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Vilar A, Sánchez-Martínez N, Blasco MJ, Álvarez-Salazar S, Batlle Vila S, G Forero C. Content agreement of depressive symptomatology in children and adolescents: a review of eighteen self-report questionnaires. Eur Child Adolesc Psychiatry 2024; 33:2019-2033. [PMID: 35962831 DOI: 10.1007/s00787-022-02056-w] [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: 03/14/2022] [Accepted: 07/25/2022] [Indexed: 11/03/2022]
Abstract
Identifying major depression in children and adolescents is more challenging than in adults. Questionnaires are often used for screening or guiding clinical assessment. Several instruments of different lengths are used as equivalent measures in diagnostic decisions. In this paper, we explore to what extent 18 commonly used depression scales for children and adolescents explore depression clinical symptoms as established by standard DSM-5 diagnosis criteria. We analyzed scale content adequacy by examining the overlap between scale contents and consensus clinical symptoms, the diagnostic time frame for active symptom assessment, and readability for the target age group. The 18 scales encompassed 52 distinct symptoms. These scales included just 50% of clinical symptoms required for diagnosis. The content overlap was low; on average, 29% of symptoms coincide across scales. Half of the scales did not use the standard period for active symptom appraisal, and some did not include a period for assessment. The reading levels on six scales were inappropriate for the scale's target population age group. The substantial heterogeneity in defining the depressive syndrome, the low overlap among scales, different periods of a positive diagnosis, and mismatch of reading competence for detecting may lead to heterogeneity in clinical diagnoses when using different scales. Improving the content of self-report in terms of homogeneity of diagnostic criteria would lead to better diagnostic decisions and patient management.
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Affiliation(s)
- Ana Vilar
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Institut de Neuropsiquiatria I Addiccions (INAD), Hospital de Dia Infanto Juvenil Litoral Mar, Parc de Salut Mar, Barcelona, Spain
| | - Néstor Sánchez-Martínez
- Department of Medicine, Universitat Internacional de Catalunya (UIC), C/Josep Trueta S/N (Hospital Universitari General de Catalunya, Sant Cugat del Vallès, 08195, Barcelona, Spain
| | - Maria Jesús Blasco
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Health Services Research Group, IMIM- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Samantha Álvarez-Salazar
- Department of Medicine, Universitat Internacional de Catalunya (UIC), C/Josep Trueta S/N (Hospital Universitari General de Catalunya, Sant Cugat del Vallès, 08195, Barcelona, Spain
| | - Santiago Batlle Vila
- Institut de Neuropsiquiatria I Addiccions (INAD), Direcció Procés Atenció Comunitària I Programes Especials. Parc de Salut Mar, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Carlos G Forero
- Department of Medicine, Universitat Internacional de Catalunya (UIC), C/Josep Trueta S/N (Hospital Universitari General de Catalunya, Sant Cugat del Vallès, 08195, Barcelona, Spain.
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Durdurak BB, Williams B, Zhigalov A, Moore A, Mallikarjun P, Wong D, Marwaha S, Morales-Muñoz I. Factors associated with chronic depressive symptoms across adolescence and young adulthood: a UK birth cohort study. Epidemiol Psychiatr Sci 2024; 33:e32. [PMID: 38920396 DOI: 10.1017/s2045796024000350] [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] [Indexed: 06/27/2024] Open
Abstract
AIMS Identifying children and/or adolescents who are at highest risk for developing chronic depression is of utmost importance, so that we can develop more effective and targeted interventions to attenuate the risk trajectory of depression. To address this, the objective of this study was to identify young people with persistent depressive symptoms across adolescence and young adulthood and examine the prospective associations between factors and persistent depressive symptoms in young people. METHODS We used data from 6711 participants in the Avon Longitudinal Study of Parents and Children. Depressive symptoms were assessed at 12.5, 13.5, 16, 17.5, 21 and 22 years with the Short Mood and Feelings Questionnaire, and we further examined the influence of multiple biological, psychological and social factors in explaining chronic depressive symptoms. RESULTS Using latent class growth analysis, we identified four trajectories of depressive symptoms: persistent high, persistent low, persistent moderate and increasing high. After applying several logistic regression models, we found that loneliness and feeling less connected at school were the most relevant factors for chronic course of depressive symptoms. CONCLUSIONS Our findings contribute with the identification of those children who are at highest risk for developing chronic depressive symptoms.
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Affiliation(s)
- B B Durdurak
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK
| | - B Williams
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK
| | - A Zhigalov
- School of Engineering and Technology, Aston University, Birmingham, UK
| | - A Moore
- Department of Psychiatry, University of Cambridge Herchel Smith Building for Brain & Mind Sciences, Cambridge, UK
| | - P Mallikarjun
- Early Intervention Service, Birmingham Women's and Children's NHS Trust, Birmingham, UK
| | - D Wong
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - S Marwaha
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK
- Specialist Mood Disorders Clinic, The Barberry Centre for Mental Health, Birmingham and Solihull NHS Trust, Birmingham, UK
| | - I Morales-Muñoz
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK
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Vinh NA, Long NT, Trang DT, Trang LT, Thuy LTT. Utilizing the Short Mood and Feelings Questionnaire to measure symptoms of depression among Vietnamese adolescents in Hanoi, Vietnam, during the COVID-19 pandemic. Front Psychiatry 2024; 15:1400128. [PMID: 38938466 PMCID: PMC11208701 DOI: 10.3389/fpsyt.2024.1400128] [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: 03/13/2024] [Accepted: 05/28/2024] [Indexed: 06/29/2024] Open
Abstract
Objective This study aimed to measure depression among children and adolescents during the COVID-19 pandemic in Hanoi, Vietnam and its associated factors by using the Short Mood and Feelings Questionnaire (SMFQ) instrument. Methods We conducted a cross-sectional study among students from grades 6 to 9 within two secondary schools in Hanoi, the capital of Vietnam. A structured questionnaire was used, including information about personal characteristics, perception of COVID-19, and SMFQ. Factor analysis, Multivariate logistic and Tobit regression models were used. Results Among 2378 students, 8.8% had depressive symptoms. The mean SMFQ score was 4.5 (SD=5.0). Being female, studying in higher grades, perceived low household income, higher perceived impacts of COVID-19 on health and higher perceived impacts of COVID-19-related quarantine on life were positively associated with factors' scores, SMFQ score and depressive symptoms. Meanwhile, having better academic performance, living with parents and having higher perceived knowledge about COVID-19 were negatively associated with factors scores, SMFQ score and depressive symptoms. Conclusions Depressive symptoms were common among secondary school students in Hanoi, Vietnam, during the COVID-19 pandemic. Tailored interventions to improve pandemic-related knowledge and family and school support should be warranted for the students to enhance their mental well-being.
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Affiliation(s)
- Ngo Anh Vinh
- Department of Adolescent Health, Vietnam National Children’s Hospital, Hanoi, Vietnam
| | | | - Do Thi Trang
- Binh Minh Center of Education Psychology Research and Application, Hanoi, Vietnam
| | - Le Thu Trang
- Binh Minh Center of Education Psychology Research and Application, Hanoi, Vietnam
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Hosozawa M, Ando S, Yamaguchi S, Yamasaki S, DeVylder J, Miyashita M, Endo K, Stanyon D, Knowles G, Nakanishi M, Usami S, Iso H, Furukawa TA, Hiraiwa-Hasegawa M, Kasai K, Nishida A. Sex Differences in Adolescent Depression Trajectory Before and Into the Second Year of COVID-19 Pandemic. J Am Acad Child Adolesc Psychiatry 2024; 63:539-548. [PMID: 37805069 DOI: 10.1016/j.jaac.2023.08.016] [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: 02/16/2023] [Revised: 07/21/2023] [Accepted: 09/28/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE Evidence on the impact of the COVID-19 pandemic on adolescent mental health is mixed and does not disentangle natural age-related changes. We compared depressive symptoms among 16-year-olds surveyed, at a fourth wave, before or during the pandemic, while accounting for expected trajectories of within-person change based on 3 prior waves. METHOD In this longitudinal cohort of 3,171 adolescents in Tokyo, Japan, adolescents were grouped based on their age 16 survey timing: pre-pandemic (February 2019 to February 2020) and during-pandemic (March 2020 to September 2021). Depressive symptoms were self-reported using the Short Mood and Feelings Questionnaire. Mixed-effect models were fitted to assess group differences while controlling for previous trends. Variations by sex, household income, and pandemic phase (early, late first-year, and second-year) were examined. RESULTS Of 2,034 eligible adolescents, 960 (455 girls) were assessed before and 1,074 (515 girls) during the pandemic. Overall, depressive symptoms increased by 0.80 points (95% CI 0.28-1.31, 0.15 SD of the population average). This increase varied by sex and pandemic phase. For boys the increase emerged in the late first-year phase and enlarged in the second-year phase (mean difference from pre-pandemic: 1.69, 0.14-3.24), whereas for girls it decreased in the early school-closure phase (mean difference: -1.98, -3.54 to -0.41) and returned to the pre-pandemic level thereafter, with no additional increases during the pandemic. CONCLUSION Into the second year of the COVID-19 pandemic, depressive symptoms of 16-year-olds worsened above the expected age-related change only in boys. Continuous monitoring and preventive approaches for adolescents at the population level are warranted. DIVERSITY & INCLUSION STATEMENT We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
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Affiliation(s)
- Mariko Hosozawa
- National Center for Global Health and Medicine, Tokyo, Japan.
| | | | | | - Syudo Yamasaki
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Jordan DeVylder
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; Fordham University, New York
| | | | - Kaori Endo
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Daniel Stanyon
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Gemma Knowles
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; King's College London, London, United Kingdom
| | - Miharu Nakanishi
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; Tohoku University Graduate School of Medicine, Miyagi, Japan; Leiden University Medical Center, Leiden, the Netherlands
| | | | - Hiroyasu Iso
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Kiyoto Kasai
- The University of Tokyo, Tokyo, Japan; The University of Tokyo Institutes for Advanced Study, Tokyo, Japan
| | - Atsushi Nishida
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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Farooq B, Russell AE, Howe LD, Herbert A, Smith ADAC, Fisher HL, Baldwin JR, Arseneault L, Danese A, Mars B. The relationship between type, timing and duration of exposure to adverse childhood experiences and adolescent self-harm and depression: findings from three UK prospective population-based cohorts. J Child Psychol Psychiatry 2024. [PMID: 38613494 DOI: 10.1111/jcpp.13986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are well-established risk factors for self-harm and depression. However, despite their high comorbidity, there has been little focus on the impact of developmental timing and the duration of exposure to ACEs on co-occurring self-harm and depression. METHODS Data were utilised from over 22,000 children and adolescents participating in three UK cohorts, followed up longitudinally for 14-18 years: the Avon Longitudinal Study of Parents and Children (ALSPAC), the Millennium Cohort Study (MCS) and the Environmental Risk (E-Risk) Longitudinal Twin Study. Multinomial logistic regression models estimated associations between each ACE type and a four-category outcome: no self-harm or depression, self-harm alone, depression alone and self-harm with co-occurring depression. A structured life course modelling approach was used to examine whether the accumulation (duration) of exposure to each ACE, or a critical period (timing of ACEs) had the strongest effects on self-harm and depression in adolescence. RESULTS The majority of ACEs were associated with co-occurring self-harm and depression, with consistent findings across cohorts. The importance of timing and duration of ACEs differed across ACEs and across cohorts. For parental mental health problems, longer duration of exposure was strongly associated with co-occurring self-harm and depression in both ALSPAC (adjusted OR: 1.18, 95% CI: 1.10-1.25) and MCS (1.18, 1.11-1.26) cohorts. For other ACEs in ALSPAC, exposure in middle childhood was most strongly associated with co-occurring self-harm and depression, and ACE occurrence in early childhood and adolescence was more important in the MCS. CONCLUSIONS Efforts to mitigate the impact of ACEs should start in early life with continued support throughout childhood, to prevent long-term exposure to ACEs contributing to risk of self-harm and depression in adolescence.
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Affiliation(s)
- Bushra Farooq
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Abigail E Russell
- Children and Young People's Mental Health Research Collaboration, University of Exeter Medical School, Exeter, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Annie Herbert
- MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Andrew D A C Smith
- Mathematics and Statistics Research Group, University of the West of England, Bristol, UK
| | - Helen L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Jessie R Baldwin
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Division of Psychology and Language Sciences, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Louise Arseneault
- Mathematics and Statistics Research Group, University of the West of England, Bristol, UK
| | - Andrea Danese
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK
| | - Becky Mars
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol Medical School, Bristol, UK
- National Institute for Health and Care Research, Biomedical Research Centre, Bristol, UK
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Yakovlev V, Lapato DM, Rana P, Ghosh P, Frye R, Roberson-Nay R. Neuron enriched extracellular vesicles' MicroRNA expression profiles as a marker of early life alcohol consumption. Transl Psychiatry 2024; 14:176. [PMID: 38575599 PMCID: PMC10994930 DOI: 10.1038/s41398-024-02874-3] [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: 08/14/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/06/2024] Open
Abstract
Alcohol consumption may impact and shape brain development through perturbed biological pathways and impaired molecular functions. We investigated the relationship between alcohol consumption rates and neuron-enriched extracellular vesicles' (EVs') microRNA (miRNA) expression to better understand the impact of alcohol use on early life brain biology. Neuron-enriched EVs' miRNA expression was measured from plasma samples collected from young people using a commercially available microarray platform while alcohol consumption was measured using the Alcohol Use Disorders Identification Test. Linear regression and network analyses were used to identify significantly differentially expressed miRNAs and to characterize the implicated biological pathways, respectively. Compared to alcohol naïve controls, young people reporting high alcohol consumption exhibited significantly higher expression of three neuron-enriched EVs' miRNAs including miR-30a-5p, miR-194-5p, and miR-339-3p, although only miR-30a-5p and miR-194-5p survived multiple test correction. The miRNA-miRNA interaction network inferred by a network inference algorithm did not detect any differentially expressed miRNAs with a high cutoff on edge scores. However, when the cutoff of the algorithm was reduced, five miRNAs were identified as interacting with miR-194-5p and miR-30a-5p. These seven miRNAs were associated with 25 biological functions; miR-194-5p was the most highly connected node and was highly correlated with the other miRNAs in this cluster. Our observed association between neuron-enriched EVs' miRNAs and alcohol consumption concurs with results from experimental animal models of alcohol use and suggests that high rates of alcohol consumption during the adolescent/young adult years may impact brain functioning and development by modulating miRNA expression.
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Affiliation(s)
- Vasily Yakovlev
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.
| | - Dana M Lapato
- Department of Human and Molecular Genetics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Pratip Rana
- Department of Computer Science, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Preetam Ghosh
- Department of Computer Science, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Rebekah Frye
- Neuroscience Program, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Roxann Roberson-Nay
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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Bleile ACE, Koppenol-Gonzalez GV, Orech B, Verreault K, Jordans MJD. Evaluating a Movement-Based Mental Health Promotion Intervention for Refugee Children in Uganda: A Quasi-Experimental Study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-16. [PMID: 38564186 DOI: 10.1080/15374416.2024.2330073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Mental health promotion interventions are widely implemented in humanitarian settings and low- and middle-income contexts (LMICs), yet evidence on effectiveness is scarce and mixed. This study evaluated the movement-based mental health promotion intervention "TeamUp" in Bidibidi refugee settlement, in Northern Uganda. METHOD A quasi-experimental study including four schools (two per arm) assessed the outcomes of 10- to 15-year-old South Sudanese and Ugandan children (n = 549). Randomly allocated, they either participated in up to 11 TeamUp sessions (n = 265) provided by trained facilitators; or belonged to a control group, which continued care as usual (n = 284). Primary outcomes measured psychosocial wellbeing, friendships and attitude to school; secondary outcomes included traumatic distress, depressive symptoms, quality of life, physical health, bullying, interoceptive awareness, and irritability. Data were collected at baseline and endline. RESULTS Children joining TeamUp, showed significantly more improvements on primary outcomes: emotional and psychosocial wellbeing (Mdiff = -1.49, SE = 0.6, p = .01), satisfaction with and attitude toward school (-0.57, SE = 0.2, p = .004); and secondary outcomes: traumatic stress (2.64, SE = 0.8, p < .001), health-related quality of life (-1.56, SE = 0.4, p = .001), physical health (-0.78, SE = 0.3, p = .014) and the TeamUp mechanisms of action scale (-3.34, SE = 0.9, p < .001), specifically the subscales social connectedness (-0.74, SE = 0.3, p = .007) and sense of agency (-0.91, SE = 0.3, p = .005), compared to the control group. No significant differences were found on bullying, interoceptive awareness, irritability and depressive symptoms. CONCLUSION The results are promising for TeamUp as a mental health promotion intervention for children affected by armed-conflict, displacement and on-going adversity. Further research will need to assess the intervention's effectiveness.
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Affiliation(s)
- Alexandra C E Bleile
- Research and Development Department, War Child
- Amsterdam Institute of Social Science Research, University of Amsterdam
| | | | - Bruce Orech
- Research and Development Department, War Child
| | | | - Mark J D Jordans
- Research and Development Department, War Child
- Amsterdam Institute of Social Science Research, University of Amsterdam
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Xu Y, Rahman Q. Sexual Orientation Identity Change, Developmental Trajectories of Depressive Symptoms, and Childhood Abuse From Adolescence to Young Adulthood. J Adolesc Health 2024; 74:523-530. [PMID: 38069933 DOI: 10.1016/j.jadohealth.2023.10.017] [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: 02/10/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE This study tested differences between youths who reported being heterosexual at ages 15.5 and 21, and those who changed from reporting being heterosexual at age 15.5 to nonheterosexual at age 21, in the developmental trajectories of depressive symptoms from age 22-24 years, and whether these longitudinal patterns were explained by childhood and adolescent abuse. METHODS The Avon Longitudinal Study of Parents and Children (ALSPAC) was used (849 male youths and 1,455 female youths). Youths' self-reported sexual orientation was measured at ages 15.5 and 21, and depressive symptoms were measured at ages 22, 23, and 24. Childhood and adolescent abuse between birth and 17 years were reported by youths and their mothers. RESULTS Male and female youths who changed from reporting being heterosexual to nonheterosexual reported significantly more depressive symptoms than their consistently heterosexual counterparts at all 3 ages (except the association for male youths at age 24), with total effects (unstandardized regression coefficients) ranging from 2.00 to 5.27. These associations were weakened but remained statistically significant when childhood and adolescent abuse was controlled for, with direct effects ranging from 1.50 to 4.68. These associations were mediated through childhood and adolescent abuse, with indirect effects ranging from 0.48 to 0.58. Differences between youths who consistently reported being heterosexual and those who changed from reporting being heterosexual to nonheterosexual in depressive symptoms decreased from age 22-24 years, possibly due to the success of identity integration. DISCUSSION Childhood and adolescent abuse may partially explain these developmental disparities.
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Affiliation(s)
- Yin Xu
- Department of Sociology & Psychology, School of Public Administration, Sichuan University, Chengdu, China.
| | - Qazi Rahman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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Ballard R, Parkhurst JT, Gadek LK, Julian KM, Yang A, Pasetes LN, Goel N, Sit DK. Bright Light Therapy for Major Depressive Disorder in Adolescent Outpatients: A Preliminary Study. Clocks Sleep 2024; 6:56-71. [PMID: 38390946 PMCID: PMC10885037 DOI: 10.3390/clockssleep6010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Bright light therapy (BLT) has not been well-studied in adolescents with major depressive disorder, particularly in outpatient settings. METHODS We conducted an 8-week clinical trial of BLT in adolescents recruited from a primary care practice with moderate to severe major depression. Acceptability and feasibility were defined by daily use of the light box and integration into daily routines. To assess treatment effects, we utilized the Short Mood and Feelings Questionnaire (SMFQ) and actigraphic sleep variables. RESULTS Of the nine enrolled adolescents, the rate of daily use of the light therapy box was 100% at week 2, 78% at week 4 (n = 7), and 67% at weeks 6 and 8 (n = 6). Participants were better able to integrate midday BLT compared to morning BLT into their day-to-day routines. Mean depression scores improved during the 2-week placebo lead-in (dim red light-DRL) and continued to show significant improvement through 6 weeks of BLT. Sleep efficiency increased significantly (p = 0.046), and sleep onset latency showed a trend toward a significant decrease (p = 0.075) in the BLT phase compared to the DRL phase. CONCLUSION Bright light treatment that was self-administered at home was feasible, acceptable, and effective for adolescent outpatients with depression. Findings support the development of larger, well-powered, controlled clinical trials of BLT in coordination with primary care.
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Affiliation(s)
- Rachel Ballard
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 10, Chicago, IL 60611, USA
| | - John T Parkhurst
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 10, Chicago, IL 60611, USA
| | - Lisa K Gadek
- Lake Forest Pediatrics, Lake Bluff, IL 60044, USA
| | - Kelsey M Julian
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 10, Chicago, IL 60611, USA
| | - Amy Yang
- Asher Center for the Study and Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., Suite 1000, Chicago, IL 60611, USA
| | - Lauren N Pasetes
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 425, Chicago, IL 60612, USA
| | - Namni Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 425, Chicago, IL 60612, USA
| | - Dorothy K Sit
- Asher Center for the Study and Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., Suite 1000, Chicago, IL 60611, USA
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Adini-Spigelman E, Gvion Y, Haruvi Catalan L, Barzilay S, Apter A, Brunstein Klomek A. Comparative Effectiveness of Ultra-Brief, IPT-A Based Crisis Intervention for Suicidal Children and Adolescents. Arch Suicide Res 2024:1-14. [PMID: 38169321 DOI: 10.1080/13811118.2023.2298499] [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] [Indexed: 01/05/2024]
Abstract
BACKGROUND In recent years, suicidal thoughts and behaviors have become increasingly common among children and adolescents, leading to an elevation in the number of visits to emergency departments in pediatric hospitals. In Israel, the rising demand for mental health treatment due to suicidal distress is also salient, creating prolonged wait periods and low case acceptance rates. Addressing the urgent need for streamlined interventions, the present study outlines the design and results of a non-inferiority effectiveness trial of an ultra-brief suicide crisis intervention based on Interpersonal Psychotherapy for Adolescents (IPT-A-SCI). METHODS 309 children and adolescents presenting to the Depression and Suicide Clinic at Schneider Children's Medical Center of Israel with depressive and anxiety symptoms and/or suicidal ideation/behavior were assigned to either IPT-A-SCI, Treatment as Usual (TAU), or waitlist condition. Assessments were conducted pre- and post-intervention/after five sessions/five weeks (as secondary assessments) in accordance with group assignment. RESULTS At secondary assessment, post IPT-A-SCI, suicide ideation, and behavior as well as depression and anxiety symptoms significantly decreased, with no group differences observed between IPT-A-SCI, TAU, and control groups. CONCLUSION IPT-A-SCI is feasible and as effective as the standard treatment in reducing suicidal, depressive, and anxiety symptoms among children and adolescents.
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Shakeshaft A, Heron J, Blakey R, Riglin L, Smith GD, Stergiakouli E, Tilling K, Thapar A. Co-development of attention deficit hyperactivity disorder and autistic trait trajectories from childhood to early adulthood. J Child Psychol Psychiatry 2023; 64:1596-1607. [PMID: 37350028 PMCID: PMC7615536 DOI: 10.1111/jcpp.13851] [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] [Accepted: 05/12/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) and autism, defined as traits or disorders, commonly co-occur. Developmental trajectories of ADHD and autistic traits both show heterogeneity in onset and course, but little is known about how symptom trajectories co-develop into adulthood. METHODS Using data from a population cohort, the Avon Longitudinal Study of Parents and Children, we examined correlations between ADHD and autistic traits across development, using the Social Communication Disorders Checklist and ADHD subscale of the Strengths and Difficulties Questionnaire. We modelled joint developmental trajectories of parent-reported ADHD and autistic traits between 4 and 25 years, then characterised trajectory classes based on sociodemographic, perinatal, psychopathology, cognition and social functioning variables and tested for associations with neurodevelopmental/psychiatric polygenic scores (PGS). RESULTS Three classes of trajectories were identified; a typically developing majority with low-stable ADHD-autistic traits (87%), a male-predominant subgroup with child/adolescent-declining traits (6%) and a subgroup with late-emerging traits (6%). ADHD-autistic trait correlations were greatest in young adulthood for the two nontypically developing classes. There were higher rates of emotional and conduct problems, low IQ, childhood seizures and poor social functioning in the declining and late-emerging classes compared to the low-stable class. Emotional, conduct and peer problems were more prevalent during childhood in the childhood/adolescent-declining class compared to other classes, but were more prevalent in young adulthood in the late-emerging class. Neurodevelopmental/psychiatric PGS also differed: both nontypically developing classes showed elevated ADHD PGS compared to the low-stable group, and the late-emerging group additionally showed elevated schizophrenia PGS and decreased executive function PGS, whereas the declining group showed elevated broad depression PGS. CONCLUSIONS Distinct patterns of ADHD-autism co-development are present across development in the general population, each with different characterising factors and genetic signatures as indexed by PGS.
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Affiliation(s)
- Amy Shakeshaft
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Jon Heron
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Rachel Blakey
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - George Davey Smith
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Evie Stergiakouli
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Kate Tilling
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
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12
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Fox KA, Nick E, Nesi J, Telzer EH, Prinstein MJ. Why Haven't You Texted Me Back? Adolescents' Digital Entrapment, Friendship Conflict, and Perceived General Health. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023:1-11. [PMID: 37796196 PMCID: PMC10995108 DOI: 10.1080/15374416.2023.2261543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Many adolescents feel pressure to be constantly available and responsive to others via their smartphones and social media. This phenomenon has been understudied using quantitative methods, and no prior study has examined adolescents' specific stress about meeting digital availability expectations within a best friendship, or entrapment. The present study offers an important preliminary examination of this unique digital stressor in a developmental context by examining prospective associations between digital entrapment, psychosocial adjustment, and health in adolescence. METHOD Students in a rural, lower-income school district in the southeastern US (n = 714; 53.8% female; 45.9% White, 22.7% Black, 24.0% Hispanic/Latino) completed self-report measures of digital entrapment, perceived general health, friendship conflict, and depressive symptoms at two timepoints, one year apart. RESULTS Digital entrapment, which 76.3% of the sample reported experiencing, was associated prospectively with higher levels of friendship conflict and worse perceived general health one year later among boys, but not girls. Findings suggest that digital entrapment is an extremely common experience for adolescents that may disproportionally affect boys. Entrapment was not prospectively associated with depressive symptoms. CONCLUSIONS Results offer insight into how boys may have different social media experiences significant to their development and health, while much work exploring gender differences in social media use thus far has elucidated negative effects for girls. Boys may perceive and respond to novel social norms of digital environments differently such that digital entrapment has the potential to be detrimental to their friendships and health.
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Affiliation(s)
- Kara A. Fox
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC
| | - Elizabeth Nick
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC
| | - Jacqueline Nesi
- Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI
- Bradley/Hasbro Research Center, Rhode Island Hospital
| | - Eva H. Telzer
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC
| | - Mitchell J. Prinstein
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC
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13
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Weavers B, Riglin L, Martin J, Anney R, Collishaw S, Heron J, Thapar A, Thapar A, Rice F. Characterising depression trajectories in young people at high familial risk of depression. J Affect Disord 2023; 337:66-74. [PMID: 37224886 PMCID: PMC10824668 DOI: 10.1016/j.jad.2023.05.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Parental depression is a common and potent risk factor for depression in offspring. However, the developmental course of depression from childhood to early-adulthood has not been characterized in this high-risk group. METHODS Using longitudinal data from 337 young people who had a parent with a history of recurrent major depressive disorder (MDD), we characterized trajectories of broadly defined depressive disorder using latent class growth analysis. We used clinical descriptions to further characterise trajectory classes. RESULTS Two trajectory classes were identified: childhood-emerging (25 %) and adulthood-emerging (75 %). The childhood-emerging class showed high rates of depressive disorder from age 12.5, which persisted through the study period. The adulthood-emerging class showed low rates of depressive disorder until age 26. Individual factors (IQ and ADHD symptoms) and parent depression severity (comorbidity, persistence and impairment) differentiated the classes but there were no differences in family history score or polygenic scores associated with psychiatric disorder. Clinical descriptions indicated functional impairment in both classes, but more severe symptomatology and impairment in the childhood-emerging class. LIMITATIONS Attrition particularly affected participation in young adulthood. Factors associated with attrition were low family income, single parent household status and low parental education. CONCLUSIONS The developmental course of depressive disorder in children of depressed parents is variable. When followed up to adult life, most individuals exhibited some functional impairment. An earlier age-of-onset was associated with a more persistent and impairing course of depression. Access to effective prevention strategies is particularly warranted for at-risk young people showing early-onsetting and persistent depressive symptoms.
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Affiliation(s)
- Bryony Weavers
- Wolfson Centre for Young People's Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK; Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK.
| | - Lucy Riglin
- Wolfson Centre for Young People's Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK; Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
| | - Joanna Martin
- Wolfson Centre for Young People's Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK; Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
| | - Richard Anney
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
| | - Stephan Collishaw
- Wolfson Centre for Young People's Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK; Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, Gloucestershire, UK
| | - Ajay Thapar
- Wolfson Centre for Young People's Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK; Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
| | - Anita Thapar
- Wolfson Centre for Young People's Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK; Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
| | - Frances Rice
- Wolfson Centre for Young People's Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK; Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
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14
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Crick DCP, Sanderson E, Jones H, Goulding N, Borges MC, Clayton G, Carter AR, Halligan S, Lawlor DA, Khandaker GM, Fraser A. Glycoprotein acetyls and depression: Testing for directionality and potential causality using longitudinal data and Mendelian randomization analyses. J Affect Disord 2023; 335:431-439. [PMID: 37196932 PMCID: PMC7615476 DOI: 10.1016/j.jad.2023.05.033] [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: 02/01/2023] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Inflammation is associated with depression, but causality remains unclear. We investigated potential causality and direction of effect between inflammation and depression. METHODS Using data from the ALSPAC birth cohort (n = 4021; 42.18 % male), we used multivariable regression to investigate bidirectional longitudinal associations of GlycA and depression and depression symptoms, assessed at ages 18y and 24y. We used two-sample Mendelian randomization (MR) to investigate potential causality and directionality. Genetic variants for GlycA were obtained from UK Biobank (UKB) (N = 115,078); for depression from the Psychiatric Genomics Consortium and UKB (N = 500,199); and for depressive symptoms (N = 161,460) from the Social Science Genetic Association Consortium. In addition to the Inverse Variance Weighted method, we used sensitivity analyses to strengthen causal inference. We conducted multivariable MR adjusting for body mass index (BMI) due to known genetic correlation between inflammation, depression and BMI. RESULTS In the cohort analysis, after adjusting for potential confounders we found no evidence of associations between GlycA and depression symptoms score or vice versa. We observed an association between GlycA and depression (OR = 1∙18, 95 % CI: 1∙03-1∙36). MR suggested no causal effect of GlycA on depression, but there was a causal effect of depression on GlycA (mean difference in GlycA = 0∙09; 95 % CI: 0∙03-0∙16), which was maintained in some, but not all, sensitivity analyses. LIMITATIONS The GWAS sample overlap could incur bias. CONCLUSION We found no consistent evidence for an effect of GlycA on depression. There was evidence that depression increases GlycA in the MR analysis, but this may be confounded/mediated by BMI.
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Affiliation(s)
- Daisy C P Crick
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
| | - Eleanor Sanderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Hannah Jones
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Neil Goulding
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Maria Carolina Borges
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Gemma Clayton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Alice R Carter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Sarah Halligan
- Department of Psychology, University of Bath, Bath, UK; Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Deborah A Lawlor
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Golam M Khandaker
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; NIHR Bristol Biomedical Research Centre, Bristol, UK; Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | - Abigail Fraser
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
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15
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Armitage JM, Tseliou F, Riglin L, Dennison C, Eyre O, Bevan Jones R, Rice F, Thapar AK, Thapar A, Collishaw S. Validation of the Strengths and Difficulties Questionnaire (SDQ) emotional subscale in assessing depression and anxiety across development. PLoS One 2023; 18:e0288882. [PMID: 37467238 PMCID: PMC10355443 DOI: 10.1371/journal.pone.0288882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023] Open
Abstract
Emotional disorders are common in childhood, and their prevalence sharply increases during adolescence. The Strengths and Difficulties Questionnaire (SDQ) is widely used for screening emotional and behavioural difficulties in children and young people, but little is known about the accuracy of the emotional subscale (SDQ-E) in detecting emotional disorders, and whether this changes over development. Such knowledge is important in determining whether symptom changes across age are due to developmental or measurement differences. This study assessed the validity of the SDQ-E and two individual items (low mood and general worry) in differentiating between cases and non-cases of Major Depressive Disorder (MDD), Generalised Anxiety Disorder (GAD), and other anxiety disorders across ages 7, 10, 13, 15, and 25 years in a UK population cohort. Analyses showed moderate accuracy of the subscale in discriminating cases of MDD (AUC = 0.67-0.85), and high accuracy for discriminating cases of GAD (AUC = 0.80-0.93) and any anxiety disorder (AUC = 0.74-0.83) compared to non-cases. The SDQ-E performed well across ages and sex, and generally performed better than the two individual items. Together our findings validate the SDQ-E as a screen for emotional disorders during childhood, adolescence, and early adulthood, and as a tool for longitudinal research on depression and anxiety disorders.
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Affiliation(s)
- Jessica May Armitage
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Wales, United Kingdom
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Foteini Tseliou
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Wales, United Kingdom
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Lucy Riglin
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Wales, United Kingdom
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Charlotte Dennison
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Wales, United Kingdom
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Olga Eyre
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Wales, United Kingdom
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Rhys Bevan Jones
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Wales, United Kingdom
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Frances Rice
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Wales, United Kingdom
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Ajay K. Thapar
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Wales, United Kingdom
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Anita Thapar
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Wales, United Kingdom
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Stephan Collishaw
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Wales, United Kingdom
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
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16
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Yakovlev V, Lapato DM, Rana P, Ghosh P, Frye R, Roberson-Nay R. Neuron Enriched Exosomal MicroRNA Expression Profiles as a Marker of Early Life Alcohol Consumption. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.09.544235. [PMID: 37333185 PMCID: PMC10274862 DOI: 10.1101/2023.06.09.544235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Background Alcohol consumption may impact and shape brain development through perturbed biological pathways and impaired molecular functions. We investigated the relationship between alcohol consumption rates and neuron-enriched exosomal microRNA (miRNA) expression to better understand the impact of alcohol use on early life brain biology. Methods Neuron-enriched exosomal miRNA expression was measured from plasma samples collected from young people using a commercially available microarray platform while alcohol consumption was measured using the Alcohol Use Disorders Identification Test. Linear regression and network analyses were used to identify significantly differentially expressed miRNAs and to characterize the implicated biological pathways, respectively. Results Compared to alcohol naïve controls, young people reporting high alcohol consumption exhibited significantly higher expression of four neuron-enriched exosomal miRNAs including miR-30a-5p, miR-194-5p, and miR-339-3p, although only miR-30a-5p and miR-194-5p survived multiple test correction. The miRNA-miRNA interaction network inferred by a network inference algorithm did not detect any differentially expressed miRNAs with a high cutoff on edge scores. However, when the cutoff of the algorithm was reduced, five miRNAs were identified as interacting with miR-194-5p and miR-30a-5p. These seven miRNAs were associated with 25 biological functions; miR-194-5p was the most highly connected node and was highly correlated with the other miRNAs in this cluster. Conclusions Our observed association between neuron-enriched exosomal miRNAs and alcohol consumption concurs with results from experimental animal models of alcohol use and suggests that high rates of alcohol consumption during the adolescent/young adult years may impact brain functioning and development by modulating miRNA expression.
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Affiliation(s)
- Vasily Yakovlev
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Dana M Lapato
- Department of Human and Molecular Genetics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Preetam Ghosh
- Department of Computer Science, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Rebekah Frye
- Neuroscience Program, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Roxann Roberson-Nay
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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17
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Shakeshaft A, Blakey R, Kwong ASF, Riglin L, Davey Smith G, Stergiakouli E, Tilling K, Thapar A. Mental-health before and during the COVID-19 pandemic in adults with neurodevelopmental disorders. J Psychiatr Res 2023; 159:230-239. [PMID: 36753897 PMCID: PMC9885110 DOI: 10.1016/j.jpsychires.2023.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 01/11/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
The COVID-19 pandemic negatively impacted mental health globally. Individuals with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), are at elevated risk of mental health difficulties. We investigated the impact of the pandemic on anxiety, depression and mental wellbeing in adults with NDDs using data from the Avon Longitudinal Study of Parents and Children (n = 3058). Mental health data were collected pre-pandemic (age 21-25) and at three timepoints during the pandemic (ages 27-28) using the Short Mood and Feelings Questionnaire, Generalized Anxiety Disorder Assessment-7, and Warwick Edinburgh Mental Wellbeing Scale. ADHD and ASD were defined using validated cut-points of the Strengths and Difficulties Questionnaire and Autism Spectrum Quotient, self-reported at age 25. We used multi-level mixed-effects models to investigate changes in mental health in those with elevated ADHD/ASD traits compared to those without. Prevalences of depression, anxiety and poor mental wellbeing were higher at all timepoints (pre-pandemic and during pandemic) in those with ADHD and ASD compared to those without. Anxiety increased to a greater extent in those with ADHD (β = 0.8 [0.2,1.4], p = 0.01) and ASD (β = 1.2 [-0.1,2.5], p = 0.07), while depression symptoms decreased, particularly in females with ASD (β = -3.1 [-4.6,-1.5], p = 0.0001). On average, mental wellbeing decreased in all, but to a lesser extent in those with ADHD (β = 1.3 [0.2,2.5], p = 0.03) and females with ASD (β = 3.0 [0.2,5.9], p = 0.04). To conclude, anxiety disproportionately increased in adults with NDDs during the pandemic, however, the related lockdowns may have provided a protective environment for depressive symptoms in the same individuals.
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Affiliation(s)
- Amy Shakeshaft
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; Wolfson Centre for Young People's Mental Health, Cardiff University, UK
| | - Rachel Blakey
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Alex S F Kwong
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Division of Psychiatry, University of Edinburgh, UK
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; Wolfson Centre for Young People's Mental Health, Cardiff University, UK
| | - George Davey Smith
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Evie Stergiakouli
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Kate Tilling
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; Wolfson Centre for Young People's Mental Health, Cardiff University, UK.
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18
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Morales-Munoz I, Ashdown-Doel B, Beazley E, Carr C, Preece C, Marwaha S. Maternal postnatal depression and anxiety and the risk for mental health disorders in adolescent offspring: Findings from the Avon Longitudinal Study of Parents and Children cohort. Aust N Z J Psychiatry 2023; 57:82-92. [PMID: 35234057 PMCID: PMC9791327 DOI: 10.1177/00048674221082519] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The impacts of postnatal psychiatric disorders on different types of mental health problems in offspring are unclear. We investigated the prospective associations of maternal postnatal depression, and anxiety, with offspring depression, anxiety, psychotic-like experiences and Borderline Personality Disorder symptoms, in adolescence, and examined whether these were independent of each other. METHODS Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Maternal postnatal depression and anxiety at 8 weeks were measured using the Edinburgh Postnatal Depression Scale and Crown-Crisp Index, respectively. Offspring mental health outcomes were measured at 10-13 years old, using a variety of questionnaire-based and interview assessments. Logistic regression analyses were used to assess the associations between maternal postnatal risk factors and offspring mental health, and path analysis was used to investigate the pathways of maternal postnatal factors to adolescent offspring outcomes. RESULTS Data were available for 14,054 mothers with information reported on postnatal depression and 13,892 on postnatal anxiety. Logistic regression analyses found significant associations between maternal postnatal depression and offspring anxiety at 10 years old (odds ratio = 1.039, 95% confidence interval = [1.005, 1.073], p = 0.022) and between maternal postnatal anxiety and offspring psychotic experiences at 12/13 years old (odds ratio = 1.042, 95% confidence interval = [1.008, 1.077], p = 0.016). These significant associations remained after applying path analyses, when we controlled for potential offspring psychopathological overlay. CONCLUSION These findings suggest that mothers with postnatal depression are more likely to have offspring with anxiety at 10 years old, and that mothers with postnatal anxiety are more likely to have offspring with psychotic experiences at 12/13 years old. Our findings suggest specific pathways in the association between postnatal anxiety/depression and offspring mental health and contribute to the importance of identifying mothers and their offspring with increased vulnerability to adverse outcomes resulting from postnatal mental health disorders.
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Affiliation(s)
- Isabel Morales-Munoz
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK,Department of Public Health Solutions, Finnish Institute for Health and Welfare (THL), Helsinki, Finland,Isabel Morales-Muñoz, Institute for Mental Health, School of Psychology, University of Birmingham, 52 Pritchattss Road, Birmingham B15 2SA, UK.
| | - Brooklyn Ashdown-Doel
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Emily Beazley
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Camilla Carr
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Cristina Preece
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK,Specialist Mood Disorders Clinic, Birmingham and Solihull Mental Health NHS Trust, Birmingham, UK
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19
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Edmondson-Stait AJ, Shen X, Adams MJ, Barbu MC, Jones HJ, Miron VE, Allardyce J, Boardman JP, Lawrie SM, McIntosh AM, Khandaker GM, Kwong AS, Whalley HC. Early-life inflammatory markers and subsequent psychotic and depressive episodes between 10 to 28 years of age. Brain Behav Immun Health 2022; 26:100528. [PMID: 36277463 PMCID: PMC9582583 DOI: 10.1016/j.bbih.2022.100528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/01/2022] [Indexed: 11/05/2022] Open
Abstract
Inflammation is implicated in depression and psychosis, including association of childhood inflammatory markers on the subsequent risk of developing symptoms. However, it is unknown whether early-life inflammatory markers are associated with the number of depressive and psychotic symptoms from childhood to adulthood. Using the prospective Avon Longitudinal Study of Children and Parents birth cohort (N = up-to 6401), we have examined longitudinal associations of early-life inflammation [exposures: interleukin-6 (IL-6), C-reactive protein (CRP) levels at age 9y; IL-6 and CRP DNA-methylation (DNAm) scores at birth and age 7y; and IL-6 and CRP polygenic risk scores (PRSs)] with the number of depressive episodes and psychotic experiences (PEs) between ages 10-28 years. Psychiatric outcomes were assessed using the Short Mood and Feelings Questionnaire and Psychotic Like Symptoms Questionnaires, respectively. Exposure-outcome associations were tested using negative binomial models, which were adjusted for metabolic and sociodemographic factors. Serum IL-6 levels at age 9y were associated with the total number of depressive episodes between 10 and 28y in the base model (n = 4835; β = 0.066; 95%CI:0.020-0.113; pFDR = 0.041) which was weaker when adjusting for metabolic and sociodemographic factors. Weak associations were observed between inflammatory markers (serum IL-6 and CRP DNAm scores) and total number of PEs. Other inflammatory markers were not associated with depression or PEs. Early-life inflammatory markers are associated with the burden of depressive episodes and of PEs subsequently from childhood to adulthood. These findings support a potential role of early-life inflammation in the aetiology of depression and psychosis and highlight inflammation as a potential target for treatment and prevention.
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Affiliation(s)
- Amelia J. Edmondson-Stait
- Translational Neuroscience PhD Programme, Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Xueyi Shen
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Mark J. Adams
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Miruna C. Barbu
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Hannah J. Jones
- National Institute for Health Research Bristol Biomedical Research Centre, At University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Veronique E. Miron
- Medical Research Council Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, UK
| | | | - James P. Boardman
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
- Medical Research Council Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, UK
| | | | | | - Golam M. Khandaker
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Alex S.F. Kwong
- Centre for Clinical Brain Sciences, University of Edinburgh, UK
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20
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Di Cara NH, Winstone L, Sloan L, Davis OSP, Haworth CMA. The mental health and well-being profile of young adults using social media. NPJ MENTAL HEALTH RESEARCH 2022; 1:11. [PMID: 37994321 PMCID: PMC7615321 DOI: 10.1038/s44184-022-00011-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/04/2022] [Indexed: 11/24/2023]
Abstract
The relationship between mental health and social media has received significant research and policy attention. However, there is little population representative data about who social media users are which limits understanding of confounding factors between mental health and social media. Here we profile users of Facebook, Twitter, Instagram, Snapchat and YouTube from the Avon Longitudinal Study of Parents and Children population cohort (N=4,083). We provide estimates of demographics and mental health and well-being outcomes by platform. We find that users of different platforms and frequencies are not homogeneous. User groups differ primarily by sex and YouTube users are the most likely to have poorer mental health outcomes. Instagram and Snapchat users tend to have higher well-being than the other social media sites considered. Relationships between use-frequency and well-being differ depending on the specific well-being construct measured. The reproducibility of future research may be improved by stratifying by sex and being specific about the well-being constructs used.
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Affiliation(s)
- Nina H. Di Cara
- Department of Population Health Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Lizzy Winstone
- Department of Population Health Science, University of Bristol, Bristol, UK
| | | | - Oliver S. P. Davis
- Department of Population Health Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- The Alan Turing Institute, London, UK
| | - Claire M. A. Haworth
- The Alan Turing Institute, London, UK
- Department of Psychological Science, University of Bristol, Bristol, UK
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21
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Handakas E, Xu Y, Segal AB, Huerta MC, Bowman K, Howe LD, Sassi F, Robinson O. Molecular mediators of the association between child obesity and mental health. Front Genet 2022; 13:947591. [PMID: 36118877 PMCID: PMC9473726 DOI: 10.3389/fgene.2022.947591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/27/2022] [Indexed: 11/24/2022] Open
Abstract
Biological mechanisms underlying the association between obesity and depression remain unclear. We investigated the role of metabolites and DNA methylation as mediators of the relationship between childhood obesity and subsequent poor mental health in the English Avon Longitudinal Study of Parents and Children. Obesity was defined according to United Kingdom Growth charts at age 7 years and mental health through the Short Mood and Feelings Questionnaire (SMFQ) completed at age 11 years. Metabolites and DNA methylation were measured by nuclear magnetic resonance spectroscopy and Illumina array in blood at the age of 7 years. The associations between obesity and SMFQ score, as continuous count data or using cut-offs to define depressive symptoms (SMFQ >7) or depression (SMFQ >11), were tested using adjusted Poisson and logistic regression. Candidate metabolite mediators were identified through metabolome-wide association scans for obesity and SMFQ score, correcting for false-discovery rate. Candidate DNA methylation mediators were identified through testing the association of putative BMI-associated CpG sites with SMFQ scores, correcting for look-up false-discovery rate. Mediation by candidate molecular markers was tested. Two-sample Mendelian randomization (MR) analyses were additionally applied to test causal associations of metabolites with depression in independent adult samples. 4,018 and 768 children were included for metabolomics and epigenetics analyses, respectively. Obesity at 7 years was associated with a 14% increase in SMFQ score (95% CI: 1.04, 1.25) and greater odds of depression (OR: 1.46 (95% CI: 0.78, 2.38) at 11 years. Natural indirect effects (mediating pathways) between obesity and depression for tyrosine, leucine and conjugated linoleic acid were 1.06 (95% CI: 1.00, 1.13, proportion mediated (PM): 15%), 1.04 (95% CI: 0.99, 1.10, PM: 9.6%) and 1.06 (95% CI: 1.00, 1.12, PM: 13.9%) respectively. In MR analysis, one unit increase in tyrosine was associated with 0.13 higher log odds of depression (p = 0.1). Methylation at cg17128312, located in the FBXW9 gene, had a natural indirect effect of 1.05 (95% CI: 1.01,1.13, PM: 27%) as a mediator of obesity and SMFQ score. Potential biologically plausible mechanisms involving these identified molecular features include neurotransmitter regulation, inflammation, and gut microbiome modulation. These results require replication in further observational and mechanistic studies.
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Affiliation(s)
- Evangelos Handakas
- Μedical Research Council Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Yiwen Xu
- Centre for Health Economics and Policy Innovation, Department of Economics and Public Policy, Imperial College Business School, London, United Kingdom
| | - Alexa Blair Segal
- Centre for Health Economics and Policy Innovation, Department of Economics and Public Policy, Imperial College Business School, London, United Kingdom
| | - Maria Carmen Huerta
- Centre for Health Economics and Policy Innovation, Department of Economics and Public Policy, Imperial College Business School, London, United Kingdom
| | - Kirsty Bowman
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Laura D. Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Franco Sassi
- Centre for Health Economics and Policy Innovation, Department of Economics and Public Policy, Imperial College Business School, London, United Kingdom
| | - Oliver Robinson
- Μedical Research Council Centre for Environment and Health, Imperial College London, London, United Kingdom
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22
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Herbert A, Heron J, Barnes M, Barter C, Feder G, Meghrawi K, Szilassy E, Fraser A, Howe LD. Exploring the causal role of intimate partner violence and abuse on depressive symptoms in young adults: a population-based cohort study. BMC Med 2022; 20:1. [PMID: 35000596 PMCID: PMC8744329 DOI: 10.1186/s12916-021-02182-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/08/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Previous studies have shown an association between experience of intimate partner violence and abuse (IPVA) and depression. Whether this is a causal relationship or explained by prior vulnerability that influences the risk of both IPVA and depression is not known. METHODS We analysed data from the Avon Longitudinal Study of Parents and Children prospective cohort (N = 1764 women, 1028 men). To assess the causal association between IPVA at 18-21 years old and logged depressive symptom scores at age 23, we used (i) multivariable linear regression, (ii) inverse probability of treatment weighting (IPTW), and (iii) difference-in-difference (DiD) analysis, which compared the mean change in logged depressive symptom scores between ages 16 and 23 between those who experienced IPVA and those who did not. RESULTS Women who experienced IPVA had on average 26% higher depressive symptom scores after adjustment for measured confounders (ratio of geometric means 1.26, 95% CI 1.13 to 1.40). In men, the difference was 5% (ratio of geometric means 1.05, 95% CI 0.92 to 1.21). Results from IPTW analysis were similar. In the DiD analysis, there was no evidence that being exposed to IPVA affected the change in depressive symptom scores over time compared to being in the non-exposed group for either women (difference-in-differences 1%, -12 to 16%) or men (-1%, -19 to 20%). CONCLUSIONS Multivariable linear regression and IPTW suggested an association between IPVA and higher depressive symptom score in women but not men, but DiD analysis indicated a null effect in both women and men. This suggests the causal origins of higher depressive symptoms in this young adult population are likely to reflect prior vulnerability that leads to both higher depressive symptoms and increased risk of IPVA exposure.
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Affiliation(s)
- Annie Herbert
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Jon Heron
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Maria Barnes
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | | | - Gene Feder
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | | | - Eszter Szilassy
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Abigail Fraser
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Laura D Howe
- Department of Population Health Sciences, University of Bristol, Bristol, UK.
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
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23
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The antecedents and outcomes of persistent and remitting adolescent depressive symptom trajectories: a longitudinal, population-based English study. Lancet Psychiatry 2021; 8:1053-1061. [PMID: 34672991 DOI: 10.1016/s2215-0366(21)00281-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Depression often first emerges in adolescence and, for many, is a lifelong disorder. The long-term clinical course of depression is highly variable. We aimed to examine the adult outcomes of adolescent-onset trajectories of clinically significant depressive symptoms and to identify factors differentiating trajectories that persist and desist in adulthood. METHODS We included participants from the English population-based Avon Longitudinal Study of Parents and Children with data on depressive symptoms. Self-reported depression symptoms were assessed on ten occasions when participants were age 10·5-25 years using the short Mood and Feelings Questionnaire, and major depressive disorder episodes were assessed at age 13·0 years, 15·0 years, 17·5 years, and 25·0 years. We characterised trajectories of depression symptoms using latent class growth analysis, for which we required depression data at least once from each of three key phases: ages 10·5-13·5 years; 16·5-18·5 years; and 21-25 years. We examined adult outcomes by assessing lifetime suicidal self-harm and functional impairment at age 24·0 years, and employment, education, and the self-reported Strengths and Difficulties Questionnaire at age 25·0 years. FINDINGS We studied 4234 participants: 2651 (63%) female, 1582 (37%) male, and one individual with missing sex data. The mean age was 10·6 years (SD 0·2) at baseline and 25·8 years (SD 0·5) at the final timepoint. Data on ethnicity were not available in our data set. We identified four depression trajectory classes: adolescent-persistent depression with onset early in adolescence (7%, n≈279), adolescent-limited depression with onset later in adolescence and remittance by adult life (14%, n≈592), adult-increasing depression (25%, n≈1056), and stable-low levels of depression (54%, n≈2307). The adolescent-persistent class was associated with poor adult outcomes for functional impairment (62%), suicidal self-harm (27%), mental health difficulties (25%), and not being in education, employment, or training (16%). Adolescent-limited depression was associated with transient adolescent stress, but by early adulthood functional impairment and mental health difficulties were similar to the stable-low group. Major depressive disorder polygenic score (odds ratio [OR] 1·36, 95% CI 1·04-1·79), adolescent educational attainment (OR 0·47, 0·30-0·74), and any early childhood adversity (OR 2·60, 1·42-4·78), that persisted into adulthood (OR 1·60, 1·38-1·87) distinguished the adolescent-persistent and adolescent-limited groups. INTERPRETATION The future course of adolescent depression can be differentiated by age at onset during adolescence, adolescent academic attainment, early and persistent adversity, and genetic loading. A detailed social and educational history could be helpful in making clinical decisions about the intensity of interventions for young people with clinically elevated depressive symptoms who seek help. FUNDING Medical Research Council, Wolfson Centre for Young People's Mental Health, Wolfson Foundation.
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