu Zhou
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016 China ,Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Kurt D Michael
- Department of Psychology, Appalachian State University, Boone, North Carolina USA
| | - Yiyun Liu
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016 China ,Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Cinzia Del Giovane
- Department of Clinical and Diagnostic Medicine and Public Health-Italian Cochrane Centre, University of Modena and Reggio Emilia, Modena, Italy
| | - Bin Qin
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016 China ,Institute of Neuroscience, Chongqing Medical University, Chongqing, China
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie, CNRS UMR 7222 “Institut des Systèmes Intelligents et Robotiques”, Hôpital de la Pitié-Salpétrière, Paris, France
| | | | - Peng Xie
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016 China ,Institute of Neuroscience, Chongqing Medical University, Chongqing, China
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Abstract
Depression is a relatively common diagnosis in children and adolescents, and is associated with significant morbidity and suicidality in this population. Evidence-based treatment of the acute illness is imperative to try to prevent the development of treatment-resistant depression or other complications. In situations where response to acute treatment is inadequate, clinicians should first consider factors that may influence outcome, such as psychiatric or medical comorbidities, psychosocial stressors, and treatment noncompliance. Selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment for depression in children and adolescents. For treatment-resistant depression, a switch to an alternate SSRI is recommended before trials of other antidepressants. Psychotherapy, such as cognitive behavioral therapy or interpersonal therapy, may improve treatment response. More research is needed examining medication augmentation strategies for treatment-resistant depression in children and adolescents.
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Affiliation(s)
- Melissa DeFilippis
- Department of Child and Adolescent Psychiatry, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0188, USA,
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42
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Cullen KR, Westlund M, Klimes-Dougan B, Mueller BA, Houri A, Eberly LE, Lim KO. Abnormal amygdala resting-state functional connectivity in adolescent depression. JAMA Psychiatry 2014; 71:1138-47. [PMID: 25133665 PMCID: PMC4378862 DOI: 10.1001/jamapsychiatry.2014.1087] [Citation(s) in RCA: 217] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
IMPORTANCE Major depressive disorder (MDD) frequently emerges during adolescence and can lead to persistent illness, disability, and suicide. The maturational changes that take place in the brain during adolescence underscore the importance of examining neurobiological mechanisms during this time of early illness. However, neural mechanisms of depression in adolescents have been understudied. Research has implicated the amygdala in emotion processing in mood disorders, and adult depression studies have suggested amygdala-frontal connectivity deficits. Resting-state functional magnetic resonance imaging is an advanced tool that can be used to probe neural networks and identify brain-behavior relationships. OBJECTIVE To examine amygdala resting-state functional connectivity (RSFC) in adolescents with and without MDD using resting-state functional magnetic resonance imaging as well as how amygdala RSFC relates to a broad range of symptom dimensions. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional resting-state functional magnetic resonance imaging study was conducted within a depression research program at an academic medical center. Participants included 41 adolescents and young adults aged 12 to 19 years with MDD and 29 healthy adolescents (frequency matched on age and sex) with no psychiatric diagnoses. MAIN OUTCOMES AND MEASURES Using a whole-brain functional connectivity approach, we examined the correlation of spontaneous fluctuation of the blood oxygen level-dependent signal of each voxel in the whole brain with that of the amygdala. RESULTS Adolescents with MDD showed lower positive RSFC between the amygdala and hippocampus, parahippocampus, and brainstem (z >2.3, corrected P < .05); this connectivity was inversely correlated with general depression (R = -.523, P = .01), dysphoria (R = -.455, P = .05), and lassitude (R = -.449, P = .05) and was positively correlated with well-being (R = .470, P = .03). Patients also demonstrated greater (positive) amygdala-precuneus RSFC (z >2.3, corrected P < .05) in contrast to negative amygdala-precuneus RSFC in the adolescents serving as controls. CONCLUSIONS AND RELEVANCE Impaired amygdala-hippocampal/brainstem and amygdala-precuneus RSFC have not previously been highlighted in depression and may be unique to adolescent MDD. These circuits are important for different aspects of memory and self-processing and for modulation of physiologic responses to emotion. The findings suggest potential mechanisms underlying both mood and vegetative symptoms, potentially via impaired processing of memories and visceral signals that spontaneously arise during rest, contributing to the persistent symptoms experienced by adolescents with depression.
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Affiliation(s)
| | - Melinda Westlund
- Psychology Department, University of Minnesota College of Liberal Arts
| | | | - Bryon A. Mueller
- Department of Psychiatry, University of Minnesota Medical School
| | - Alaa Houri
- Department of Psychiatry, University of Minnesota Medical School
| | | | - Kelvin O. Lim
- Department of Psychiatry, University of Minnesota Medical School
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Pogge DL, Stokes J, Buccolo ML, Pappalardo S, Harvey PD. Discovery of previously undetected intellectual disability by psychological assessment: a study of consecutively referred child and adolescent psychiatric inpatients. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1705-1710. [PMID: 24679700 DOI: 10.1016/j.ridd.2014.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 03/02/2014] [Accepted: 03/06/2014] [Indexed: 06/03/2023]
Abstract
Intellectual disability is associated with an increased risk of behavioral disturbances and also complicates their treatment. Despite increases in the sophistication of medical detection of early risk for intellectual disability, there is remarkably little data about the detection of intellectual disability in cases referred for psychiatric treatment. In this study, we used a 10-year sample of 23,629 consecutive child and adolescent admissions (ages between 6 and 17) to inpatient psychiatric treatment. Eleven percent (n=2621) of these cases were referred for psychological assessment and were examined with a general measure of intellectual functioning (i.e., WISC-IV). Of these cases, 16% had Full Scale IQs below 70. Of the cases whose therapists then referred them for formal assessment of their adaptive functioning (i.e., ABAS-II) 81% were found to have composite scores below 70 as well. Only one of the cases whose Full Scale IQ was less than 70 had a referral diagnosis of intellectual disability. Cases with previously undetected intellectual disability were found to be significantly more likely to have a diagnosis of a psychotic disorder and less likely to have a diagnosis of mood disorder than cases with IQs over 70. Disruptive behavior disorder diagnoses did not differ as a function of intellectual performance. These data suggest a high rate of undetected intellectual disability in cases with a psychiatric condition serious enough to require hospitalization and this raises the possibility that many such cases may be misdiagnosed, the basis of their problems may be misconceptualized, and they may be receiving treatments that do not take into account their intellectual level.
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Affiliation(s)
- David L Pogge
- Four Winds Hospital, Katonah, NY, United States; Fairleigh Dickinson University, Teaneck, NJ, United States
| | - John Stokes
- Pace University, New York, NY, United States
| | | | - Stephen Pappalardo
- Four Winds Hospital, Katonah, NY, United States; Fairleigh Dickinson University, Teaneck, NJ, United States
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL, United States.
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Andrews JT, Seide M, Guarda AS, Redgrave GW, Coffey DBJ. Electroconvulsive therapy in an adolescent with severe major depression and anorexia nervosa. J Child Adolesc Psychopharmacol 2014; 24:94-8. [PMID: 24679175 DOI: 10.1089/cap.2014.2422] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Joseph T Andrews
- 1 Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine , Baltimore, Maryland
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45
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Camus SMJ, Rochais C, Blois-Heulin C, Li Q, Hausberger M, Bezard E. Depressive-like behavioral profiles in captive-bred single- and socially-housed rhesus and cynomolgus macaques: a species comparison. Front Behav Neurosci 2014; 8:47. [PMID: 24600363 PMCID: PMC3928569 DOI: 10.3389/fnbeh.2014.00047] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 01/30/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To unravel the causes of major depressive disorder (MDD), the third leading cause of disease burden around the world, ethological animal models have recently been proposed. Our previous studies highlighted a depressive-like profile among single- and socially-housed farm-bred cynomolgus macaques. Although phylogenetically close, cynomolgus and rhesus macaques, the two most commonly used macaque species in biomedical research, differ on several levels such as patterns of aggression, reconciliation, temperament, or dominance styles. The question of whether one captive macaque species was more vulnerable than another in the development of a pathological profile reminiscent of MDD symptoms was explored. METHODS Behavioral data (including body postures, orientations, gaze directions, inter-individual distances, and locations in the cage) were collected in farming conditions. Using an unbiased validated ethological scan-sampling method, followed by multiple correspondence and hierarchical clustering analyses, 40 single- and 35 socially-housed rhesus macaques were assessed. Independently, for each housing condition, inter-species comparisons were made with previously acquired data on farm-bred cynomolgus monkeys. RESULTS Consistent with our previous studies, we found depressive-like characteristics (e.g., inactivity, low level of investigation and maintenance, long time spent inactive while facing the wall) among single- and socially-housed rhesus macaques. Species-specificities were reported in non-depressive time budgets and in the prevalence of the pathological profiles. CONCLUSIONS Our results suggest that rhesus may be more vulnerable to developing a despair-like state than cynomolgus macaques, both in single- and in social-housing conditions. Therefore, rhesus macaques are more suitable for use as a "spontaneous" model of depressive disorders.
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Affiliation(s)
- Sandrine M. J. Camus
- Institut des Maladies Neurodégénératives, Université de Bordeaux, UMR 5293Bordeaux, France
| | - Céline Rochais
- Ethologie Animale et Humaine, Université de Rennes 1, CNRS, UMR 6552Rennes, France
| | | | - Qin Li
- Motac Neuroscience Ltd.Manchester, UK
- Institute of Lab Animal Sciences, China Academy of Medical SciencesBeijing, China
| | - Martine Hausberger
- Ethologie Animale et Humaine, Université de Rennes 1, CNRS, UMR 6552Rennes, France
| | - Erwan Bezard
- Institut des Maladies Neurodégénératives, Université de Bordeaux, UMR 5293Bordeaux, France
- Motac Neuroscience Ltd.Manchester, UK
- Institute of Lab Animal Sciences, China Academy of Medical SciencesBeijing, China
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46
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Parise EM, Alcantara LF, Warren BL, Wright KN, Hadad R, Sial OK, Kroeck KG, Iñiguez SD, Bolaños-Guzmán CA. Repeated ketamine exposure induces an enduring resilient phenotype in adolescent and adult rats. Biol Psychiatry 2013; 74:750-9. [PMID: 23790225 PMCID: PMC3785550 DOI: 10.1016/j.biopsych.2013.04.027] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 04/10/2013] [Accepted: 04/27/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND Major depressive disorder afflicts up to 10% of adolescents. However, nearly 50% of those afflicted are considered nonresponsive to available treatments. Ketamine, a noncompetitive N-methyl-D-aspartate receptor antagonist has shown potential as a rapid-acting and long-lasting treatment for major depressive disorder in adults. Thus, the effectiveness and functional consequences of ketamine exposure during adolescence were explored. METHODS Adolescent male rats (postnatal day [PD] 35) received two ketamine (0, 5, 10, or 20 mg/kg) injections, 4 hours apart, after exposure to day 1 of the forced swim test (FST). The next day, rats were reexposed to the FST to assess ketamine-induced antidepressant-like responses. Separate groups were exposed to chronic unpredictable stress to confirm findings from the FST. After these initial experiments, adolescent naive rats were exposed to either 1 or 15 consecutive days (PD35-49) of ketamine (20 mg/kg) twice daily. Ketamine's influence on behavioral reactivity to rewarding (i.e., sucrose preference) and aversive (i.e., elevated plus-maze, FST) circumstances was then assessed 2 months after treatment. To control for age-dependent effects, adult rats (PD75-89) were exposed to identical experimental conditions. RESULTS Ketamine (20 mg/kg) reversed the chronic unpredictable stress-induced depression-like behaviors in the FST. Repeated ketamine exposure resulted in anxiolytic- and antidepressant-like responses 2 months after drug exposure. None of the ketamine doses used were capable of inducing drug-seeking behaviors as measured by place preference conditioning. CONCLUSIONS Repeated ketamine exposure induces enduring resilient-like responses regardless of age of exposure. These findings point to ketamine, and its repeated exposure, as a potentially useful antidepressant during adolescence.
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Affiliation(s)
- Eric M. Parise
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL
| | - Lyonna F. Alcantara
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL
| | - Brandon L. Warren
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL
| | - Katherine N. Wright
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL
| | - Roey Hadad
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL
| | - Omar K. Sial
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL
| | - Kyle G. Kroeck
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL
| | - Sergio D. Iñiguez
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL
| | - Carlos A. Bolaños-Guzmán
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL
- Corresponding author: Dr. CA Bolaños-Guzmán Department of Psychology and Program in Neuroscience, Florida State University, 1107 West Call Street, Tallahassee, FL 32306-4301. Tel: (850) 644-2627; Fax (850) 645-7518;
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47
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Casey MF, Perera DN, Clarke DM. Psychosocial treatment approaches to difficult‐to‐treat depression. Med J Aust 2013; 199:S52-5. [DOI: 10.5694/mja12.10629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 08/16/2012] [Indexed: 01/21/2023]
Affiliation(s)
- Melissa F Casey
- Southern Health, Melbourne, VIC
- School of Psychology and Psychiatry, Monash University, Melbourne, VIC
| | - Dinali N Perera
- School of Psychology and Psychiatry, Monash University, Melbourne, VIC
| | - David M Clarke
- School of Psychology and Psychiatry, Monash University, Melbourne, VIC
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48
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Must A, Horvath S, Nemeth VL, Janka Z. The Iowa Gambling Task in depression - what have we learned about sub-optimal decision-making strategies? Front Psychol 2013; 4:732. [PMID: 24133474 PMCID: PMC3794198 DOI: 10.3389/fpsyg.2013.00732] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 09/22/2013] [Indexed: 12/16/2022] Open
Abstract
Our earlier study found patients with depression to show a preference for larger reward as measured by the Iowa Gambling Task (IGT). In this IGT version, larger rewards were associated with even larger consequent losses. In the light of the clinical markers defining depressive disorder, this finding might appear controversial at first. Performance of depressed patients on various decision-making (DM) tasks is typically found to be impaired. Evidence points toward reduced reward learning, as well as the difficulty to shift strategy and integrate environmental changes into DM contingencies. This results in an impaired ability to modulate behavior as a function of reward, or punishment, respectively. Clinical symptoms of the disorder, the genetic profile, as well as personality traits might also influence DM strategies. More severe depression increased sensitivity to immediate large punishment, thus predicting future decisions, and was also associated with higher harm avoidance. Anhedonic features diminished reward learning abilities to a greater extent, even predicting clinical outcome. Several questions about how these aspects relate remain to be clarified. Is there a genetic predisposition for the DM impairment preceding mood symptoms? Is it the consequence of clinical signs or even learned behavior serving as a coping strategy? Are patients prone to develop an aversion of loss or are they unable to sense or deal with reward or the preference of reward? Does the DM deficit normalize or is a persisting impairment predictor for clinical outcome or relapse risk? To what extent is it influenced by medication effects? How does a long-lasting DM deficit affect daily life and social interactions? Strikingly, research evidence indicates that depressed patients tend to behave less deceptive and more self-focused, resulting in impaired social DM. The difficulty in daily interpersonal interactions might contribute to social isolation, further intensifying depressive symptoms.
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Affiliation(s)
- Anita Must
- Department of Psychiatry, University of Szeged Szeged, Hungary
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49
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Liao YL, Wang PS, Lu CF, Hung CI, Li CT, Lin CP, Hsieh JC, Su TP, Wu YT. Cortical shape and curvedness analysis of structural deficits in remitting and non-remitting depression. PLoS One 2013; 8:e68625. [PMID: 23874696 PMCID: PMC3712962 DOI: 10.1371/journal.pone.0068625] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 05/31/2013] [Indexed: 12/14/2022] Open
Abstract
In morphometric neuroimaging studies, the relationship between brain structural changes and the antidepressant treatment response in patients with major depressive disorder has been explored to search depression-trait biomarkers. Although patients were treated with serotonin-related drugs, whether the same treatment resulted in remission and non-remission in depressed patients is currently under investigation. We recruited 25 depressed patients and 25 healthy controls and acquired volumetric magnetic resonance imaging of each participant. We used the shape index and curvedness to classify cortical shapes and quantify shape complexities, respectively, in studying the pharmacological effect on brain morphology. The results showed that different regions of structural abnormalities emerged between remitting and non-remitting patients when contrasted with healthy controls. In addition to comparing structural metrics in each cortical parcellation, similar to the traditional voxel-based morphometric method, we highlighted the importance of structural integrity along the serotonin pathway in response to medication treatment. We discovered that disrupted serotonin-related cortical regions might cause non-remission to antidepressant treatment from a pharmacological perspective. The anomalous areas manifested in non-remitting patients were mainly in the frontolimbic areas, which can be used to differentiate remitting from non-remitting participants before medication treatment. Because non-remission is the failure to respond to treatment with serotonin-related drugs, our method may help clinicians choose appropriate medications for non-remitting patients.
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Affiliation(s)
- Yuan-Lin Liao
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Po-Shan Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- The Neurological Institute, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
- Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Feng Lu
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Chih-I Hung
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Ta Li
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Po Lin
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Jen-Chuen Hsieh
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Integrated Brain Research Laboratory, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Neuropsychiatric Research, National Health and Research Institute, Taipei, Taiwan
| | - Tung-Ping Su
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- * E-mail: (TPS); (YTW)
| | - Yu-Te Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- * E-mail: (TPS); (YTW)
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Camus SMJ, Blois-Heulin C, Li Q, Hausberger M, Bezard E. Behavioural profiles in captive-bred cynomolgus macaques: towards monkey models of mental disorders? PLoS One 2013; 8:e62141. [PMID: 23658620 PMCID: PMC3639229 DOI: 10.1371/journal.pone.0062141] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 03/18/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND To date, experimental and preclinical studies on neuropsychiatric conditions have almost exclusively been performed in experimentally-induced animal models and have only rarely relied upon an ethological approach where animals have been observed in more naturalistic settings. The laboratory species of choice has been the rodent while the potential of more closely-related non-human primates have remained largely underexplored. METHODS The present study, therefore, aimed at investigating the possible existence of spontaneous atypical/abnormal behaviours displayed by 40 cynomolgus macaques in captive conditions using an unbiased ethological scan-sampling analysis followed by multifactorial correspondence analysis and a hierarchical clustering. RESULTS The study identified five distinct profiles (groups A to E) that significantly differed on several behaviours, body postures, body orientations, gaze directions and locations in the cage environment. We suggest that animals from the low n groups (D and E) present depressive-like and anxious-like symptoms, reminiscent of depressive and generalized anxiety disorders. Inter-individual differences were highlighted through unbiased ethological observations of spontaneous behaviours and associated parameters, although these were not associated with differences in plasma or cerebrospinal fluid levels of either stress-related hormones or monoamines, i.e. in accordance with the human situation. CONCLUSIONS No interventional behavioural testing was required to discriminate between 3 typical and 2 atypical ethologically-defined behavioural profiles, reminiscent of certain depressive-like and anxiety-like symptoms. The use of unbiased behavioural observations might, thus, allow the identification of animal models of human mental/behavioural disorders and their most appropriate control groups.
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Affiliation(s)
- Sandrine M. J. Camus
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
| | | | - Qin Li
- Institute of Lab Animal Sciences, China Academy of Medical Sciences, Beijing, China
- Motac Neuroscience Ltd, Manchester, United Kingdom
| | - Martine Hausberger
- CNRS, UMR 6552 Ethologie Animale et Humaine, Université de Rennes 1, Rennes, France
| | - Erwan Bezard
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
- Motac Neuroscience Ltd, Manchester, United Kingdom
- CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
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