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Zhang X, Zhou Y, Sun J, Yang R, Chen J, Cheng X, Li Z, Chen X, Yang C, Zhu X, Cao L. A cohort study of adolescents with depression in China: tracking multidimensional outcomes and early biomarkers for intervention. Gen Psychiatr 2022; 35:e100782. [PMID: 36118419 PMCID: PMC9422794 DOI: 10.1136/gpsych-2022-100782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/27/2022] [Indexed: 11/22/2022] Open
Abstract
Background Depression in adolescents is recognised as a global public health concern, but little is known about the trajectory of its clinical symptoms and pathogenesis. Understanding the nature of adolescents with depression and identifying early biomarkers can facilitate personalised intervention and reduce disease burden. Aims To track multidimensional outcomes of adolescents with depression and develop objective biomarkers for diagnosis, as well as response to treatment, prognosis and guidance for early identification and intervention. Methods This is a multidimensional cohort study on the Symptomatic trajectory and Biomarkers of Early Adolescent Depression (sBEAD). We planned to recruit more than 1000 adolescents with depression and 300 healthy controls within 5 years. Multidimensional clinical presentations and objective indicators are collected at baseline, weeks 4, 8, 12 and 24, and years 1, 2, 3, 4 and 5. Conclusions To the best of our knowledge, this is the first longitudinal cohort study that examines multidimensional clinical manifestations and multilevel objective markers in Chinese adolescents with depression. This study aims at providing early individualised interventions for young, depressed patients to reduce the burden of disease. Trial registration number Chinese Clinical Trial Registry ID ChiCTR2100049066.
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Affiliation(s)
- Xiaofei Zhang
- Department of Child and Adolescent Psychiatry, Early Detection and Intervention Center for Adolescent Mood Disorders, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yanling Zhou
- Department of Child and Adolescent Psychiatry, Early Detection and Intervention Center for Adolescent Mood Disorders, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jiaqi Sun
- Department of Child and Adolescent Psychiatry, Early Detection and Intervention Center for Adolescent Mood Disorders, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ruilan Yang
- Department of Child and Adolescent Psychiatry, Early Detection and Intervention Center for Adolescent Mood Disorders, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jianshan Chen
- Department of Child and Adolescent Psychiatry, Early Detection and Intervention Center for Adolescent Mood Disorders, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaofang Cheng
- Department of Radiology, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zezhi Li
- Deparment of Adult Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xinlei Chen
- Department of Child and Adolescent Psychiatry, Early Detection and Intervention Center for Adolescent Mood Disorders, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chanjuan Yang
- Department of Child and Adolescent Psychiatry, Early Detection and Intervention Center for Adolescent Mood Disorders, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xinhong Zhu
- Brain Disease and Health Reaserch Center, Pazhou Laboratory, Guangzhou, Guangdong, China
| | - Liping Cao
- Department of Child and Adolescent Psychiatry, Early Detection and Intervention Center for Adolescent Mood Disorders, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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Gajwani R, Wilson N, Nelson R, Gumley A, Smith M, Minnis H. Recruiting and exploring vulnerabilities among young people at risk, or in the early stages of serious mental illness (borderline personality disorder and first episode psychosis). Front Psychiatry 2022; 13:943509. [PMID: 35990053 PMCID: PMC9386049 DOI: 10.3389/fpsyt.2022.943509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Many gaps exist in our understanding of the developmental pathways to severe mental illness (SMI), including borderline personality disorder (BPD) and psychosis. However, those who have experienced adverse childhood experiences (ACEs) are at an increased risk and there is evidence to suggest that one of the earliest markers is emotional dysregulation. An area which has received relatively less research attention is the role neurodevelopmental disorders (NDDs) play. The aim of this feasibility study was therefore to explore the clinical profiles of young people early in the course of SMI, including their profiles of ACEs, emotional regulation difficulties, borderline personality traits and NDDs. METHODS A cross-sectional study of young people (aged 15-25) at risk of SMI, currently being seen within NHS mental health services, was conducted. This included those with early symptoms of psychosis and/or BPD as assessed by diagnostic interview. Eligible participants self-completed a battery of sociodemographic, clinical, and psychological measures in the company of a researcher. This included assessments of: symptoms of NDDs; borderline pathology traits; ACEs; and difficulties in emotional regulation. Statistical analyses included Mann-Whitney U tests and multiple regression. RESULTS Of the 118 potentially eligible participants who were referred, 48 were ultimately included in the study. Young people early in the course of SMI reported a high prevalence of ACEs and deficits in emotional regulation. In total, 79% met criteria for attention deficit hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD). Emotional dysregulation was found to significantly mediate the association between both ACEs and the frequency of NDDs and borderline personality traits, however given the small sample size these results are preliminary in nature. CONCLUSION Young people early in the course of SMI are at an increased risk of experiencing multiple childhood adversities and our results indicate a high prevalence of NDDs amongst them. Emotional dysregulation emerged as a potentially significant early marker of future clinical severity. We suggest that the clinical implications of our findings include routine screening for NDDs and ACEs and an increased recognition of the significance of emotional dysregulation. However, larger scale longitudinal studies are needed to investigate these preliminary findings further.
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Affiliation(s)
- Ruchika Gajwani
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom.,NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Naomi Wilson
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Rebecca Nelson
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Andrew Gumley
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom.,NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Michael Smith
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom.,NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Helen Minnis
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom.,NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
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