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Muyiduli X, Zhang R, Zhang J, Zhe W, Dong Y, Wang W, Fang P, Zhang Y, Zhang S, Sulidan A, Rejiafu S, Sun J. Prevalence and relevant factors of depression among adolescents in Xinjiang, China: A cross-sectional survey. Medicine (Baltimore) 2024; 103:e37090. [PMID: 38363909 PMCID: PMC10869075 DOI: 10.1097/md.0000000000037090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/05/2024] [Indexed: 02/18/2024] Open
Abstract
The aim of this study is to elucidate the prevalence of depression and examine the contributing factors to depression among adolescents in Xinjiang, China. A stratified cluster sampling methodology was employed in this study, with the sample size determined through consideration of prior studies on adolescent depression. Employing this approach, 6 schools were chosen from each prefecture-level city, designated as urban areas, and 3 schools were selected from each county. Subsequently, individual classes were treated as units, and a minimum of 80 students from each grade were surveyed within the entire class. The investigation of adolescents involved the administration of a questionnaire assessing the factors influencing depression, along with the Center for Epidemiologic Studies Depression Scale (CES-D). Multivariate linear regression was used to analyze the influencing factors of depression. The occurrence rates of depression were 12.17%, 13.05%, 12.32%, and 9.29% in junior middle school, senior middle school, vocational high school, and college, respectively. The corresponding CES-D scores were 10.54 ± 8.26, 11.20 ± 8.37, 12.17 ± 6.94, and 11.33 ± 6.28. Significant associations with the CES-D score were observed for gender, smoking, alcohol consumption, and spending more than 4 hours online daily across the educational levels mentioned. The risk of experiencing depressive symptoms was elevated among female junior and senior high school students who spent more than 4 hours daily on the internet, engaged in cigarette smoking, and consumed alcohol. The findings underscore the significance of targeting high-risk groups, particularly through home-school collaborations, to mitigate excessive internet use and consequently reduce the likelihood of depressive symptoms in students.
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Affiliation(s)
- Xiamusiye Muyiduli
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Rong Zhang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Jun Zhang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Wei Zhe
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yan Dong
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Wenlei Wang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Ping Fang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yi Zhang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Song Zhang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Adila Sulidan
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Shawulaxi Rejiafu
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Jingxuan Sun
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
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Kim JS, Wang B, Kim M, Lee J, Kim H, Roh D, Lee KH, Hong SB, Lim JS, Kim JW, Ryan N. Prediction of Diagnosis and Treatment Response in Adolescents With Depression by Using a Smartphone App and Deep Learning Approaches: Usability Study. JMIR Form Res 2023; 7:e45991. [PMID: 37223978 DOI: 10.2196/45991] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/25/2023] [Accepted: 04/18/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Lack of quantifiable biomarkers is a major obstacle in diagnosing and treating depression. In adolescents, increasing suicidality during antidepressant treatment further complicates the problem. OBJECTIVE We sought to evaluate digital biomarkers for the diagnosis and treatment response of depression in adolescents through a newly developed smartphone app. METHODS We developed the Smart Healthcare System for Teens At Risk for Depression and Suicide app for Android-based smartphones. This app passively collected data reflecting the social and behavioral activities of adolescents, such as their smartphone usage time, physical movement distance, and the number of phone calls and text messages during the study period. Our study consisted of 24 adolescents (mean age 15.4 [SD 1.4] years, 17 girls) with major depressive disorder (MDD) diagnosed with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version and 10 healthy controls (mean age 13.8 [SD 0.6] years, 5 girls). After 1 week's baseline data collection, adolescents with MDD were treated with escitalopram in an 8-week, open-label trial. Participants were monitored for 5 weeks, including the baseline data collection period. Their psychiatric status was measured every week. Depression severity was measured using the Children's Depression Rating Scale-Revised and Clinical Global Impressions-Severity. The Columbia Suicide Severity Rating Scale was administered in order to assess suicide severity. We applied the deep learning approach for the analysis of the data. Deep neural network was employed for diagnosis classification, and neural network with weighted fuzzy membership functions was used for feature selection. RESULTS We could predict the diagnosis of depression with training accuracy of 96.3% and 3-fold validation accuracy of 77%. Of the 24 adolescents with MDD, 10 responded to antidepressant treatments. We predicted the treatment response of adolescents with MDD with training accuracy of 94.2% and 3-fold validation accuracy of 76%. Adolescents with MDD tended to move longer distances and use smartphones for longer periods of time compared to controls. The deep learning analysis showed that smartphone usage time was the most important feature in distinguishing adolescents with MDD from controls. Prominent differences were not observed in the pattern of each feature between the treatment responders and nonresponders. The deep learning analysis revealed that the total length of calls received as the most important feature predicting antidepressant response in adolescents with MDD. CONCLUSIONS Our smartphone app demonstrated preliminary evidence of predicting diagnosis and treatment response in depressed adolescents. This is the first study to predict the treatment response of adolescents with MDD by examining smartphone-based objective data with deep learning approaches.
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Affiliation(s)
- Jae Sung Kim
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Bohyun Wang
- Department of Computer Science, Gachon University, Seongnam, Republic of Korea
| | - Meelim Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Jung Lee
- Integrative Care Hub, Children's Hospital, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyungjun Kim
- AI.ble Therapeutics Inc, Seoul, Republic of Korea
| | - Danyeul Roh
- AI.ble Therapeutics Inc, Seoul, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soon-Beom Hong
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Joon Shik Lim
- Department of Computer Science, Gachon University, Seongnam, Republic of Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Neal Ryan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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Fitriana E, Purba FD, Salsabila SP, Danasasmita FS, Afriandi I, Tarigan R, Ichsan A, Pandia V. Psychometric Properties of the Suicidal Ideation Scale in the Indonesian Language. J Prim Care Community Health 2022; 13:21501319221143716. [PMID: 36524691 PMCID: PMC9761796 DOI: 10.1177/21501319221143716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Suicide is one of the leading cause of mortality among adolescents and young adults, especially in low to middle-income countries. Research found that screening for suicidal ideation in non-clinical populations such as schools or communities is an important step toward preventing suicide. Despite so, not all screening tools have the capabilities to accurately detect suicidal ideation among adolescents and young adults in non-clinical populations. The Suicidal Ideation Scale (SIS) is one of the most used questionnaires to measure suicidal thoughts in non-clinical populations. This study aims to investigate the psychometric properties of SIS among adolescents and young adults in Indonesia, especially in non-clinical populations. METHODS After a series of language and cultural adaptations, 1254 senior high school and university students completed the Indonesian version of SIS using 3 standard questionnaires, namely Patient Health Questionnaire-9/PHQ-9, Beck Depression Inventory-II/BDI-II, and Children's Depression Inventory/CDI. The SIS content validity, internal consistency, test-retest reliability and concurrent, as well as internal structure validity, were investigated using content validity index (CVI), Cronbach's Alpha, Pearson product-moment correlation, and confirmatory factor analysis (CFA), respectively. RESULTS The result showed that SIS has good to excellent internal consistency and test-retest reliability. Based on the validity indicators, it has satisfactory content and convergent validity, and further support the one-factor and 2-factor model for factorial validity. Both one-factor and 2 factor model are suitable to use in non-clinical settings. CONCLUSIONS SIS is a valid and reliable tool for suicide ideation screening in adolescents and young adults in non-clinical populations. This validated questionnaire can be used in the early detection of suicidal ideation among adolescents and young adults in non-clinical populations, thus contributing to developing strategies and policies to prevent suicide among Indonesian adolescents and young adults at group and institutional levels.
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Affiliation(s)
- Efi Fitriana
- Department of General and Experimental
Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia,Efi Fitriana, Department of General and
Experimental Psychology, Faculty of Psychology Universitas Padjadjaran,
Kabupaten Sumedang, Jawa Barat, 45363, Indonesia.
| | - Fredrick Dermawan Purba
- Department of Developmental Psychology,
Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
| | - Safira Putri Salsabila
- Undergraduate Study Program in
Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
| | - Febrianti Santiardi Danasasmita
- Department of Psychiatry, Faculty of
Medicine, Universitas Padjadjaran – dr. Hasan Sadikin General Hospital, Bandung,
Indonesia
| | - Irvan Afriandi
- Department of Public Health, Faculty of
Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Rodman Tarigan
- Department of Child Health, Faculty of
Medicine, Universitas Padjadjaran – dr. Hasan Sadikin General Hospital, Bandung,
Indonesia
| | - Abdullah Ichsan
- Department of Psychiatry, Faculty of
Medicine, Universitas Padjadjaran – dr. Hasan Sadikin General Hospital, Bandung,
Indonesia
| | - Veranita Pandia
- Department of Psychiatry, Faculty of
Medicine, Universitas Padjadjaran – dr. Hasan Sadikin General Hospital, Bandung,
Indonesia
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Kim G, Shin J, Kim JW. The mediating role of internalizing and externalizing symptoms in the relationship between childhood trauma and suicidality among adolescents: a structural equation model. Child Adolesc Psychiatry Ment Health 2021; 15:79. [PMID: 34949214 PMCID: PMC8705103 DOI: 10.1186/s13034-021-00434-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study is to investigate the direct and indirect effects of childhood trauma, internalizing symptoms, and externalizing symptoms on suicidality among adolescents, thereby establishing a structural equation model. METHODS The present study uses a cross-sectional descriptive design. Among 147 adolescents aged 12-17, 93 outpatients diagnosed with major depressive disorder and 54 controls were included in the study. They completed the Early Trauma Inventory Self-Report (Short Form) and Columbia Suicidality Severity Rating Scale. Their parents completed the Child Behavior Checklist. Analyses were performed using Pearson's correlation and structural equation modelling. RESULTS Childhood trauma had both direct and indirect effects, via internalizing symptoms and externalizing symptoms, on suicidality. Internalizing symptoms had a direct effect on suicidality. Meanwhile, externalizing symptoms were not directly associated with suicidality, but indirectly associated via internalizing symptoms. CONCLUSIONS Findings provide in-depth understanding of the mediating role of internalizing symptoms and externalizing symptoms in the relationship between childhood trauma and suicidality, suggesting that the therapeutic interventions for both internalizing symptoms and externalizing symptoms may be important to prevent suicide in adolescents with childhood trauma.
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Affiliation(s)
- Gangsan Kim
- grid.412484.f0000 0001 0302 820XDepartment of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jiyoon Shin
- grid.412484.f0000 0001 0302 820XDepartment of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea ,grid.31501.360000 0004 0470 5905Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Won Kim
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea. .,Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Kim H, Kim K, Kim JW. The Reliability and Validity of the Korean Version of the Mood and Feelings Questionnaire for Depression in Youth: A Cross-Cultural Perspective. Child Psychiatry Hum Dev 2021; 52:399-408. [PMID: 32671498 DOI: 10.1007/s10578-020-01026-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We aimed to assess cross-cultural differences in depressive symptoms and the validity of the Korean version of the Mood and Feelings Questionnaire (MFQ). Four hundred and sixty-four children and adolescents (aged 7-19, 278 girls) with any psychiatric diagnosis, 290 of whom had major depressive disorder, were included. The levels of depressive symptoms in children and adolescents were evaluated by children/adolescents and their parents. We conducted Pearson's r and Cronbach's α, confirmative factor analysis and item response theory tests. The Korean version of the MFQ demonstrated excellent criterion validity and discriminant validity. There were no cultural differences in the clinical manifestations of depression in youth from Western countries and Korea. Korean youths with depression were more likely to complain of cognitive and emotional symptoms than somatic symptoms. The Korean version of the MFQ demonstrated promising psychometric properties in a clinical sample of children and adolescents.
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Affiliation(s)
- Haebin Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Kyoungmin Kim
- Department of Psychiatry, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Jae-Won Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea. .,Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea. .,Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Choi CH, Lee J, Lee KH, Hong SB, Kim SH, Han JY, Kim JW, Cho SC, Kim JW. Effects of Antidepressant Treatment on Symptom Measures of Attention in Adolescents with Depression: A Preliminary Open-Label Study. J Child Adolesc Psychopharmacol 2021; 31:288-293. [PMID: 33417814 DOI: 10.1089/cap.2020.0101] [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: 11/13/2022]
Abstract
Objective: The effects of selective serotonin reuptake inhibitor (SSRI) on deficits in attention and executive function in adolescents with major depressive disorder (MDD) are relatively unknown. We aimed to investigate changes in symptom measures of attention in adolescents with MDD treated with escitalopram. Methods: The study included 82 MDD adolescents and 54 healthy controls aged from 12 to 17 years. Symptom measures of attention were assessed using the Attention-Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS) and Child Behavior Checklist attention problems scale at baseline and during week 8. Adolescents who showed at least 40% improvement in the Children's Depression Rating Scale-Revised (CDRS-R) scores from baseline to week 8 were referred to as "responders." Results: No baseline differences were found between the responders (n = 47) and nonresponders (n = 35) in their age, sex, intelligence quotient, CDRS-R score, and attention measures. Linear mixed models showed significant group-by-time interaction effect in the ADHD-RS inattention subscale score, but not in the other attention measures. Conclusion: Our results suggest that treating depressive symptoms with SSRI may lead to improvements in attention in MDD adolescents. Monitoring changes in symptom measures of attention can be useful when treating adolescents with MDD. ClinicalTrials.gov identifier: NCT03547219.
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Affiliation(s)
- Chi-Hyun Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Jung Lee
- Integrative Care Hub, Seoul National University Children's Hospital, Seoul, Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
| | - Soon-Beom Hong
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
| | - Seong-Hae Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
| | - Ji-Youn Han
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
| | - Jun Won Kim
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Soo Churl Cho
- Department of Psychiatry, Armed Forces Capital Hospital, Seongnam-si, Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
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Stallwood E, Monsour A, Rodrigues C, Monga S, Terwee C, Offringa M, Butcher NJ. Systematic Review: The Measurement Properties of the Children's Depression Rating Scale-Revised in Adolescents With Major Depressive Disorder. J Am Acad Child Adolesc Psychiatry 2021; 60:119-133. [PMID: 33130251 DOI: 10.1016/j.jaac.2020.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 09/30/2020] [Accepted: 10/23/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To systematically appraise existing evidence of the measurement properties of the Children's Depression Rating Scale-Revised (CDRS-R) in adolescents with major depressive disorder (MDD). The CDRS-R is the most commonly used scale in adolescent depression research, yet was originally designed for use in children 6 to 12 years old. METHOD Seven databases were searched for studies that evaluated the measurement properties of the CDRS-R in adolescents (ages 12-18 years). Of 65 studies screened by full-text, 6 were included. Measurement properties were appraised using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. The COSMIN minimum requirements for recommending the use of an outcome measurement instrument are (1) evidence for sufficient content validity (any level of evidence), and (2) at least low-quality evidence for sufficient internal consistency. RESULTS Four studies assessed an English-language version of the CDRS-R; the other 2 assessed German and Korean versions, respectively. No study assessed content validity, cross-cultural validity/measurement invariance, or measurement error of the CDRS-R in adolescents with MDD. Low-quality evidence was found for sufficient construct validity (n = 4 studies) and responsiveness (n = 2 studies) assessed via comparator instruments. Very-low-quality evidence was found for sufficient interrater reliability (n = 2 studies). The results for structural validity (n = 3 studies) and internal consistency (n = 5 studies) were inconclusive. CONCLUSION It remains unclear whether the CDRS-R appropriately measures depressive symptom severity in adolescent MDD. Before use of the CDRS-R in adolescent MDD research can be recommended, evidence of sufficient psychometric properties in adolescents with MDD is needed.
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Affiliation(s)
- Emma Stallwood
- Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Andrea Monsour
- Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Craig Rodrigues
- Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Suneeta Monga
- Hospital for Sick Children, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Caroline Terwee
- Amsterdam UMC, Vrije Universiteit Amsterdam, and the Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Martin Offringa
- Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - Nancy J Butcher
- Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Ontario, Canada.
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The indirect effect of peer problems on adolescent depression through nucleus accumbens volume alteration. Sci Rep 2020; 10:12870. [PMID: 32733056 PMCID: PMC7392894 DOI: 10.1038/s41598-020-69769-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/13/2020] [Indexed: 11/15/2022] Open
Abstract
Literature suggests that neurobiological factors such as brain structure play an important role in linking social stress with depression in adolescence. We aimed to examine the role of subcortical volumetric alteration in the association between peer problems as one type of social stress and adolescent depression. We hypothesized that there would be indirect effects of peer problems on adolescent depression through subcortical volumetric alteration. Seventy eight adolescents with major depressive disorder (MDD) (age mean [SD] = 14.9 ± 1.5, 56 girls) and 47 healthy controls [14.3 ± 1.4, 26 girls]) participated in this study. High-resolution structural T1 images were collected using the Siemens 3T MR scanner. Subcortical volumes were segmented using the Freesurfer 6.0 package. Peer problems were assessed using the Peer-Victimization Scale and the Bullying-Behavior Scale. There was a significant indirect effect of peer problems on adolescent depression through nucleus accumbens (NAcc) volume alteration, but not through the amygdala and hippocampal volumes. This result supported our model, which stated that peer problems have indirect effects through subcortical volumetric alteration (i.e., increased NAcc volume) on adolescent depression. Our finding suggests that altered NAcc volume may serve as a pathway, through which peer problems as one type of social stressor contribute to adolescent depression.
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Lee J, Lee KH, Kim SH, Han JY, Hong SB, Cho SC, Kim JW, Brent D. Early changes of serum BDNF and SSRI response in adolescents with major depressive disorder. J Affect Disord 2020; 265:325-332. [PMID: 32090756 DOI: 10.1016/j.jad.2020.01.045] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 12/11/2019] [Accepted: 01/12/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Recent evidence suggests that brain-derived neurotrophic factor (BDNF) levels and their early changes may predict antidepressant response in adults with major depressive disorder (MDD). However, in adolescents, BDNF levels in depression and their changes during antidepressant treatment are relatively unknown. We aimed to investigate whether pre-treatment BDNF levels and their early changes predict antidepressant response in depressed adolescents. METHODS The study included 83 MDD adolescents and 52 healthy controls aged 12 to 17 years. All depressed adolescents were treated with escitalopram in an 8 week, open-label trial. Depression severity and serum BDNF level at baseline, and weeks 2 and 8 were measured with the Children's Depression Rating Scale-Revised (CDRS-R) and ELISA, respectively. RESULTS Responders showed a significant decrease in BDNF levels at week 2 but non-responders and healthy controls had no changes in BDNF levels at week 2. The early decrease (baseline - week 2) of BDNF levels predicted SSRI response with moderate sensitivity and specificity. Logistic regression analysis revealed that early BDNF decrease predicted SSRI response at week 8 after controlling for other demographic and clinical variables. LIMITATIONS The follow-up duration of the study was limited in 8 weeks. It remains possible that serum BDNF levels would have changed with longer treatment. CONCLUSIONS This is the first longitudinal study to investigate the effect of antidepressants on BDNF levels in adolescents with MDD. Our findings suggest that a decrease of serum BDNF levels in early phase of SSRI treatment may be associated later SSRI response in adolescents with MDD.
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Affiliation(s)
- Jung Lee
- Integrative Care Hub, Children's Hospital, Seoul National University Hospital, Seoul, South Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Seong Hae Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Ji Youn Han
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Soon-Beom Hong
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Soo-Churl Cho
- Department of Psychiatry, Korea Armed Forces Capital Hospital, Gyenggi-do, South Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.
| | - David Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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Shin J, Kim KM, Lee KH, Hong SB, Lee J, Choi CH, Han JY, Kim SH, Suh DE, Cho SC, Kim JW. Psychometric properties and factor structure of the Korean version of the screen for child anxiety related emotional disorders (SCARED). BMC Psychiatry 2020; 20:89. [PMID: 32111188 PMCID: PMC7049176 DOI: 10.1186/s12888-020-02505-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 02/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the psychometric properties of the Korean version of Screen for Child Anxiety Related Emotional Disorders (SCARED) on a sample of Korean youths and to examine the cross-cultural differences in adolescents' anxiety. METHODS Our study included 147 adolescents (ages 12-17, 92 girls), 93 with major depressive disorder and 54 as controls. Participants were evaluated using the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL), SCARED, Child Behavior Checklist (CBCL), Disruptive Behavioral Disorder Scale (DBD) and Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Pearson's r and Cronbach's α values of the SCARED were calculated, and exploratory factor analysis was conducted. RESULTS The Korean SCARED scores were correlated with the total anxiety scores of K-SADS-PL (r = 0.74) and the CBCL anxious/depressed subscale scores (r = 0.35). Results showed a five-factor structure with good internal consistency, in which some items were loaded on different factors compared to previous studies. CONCLUSIONS The Korean SCARED demonstrated promising psychometric properties, and could be a valid scale for screening anxiety symptoms in primary care. The fact that different items comprised the factors may reflect the cultural difference between United States and Korea in experiencing anxiety.
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Affiliation(s)
- Jiyoon Shin
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-Ro, Chongno-Gu, Seoul, 03080, Republic of Korea
| | - Kyoung Min Kim
- Department of Psychiatry, Dankook University College of Medicine, Cheonan, 31116, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-Ro, Chongno-Gu, Seoul, 03080, Republic of Korea
| | - Soon-Beom Hong
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-Ro, Chongno-Gu, Seoul, 03080, Republic of Korea
| | - Jung Lee
- Integrative Care Hub, Seoul National University Children's Hospital, Seoul, 03080, Republic of Korea
| | - Chi-Hyun Choi
- Department of Psychiatry, Seoul National University Boramae Medical Center, Seoul, 07061, Republic of Korea
| | - Ji Youn Han
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-Ro, Chongno-Gu, Seoul, 03080, Republic of Korea
| | - Seong Hae Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-Ro, Chongno-Gu, Seoul, 03080, Republic of Korea
| | - Da Eun Suh
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-Ro, Chongno-Gu, Seoul, 03080, Republic of Korea
| | - Soo-Churl Cho
- Department of Psychiatry, Korea Armed Forces Capital Hospital, Bundang, Republic of Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-Ro, Chongno-Gu, Seoul, 03080, Republic of Korea.
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