Depression in young people: description, assessment and evidence-based treatment

Symptoms of depression and anxiety in young people in El Salvador: Associations with peer and family relationships, artistic activities and health behaviours during the COVID-19 pandemic

BACKGROUND

Little is known regarding the correlates of mental health, during the COVID-19 pandemic, in lower income countries. Using data from almost the entire population of graduating high school students in El Salvador, we examine the associations between depression and anxiety symptoms and potentially protective factors including peer and family relationships, health behaviours and artistic leisure activities.

METHODS

Data comes from the AVANZO survey conducted in El Salvador with 42,314 graduating high school students aged 15-21 in November 2020. Participants completed the Revised Child Anxiety and Depression Scale and Socioemotional Skills Scale. Using a structural equation modelling framework, we tested the associations between these variables and whether these associations varied by sex.

RESULTS

Participants who experienced more positive family relationships reported fewer symptoms of depression (β = -0.304, p < .001) and anxiety (β = -0.103, p < .001). Similar results were found between health behaviours and symptoms of depression (β = -0.398, p < .001), and anxiety (β = -0.312, p < .001). Peer relationships were non-significantly associated with depression and anxiety symptoms. Associations were similar for boys and girls.

LIMITATIONS

Students undertook the mental health survey as part of an academic test, which might have increased mental stress. The Socioemotional Skills Scales is newly developed, and results are cross-sectional.

CONCLUSIONS

Our findings provide insight into the experiences of an understudied population during the pandemic and identify positive family relationships and health behaviours as important correlates of mental health during this time.

Associations Between Children's Depressive Symptoms, Life Events, and Family Factors Among School-Aged Children

BACKGROUND

About 20-30% of children worldwide report depressive symptoms. This study examined associations between children's depressive symptoms, life events, and family factors.

METHODS

Nationally representative data (n = 95,725) were drawn from the 2017 School Health Promotion Study in Finland. The respondents were 4th and 5th grade pupils (aged 10-12) in primary schools and their parents/guardians (n = 33,726). Data were analyzed for child-parent dyads (n = 32,181). Associations were studied using cross tabulation and logistic regression models.

RESULTS

Children's reports of poor self-rated health, problems with family interactions, and the accumulation of life events were statistically significantly associated with depressive symptoms, also when controlling for sociodemographic factors. Financial situation and parent's depressed mood, both reported by parents, were associated with children's depressive symptoms when both were included in the regression model. However, this association disappeared when other predictors were added to the model.

CONCLUSION

The results make apparent the complex associations between children's depressive symptoms and family factors. Further research is needed on the discrepancies between parent and child experiences.

System Dynamics of Cognitive Vulnerabilities and Family Support Among Latina Children and Adolescents

The paper describes an approach to developing a data-driven development of a feedback theory of cognitive vulnerabilities and family support focused on understanding the dynamics experienced among Latina children, adolescents, and families. Family support is understood to be a response to avoidant and maladaptive behaviors that may be characteristic of cognitive vulnerabilities commonly associated depression and suicidal ideation. A formal feedback theory is developed, appraised, and analyzed using a combination of secondary analysis of qualitative interviews (N = 30) and quantitative analysis using system dynamics modeling and simulation. Implications for prevention practice, treatment, and future research are discussed.

Early identification of depressive symptoms in school-aged children: Psychometric properties and validation of a new short version of Short Mood & Feelings Questionnaire

BACKGROUND

Depressive mood is a common problem among children in Western countries. Professionals in school and other health services have an important role in identifying children at increased risk for depression. The Short Mood and Feelings Questionnaire (SMFQ) is a widely used screening tool, but its 13 items still make it quite time-consuming to complete. There is an urgent need for a quick and easy-to-complete self-report depressive mood scale for use in school health examinations.

AIM

This paper aims to describe and validate a revised version of SMFQ: FsMFQ-6 is intended as a short screening tool for the early identification of depressive symptoms in children.

METHODS

Nationally representative data (n = 95,725) were drawn from the 2017 School Health Promotion Study. The respondents were fourth- and fifth-grade pupils (aged 10-12) in Finnish primary schools. The data were analysed separately by gender. The construct validity of the scale was studied by principal component analysis and confirmatory factor analysis (CFA), convergent validity by both receiver operating characteristic (ROC) analysis and Spearman's correlation coefficient. Reliability was tested by Cronbach's alpha coefficient.

RESULTS

Principal component analysis yielded a one-component model: the Finnish Short Mood and Feelings Questionnaire 6 (FsMFQ-6). CFA confirmed the validity of FsMFQ-6. Compared with mood at home (AUC = 0.80) and mood at school (AUC = 0.85), overall sensitivity and specificity were optimal at cut-off point 0. Cronbach's alpha coefficient was 0.73, indicating good internal consistency. The results for girls and boys were almost identical.

CONCLUSION

The results confirmed the validity and reliability of FsMFQ-6. FsMFQ-6 recognises depressive mood in children and is suitable for screening depressive symptoms in fourth- and fifth-grade pupils in Finland. However, it is important to pay close attention to children who choose the 'Sometimes' response option more than once, for that can be a sign of depressive symptoms.

A Pilot Evaluation of the Rapid Response Program: A Home Based Family Therapy

A pilot evaluation study of the implementation of the Rapid Response Program, a program utilizing the ecosystemic structural family therapy model, in a rural area of Pennsylvania was conducted. This approach was implemented in children's mental health to supplant a costly model of care that had not proven to break the cycle of dependency for children with severe behavioral problems and their families. Initial results show that the Rapid Response Program appears to improve problematic family patterns and children's behavioral problems. The study results are limited by small sample size; however, the outcomes suggest that the program warrants further study using a more rigorous research design with a larger sample.

Assessing the Association Between Depression and Savings for Kenyan Youth Using a Validated Child Depression Inventory Measure

PURPOSE

The Child Depression Inventory (CDI) is a commonly used measure of depression among youth and has been used in studies conducted in sub-Saharan Africa demonstrating positive effects of financial asset-building interventions on physical and mental health outcomes. However, before we can be certain that asset building does indeed improve mental health functioning, we must first be sure that the instruments used to measure mental health in this population are valid and culturally appropriate.

METHODS

This two-part study used baseline data from a sample of youth (N = 1,348, 13-18 years) participating in the YouthSave-Impact Study Kenya to clarify the psychometric properties of the 10-item CDI (study A), and then used the 10-item CDI to assess the relationship between financial assets and mental health functioning among this sample of adolescents (study B).

RESULTS

Factor analysis on the 10-item CDI indicated a one-factor eight-item measure with excellent model fit. Invariance testing indicated that the measure performed differently for male and female respondents. Finally, using the latent structure as the dependent variable, the second part of the analysis established that cash savings were associated with depression. Female and male adolescents with savings reported lower depression (female β = -.17, p ≤ .003; male β = -.12, p ≤ .020) than other youth.

CONCLUSION

This study identified a reasonable one-factor eight-item depression measure that was noninvariant across gender. This validated measure was used to confirm the association between financial assets and mental health outcomes, hence, supporting the hypothesis that financial assets are associated with mental health outcomes.

Depression in youth recovering from concussion: Correlates and predictors

OBJECTIVES

Although depression can be a serious consequence of concussion, little is known about the factors that predict depression and concussion recovery outcomes in children. The purpose of this study was to explore the risk and possible predictors of developing significant depressive symptoms in children recovering from concussion.

METHODS

A prospective cohort study was conducted in a paediatric tertiary care clinic. Depression data were collected from 92 children using the Children's Depression Inventory-2 (CDI-2) screening tool. Correlations, t-tests and logistic regression were used to examine the associations between depression scores and demographic as well as injury-related factors.

RESULTS

Depressive symptoms were found in 22% of the children (T score on CDI-2 >65). Children with evidence of depressive symptomatology had significantly higher mean post-concussive symptom inventory (PCSI) scores in recovery (p = 0.004) than children who were not depressed. Variables of i) Sex; ii) hospital admission; iii) number of head injuries; iv) post-concussion symptom score and v) experience of prolonged symptoms were predictive of clinically significant CDI T scores, explaining 36% of the variation in the binary logistic model.

CONCLUSION

Depression is commonly reported in this subset of children. High post-concussive symptom scores and hospital admission were strong predictors of depression. Screening for depression should be standard practice in concussion management in children and youth.

Media representation of depression in young people: a corpus-based analysis of Irish newspaper coverage

Objectives

Newspaper media are an important source of information regarding mental health and have a significant influence on people’s awareness of, and decision making around, mental health issues. Depression in young people has seen increasing media attention in recent years, but few studies have examined media representation of mental health, specifically in young people. The current study used a quantitative approach to examine the words used in reports concerning depression in young people, in Irish broadsheets, published between 2007 and 2011.

Method

A sample of 269 texts, containing 176 223 words, was collected from three Irish broadsheet newspapers, using the search terms ‘depression’ or ‘depressed’ or ‘mental health’ and ‘youth’ or ‘young people’. A corpus-based approach was used to examine word frequencies, clusters and keywords.

Results

The analysis identified textual patterns, suggesting recurring associations between youth depression and suicide, and, to a lesser extent, alcohol use and bullying. Keywords relating to emotional distress and symptoms of depression were less frequent and sometimes associated with constructions inferring lack of agency (such as ‘suffering from’). A focus on the role of the parents was also evident. Of the professions mentioned, psychiatrists were referred to most often.

Conclusions

The analysis suggests that media coverage of depression in young people accurately reflects concerns reported in surveys by young people, but provides less information that might help in recognising depression in a young person.

Developmentally informed evaluation of depression: evidence-based instruments

This article has two primary aims: (1) to describe how to incorporate evidence-based assessment procedures into diagnostic practice and (2) to present a review of the more commonly used interview methods and clinical measures of depression among preschoolers, school-age children, and adolescents.

The clinical practice of Cognitive Behavioural Therapy for children and young people with a diagnosis of Asperger's Syndrome

Children and young people diagnosed with Asperger's Syndrome (AS) have significant social-communication difficulties and impaired empathy and theory of mind skills. These difficulties place them at risk of developing mental health problems, particularly anxiety, depression and obsessive compulsive disorder. Although Cognitive Behavioural Therapy (CBT) is recognised as an effective intervention for these problems in both child and adult populations, little research has specifically looked at the use of CBT with children and young people with an AS diagnosis. However, limited evidence suggests that CBT, if suitably adapted, is a feasible and potentially helpful treatment option. This paper focuses on the clinical practice of CBT and explores how the underpinning therapeutic relationship can be modified to meet the cognitive needs of this particular group of young clients.