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Piccin J, Viduani A, Buchweitz C, Pereira RB, Zimerman A, Amando GR, Cosenza V, Ferreira LZ, McMahon NA, Melo RF, Richter D, Reckziegel FD, Rohrsetzer F, Souza L, Tonon AC, Costa-Valle MT, Zajkowska Z, Araújo RM, Hauser TU, van Heerden A, Hidalgo MP, Kohrt BA, Mondelli V, Swartz JR, Fisher HL, Kieling C. Prospective Follow-Up of Adolescents With and at Risk for Depression: Protocol and Methods of the Identifying Depression Early in Adolescence Risk Stratified Cohort Longitudinal Assessments. JAACAP OPEN 2024; 2:145-159. [PMID: 38863682 PMCID: PMC11163476 DOI: 10.1016/j.jaacop.2023.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 06/13/2024]
Abstract
Objective To present the protocol and methods for the prospective longitudinal assessments-including clinical and digital phenotyping approaches-of the Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo) study, which comprises Brazilian adolescents stratified at baseline by risk of developing depression or presence of depression. Method Of 7,720 screened adolescents aged 14 to 16 years, we recruited 150 participants (75 boys, 75 girls) based on a composite risk score: 50 with low risk for developing depression (LR), 50 with high risk for developing depression (HR), and 50 with an active untreated major depressive episode (MDD). Three annual follow-up assessments were conducted, involving clinical measures (parent- and adolescent-reported questionnaires and psychiatrist assessments), active and passive data sensing via smartphones, and neurobiological measures (neuroimaging and biological material samples). Retention rates were 96% (Wave 1), 94% (Wave 2), and 88% (Wave 3), with no significant differences by sex or group (p > .05). Participants highlighted their familiarity with the research team and assessment process as a motivator for sustained engagement. Discussion This protocol relied on novel aspects, such as the use of a WhatsApp bot, which is particularly pertinent for low- to-middle-income countries, and the collection of information from diverse sources in a longitudinal design, encompassing clinical data, self-reports, parental reports, Global Positioning System (GPS) data, and ecological momentary assessments. The study engaged adolescents over an extensive period and demonstrated the feasibility of conducting a prospective follow-up study with a risk-enriched cohort of adolescents in a middle-income country, integrating mobile technology with traditional methodologies to enhance longitudinal data collection.
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Affiliation(s)
- Jader Piccin
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Anna Viduani
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Claudia Buchweitz
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Rivka B. Pereira
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Aline Zimerman
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Guilherme R. Amando
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Victor Cosenza
- Universidade Federal de Pelotas (UFPEL), Pelotas, Brazil
| | | | - Natália A.G. McMahon
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | | | - Danyella Richter
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Frederico D.S. Reckziegel
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Fernanda Rohrsetzer
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Laila Souza
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - André C. Tonon
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marina Tuerlinckx Costa-Valle
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Zuzanna Zajkowska
- King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | | | - Tobias U. Hauser
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom, Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom and with Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Alastair van Heerden
- Human and Social Development, Human Sciences Research Council, Pietermaritzburg, South Africa and Medical Research Council/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Maria Paz Hidalgo
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Valeria Mondelli
- King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
- National Institute for Health and Care Research Maudsley Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | | | - Helen L. Fisher
- King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
- ESRC Centre for Society and Mental Health, King’s College London, London, United Kingdom
| | - Christian Kieling
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
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Yoon L, Rohrsetzer F, Battel L, Anés M, Manfro PH, Rohde LA, Viduani A, Zajkowska Z, Mondelli V, Kieling C, Swartz JR. Frontolimbic Network Topology Associated With Risk and Presence of Depression in Adolescents: A Study Using a Composite Risk Score in Brazil. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:426-435. [PMID: 35358744 DOI: 10.1016/j.bpsc.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/09/2022] [Accepted: 03/20/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND There have been significant challenges in understanding functional brain connectivity associated with adolescent depression, including the need for a more comprehensive approach to defining risk, the lack of representation of participants from low- and middle-income countries, and the need for network-based approaches to model connectivity. The current study aimed to address these challenges by examining resting-state functional connectivity of frontolimbic circuitry associated with the risk and presence of depression in adolescents in Brazil. METHODS Adolescents in Brazil ages 14 to 16 years were classified into low-risk, high-risk, and depressed groups using a clinical assessment and composite risk score that integrates 11 sociodemographic risk variables. After excluding participants with excessive head movement, resting-state functional magnetic resonance imaging data of 126 adolescents were analyzed. We compared group differences in frontolimbic network connectivity using region of interest-to-region of interest, graph theory, and seed-based connectivity analyses. Associations between self-reported depressive symptoms and brain connectivity were also explored. RESULTS Adolescents with depression showed greater dorsal anterior cingulate cortex (ACC) connectivity with the orbitofrontal cortex compared with the 2 risk groups and greater dorsal ACC global efficiency than the low-risk group. Adolescents with depression also showed reduced local efficiency and a lower clustering coefficient of the subgenual ACC compared with the 2 risk groups. The high-risk group also showed a lower subgenual ACC clustering coefficient relative to the low-risk group. CONCLUSIONS These findings highlight altered connectivity and topology of the ACC within frontolimbic circuitry as potential neural correlates and risk factors of developing depression in adolescents in Brazil. This study broadens our understanding of the neural connectivity associated with adolescent depression in a global context.
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Affiliation(s)
- Leehyun Yoon
- Department of Human Ecology, University of California, Davis, Davis, California
| | - Fernanda Rohrsetzer
- Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas Battel
- Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Mauricio Anés
- Division of Medical Physics and Radioprotection, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Pedro H Manfro
- Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luis A Rohde
- Institute of Developmental Psychiatry for Children and Adolescents, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; ADHD Outpatient and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Anna Viduani
- Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Zuzanna Zajkowska
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Valeria Mondelli
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, London, United Kingdom; National Institute for Health Research Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, King's College London, London, United Kingdom
| | - Christian Kieling
- Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Johnna R Swartz
- Department of Human Ecology, University of California, Davis, Davis, California.
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