Depressive Störungen im Kindes- und Jugendalter

Prevalence and risk factors of depressive symptoms in children and adolescents with juvenile idiopathic arthritis

Depression is a serious disorder disproportionately affecting people with chronic diseases, yet, to date is rarely recognized comorbidity in pediatric rheumatology clinical routine care. The aim of this study was to investigate the prevalence of depressive symptoms and depression in children with Juvenile idiopathic arthritis (JIA) and to identify associations to risk factors. Depressive symptoms were assessed using the Beck's Depression Inventory (BDI)-Fast Screen Questionnaire validated for ages 13 and older and confirmed by the BDI or Hamilton Depression Scale. A cross-sectional analysis of 148 patients attending the rheumatology outpatient clinic of the Asklepios Children's Hospital Sankt Augustin between January 2018 and May 2019 was performed. Possible associations between routinely assessed parameters of disease activity and treatment were analysed. 148 JIA patients (71.5% female), median age 14.7 years, were included. The prevalence for depressive symptoms was 13% and for depression 9.5%, of which 71.4% were newly identified with depression. Significant associations with depressive symptoms included rheumatoid factor negative polyarthritis, higher pain scores, functional limitations, higher disease activity, decreased general well-being, higher number of medications taken and not being in remission. In addition, poor treatment response (persistent pain despite therapy) and failure to achieve minimal activity/remission of disease despite intensified therapy with biologics correlated significantly with depressive symptoms. Depressive symptoms are an important comorbidity in JIA. Early recognition and treatment of psychological distress is essential to prevent deterioration in quality of life and long-term prognosis. Consequently, treat-to-target principles should include mental health as a therapeutic goal.

[Therapy of insomnia and nightmares in childhood and adolescence]

Therapy of insomnia and nightmares in childhood and adolescence Abstract. Sleep problems and sleep disorders have a high prevalence in childhood and adolescence. Normally, such conditions persist and often become chronic. Daytime impairments are widespread with concentration deficits, mental problems, and also a higher suicide risk. Therefore, early and effective interventions are necessary. As symptoms change with age, therapy should be adjusted accordingly. Various strategies for infants and toddlers, schoolchildren, and adolescents will be named. In addition, evidence of these therapy strategies will be shown. All in all, more randomized controlled studies addressing children and adolescents are needed. Furthermore, studies with children and adolescents suffering from comorbid disorders or mental disorders and sleep problems should be conducted.

Veränderungen psychischer Belastung durch die Förderung von rechenschwachen Kindern und Jugendlichen

Fragestellung: Die vorliegende Studie untersuchte die Effekte der Förderung rechenschwacher Kinder mit der Wasserglasmethode im Vergleich zu konventioneller Nachhilfe. Methodik: In einem Prä-Post-Kontrollgruppendesign wurden N = 46 Kinder im Alter von 7 bis 12 Jahren und deren Eltern hinsichtlich Prüfungsangst, Schulunlust, Manifester Angst, Aufmerksamkeitsproblemen sowie internaler und externaler Auffälligkeiten befragt. Ergebnisse: Es zeigte sich, dass Kinder, die mit der Wasserglasmethode behandelt wurden, eine stärkere Reduktion von Prüfungsangst, Schulunlust und Aufmerksamkeitsproblemen, tendenziell auch im CBCL-Gesamtwert zeigten. Diese Veränderungen waren durch die Verbesserung der mathematischen Leistung mediiert. Darüber hinaus ließ sich feststellen, dass überzufällig viele Kinder zu Beginn der Intervention im internalen Störungsspektrum klinisch relevante Störungen aufwiesen. Schlussfolgerungen: Eine dyskalkuliespezifische Intervention bei Rechenschwäche wirkt sich positiv auf das psychische Funktionsniveau der Kinder aus. Weitere Studien sind notwendig, um die Wirkmechanismen und den Einfluss auf die mathematische Leistungsfähigkeit zu überprüfen.

Validation of Children's Depression Scale in the Basque-speaking population

The aim of this study was to validate the Basque version of the CDS (Children's Depression Scale, Lang & Tisher, 1978), one of the most widely used questionnaires for the assessment of childhood depression, which has already been proved to be a valid and reliable tool in different cultures. The questionnaire was administered to a community sample of 886 participants (432 males and 454 females) aged between 8 and 16. A two-factor solution was obtained (Depressive dimension and Positive Dimension), which accounted for 29.86 % of the variance. Reliability with regard to internal consistency level and long-term stability was good (alpha = .95 and .79; and R = .73 and .59 for Depressive and Positive dimensions, respectively). Analysis of Differential Item Functioning with respect to age and gender showed that 91% and 88% of the items, respectively, did not present DIF. External validity evidence for the questionnaire was also obtained. We consider that the present work offers researchers and professionals interested in this area of study a valid and reliable tool for assessing depressive symptoms in Basque-speaking children and adolescents.

Wirksamkeit von schulbasierten Gruppeninterventionen zur Depressionsprävention

Fünf bis zehn Prozent aller Kinder und Jugendlichen in Deutschland leiden an depressiven Symptomen. Chronische Depressionen gehen regelmäßig mit ersten Erkrankungssymptomen im Kindes- und Jugendalter einher. Der frühen Prävention depressiver Störungen kommt folglich eine hohe Bedeutung zu. Wir untersuchten die Wirksamkeit nichtpharmakologischer schulbasierter Gruppeninterventionen zur Depressionsprävention anhand eines systematischen Literaturreviews. Signifikante Verbesserungen depressiver Störungen konnten in 61 Prozent der eingeschlossenen Studien festgestellt werden. Aufgrund der Heterogenität von Studiendurchführung und –design können keine eindeutigen Aussagen abgeleitet werden, welche Faktoren zu einem Erfolg oder Misserfolg der Programme beitragen. Eine flächendeckende Umsetzung erscheint aufgrund der offenen Fragen zur optimalen Ausgestaltung verfrüht.

Depressive symptoms of children and adolescents in a German representative sample: results of the BELLA study

BACKGROUND

In Europe, a considerable proportion of children and adolescents is affected by depressive symptoms, impairing their everyday life and social functioning.

OBJECTIVES

The aim of this paper is to provide an overview of the depressive symptoms in children and adolescents in Germany, addressing risk factors, comorbidity, and impact of depressive symptoms on everyday life.

METHODS

In the BELLA study, the mental health module of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a representative sample of young people aged 7-17 years was enrolled. Depressiveness, assessed by the CES-DC, as well as other mental health problems were examined in the context of risk and protective factors.

RESULTS

Depressive symptoms showed high prevalence in parent- and self-reports. Higher depression scores were found in those with a high number of psychosocial risks existing in the family, and they decreased as the number of protective factors the children and adolescents had at their disposal increased. Although only half of the boys and girls with high depression scores were regarded as significantly impaired, all of them had a much higher risk for additional mental health problems. Furthermore, their health-related quality of life was limited compared to their peers who had low depression scores.

CONCLUSIONS

To differentiate between clinically significant depression and milder forms, it is necessary to take into account the different perspectives of children and their parents. Prevention and intervention should acknowledge the widespread distribution of depressive symptoms in children and adolescents, the high comorbidity of depressive and other mental health problems and the impact of depression on the aspects of everyday life.