Adolescent Depression Research Articles

Predictive models of post-traumatic stress disorder, complex post-traumatic stress disorder, depression, and anxiety in children and adolescents following a single-event trauma.

This study examined the power of theory-derived models to account for the development of PTSD, Complex PTSD (CPTSD), depression, and anxiety in children and adolescents who had experienced a single-event trauma. Children (n = 234, aged 8-17 years) recruited from local Emergency Departments were assessed at two and nine weeks post-trauma. Data obtained from self-report questionnaires completed by the child, telephone interviews with parents, and hospital data were used to develop four predictive models of risk factors for PTSD, CPTSD, depression, and Generalized Anxiety Disorder (GAD). ICD-11 proposed diagnostic criteria were used to generate measures for CPTSD and PTSD to assess for risk factors and identify the sample prevalence of these disorders. At nine weeks post-trauma, 64% did not meet criteria for any disorder, 23.5% met criteria for PTSD, and 5.2% met criteria for CPTSD. 23.9% and 10.7% had developed clinically significant symptoms of depression and GAD, respectively. A cognitive model was the most powerful predictive model, a psychosocial model was weak, and subjective markers of event severity were more powerful than objective measures. Youth exposed to single-incident trauma may develop different forms of psychopathology, and PTSD and CPTSD are frequently experienced alongside other conditions. The cognitive model of PTSD shows utility in identifying predictors of PTSD, CPTSD, depression, and GAD, particularly the role of trauma-related negative appraisals. This supports the application of cognitive interventions which focus upon re-appraising trauma-related beliefs in youth.

A Dose-Finding, Biomarker Validation, and Effectiveness Study of Transcranial Magnetic Stimulation for Adolescents With Depression

Research and clinical application of transcranial magnetic stimulation (TMS) for adolescents with major depressive disorder (MDD) has advanced slowly. Significant gaps persist in our understanding of optimized, age-specific protocols and dosing strategies. This study aimed to compare the clinical effects of 1 Hz versus 10 Hz TMS regimens and examine a biomarker-informed treatment approach with glutamatergic intracortical facilitation (ICF). Participants with moderate-to-severe symptoms of MDD were randomized to 30 sessions of left prefrontal 1 Hz or 10 Hz TMS, stratified by baseline ICF measures. The primary clinical outcome measure was the Children's Depression Rating Scale, Revised (CDRS-R). The CDRS-R and ICF biomarker were collected weekly. Forty-one participants received either 1 Hz (n = 22) or 10 Hz (n = 19) TMS treatments. CDRS-R scores improved compared to baseline in both 1 Hz and 10 Hz groups. For participants with low ICF at baseline, the overall least squares means of CDRS-R scores over the 6-week trial showed that depressive symptom severity was lower for the group treated with 1 Hz TMS than for those who received 10 Hz TMS. There were no significant changes in weekly ICF measurements across the 6 weeks of TMS treatment. Low ICF may reflect optimal glutamatergic N-methyl-d-aspartate (NMDA) receptor activity that facilitates the therapeutic effect of 1 Hz TMS through long-term depression-like mechanisms on synaptic plasticity. The stability of ICF suggests that it is a tonic, trait-like measure of NMDA receptor-mediated neurotransmission, with potential utility to inform parameter selection for therapeutic TMS in adolescents with MDD.

Depression Part 1: Evaluation.

By young adulthood, 1 in 5 teens will experience an episode of major depression. The second leading cause of death among youths aged 15 to 24 years is suicide, most of which will have been caused by untreated or undiagnosed depression. Depression is a highly heritable condition: depressed children often have depressed parents. Support to caregivers is important because depressed parents can have negative effects on children's development and future mental health. Groups more vulnerable to mental health disorders such as depression include Black, Indigenous, and persons of color and lesbian, gay, bisexual, transgender, or queer/questioning, who in recent years have the highest rate of suicide attempts (Black teens, sexual minority youth), the highest increases in suicide rates (Black children and youths), and the highest suicide rates (American Indian/Alaskan native). They frequently experience more adverse childhood events, which increases the risk of depression and suicide attempts. Pediatricians are most likely to care for these vulnerable youths, who often are less engaged in specialty mental health care for a variety of reasons, including stigma and barriers to access. By offering behavioral and mental health care to vulnerable populations in primary care, mental health equity may be achieved. Screening for depression and assessment for suicide are within the scope of pediatric practice and among the competencies recommended by the American Academy of Pediatrics and The American Board of Pediatrics.

90 The association between risk of depression and combined vigorous physical activity and screen time behaviours in French-speaking Belgian adolescents

Abstract Purpose While there is a clear consensus on the positive effect of physical activity on reducing the risk of depression, the literature on the association between screen time and risk of depression is rather conflicting. Also, no clear consensus has been reached on whether being sufficiently active could alleviate the negative effects of being sedentary on mental health. The purpose of this study was to investigate the association of combined vigorous physical activity (VPA) and screen time (ST) behaviours with the risk of depression (RD) in Belgian adolescents. Methods The analysis used data collected through self-reported questionnaires from 8412 adolescents aged 10 to 20 included in the 2022 “Health Behaviour in School-aged Children” (HBSC) study in French-speaking schools. RD was measured using the World Health Organisation Five Well-being Index (WHO-5), with scores ≤28/100 indicating RD. VPA and ST behaviours were identified by combining data on ST (TV, video games and internet use) and VPA in three categories: (1) low ST (total weekly ST < 4hours/day), independently of VPA; (2) high VPA-high ST (VPA≥3 times/week and total weekly ST ≥ 4hours/day) and (3) low VPA-high ST (VPA<3 times/week and total weekly ST ≥ 4hours/day). The association between RD and VPA-ST behaviours was measured using adjusted binary logistic regression. Results In 2022, 15.4% had low ST, 40.6% high VPA-high ST, and 44.0% low VPA-high ST behaviours. Moreover, 13.2% were at risk of depression. This prevalence was eight times higher in low VPA-high ST (62.9%) and four times higher in high VPA-high ST (29.5%) than in low ST (7.6%) adolescents. After adjusting for sociodemographic characteristics, body mass index and sleep duration, adolescents with low VPA-high ST behaviours were more likely to be at risk of depression (aOR=1.17, 95%CI: 1.31-2.35) compared to those with low ST, but this was not the case for those who had high VPA-high ST (aOR=1.18, 95%CI: 0.81-1.71). Conclusion These findings suggest that having either low ST or sufficient VPA may be protective for RD in adolescents. With ST increasing and PA remaining low in French-speaking Belgian adolescents, health promotion initiatives should continue to promote both PA and the reduction of sedentary behaviours in adolescents.

Interventional approaches to treatment resistant depression (DTR) in children and adolescents: A systematic review and meta-analysis

BackgroundMajor depressive disorder (MDD) is highly prevalent in youth. Conventional treatment paradigms primarily involve selective serotonin reuptake inhibitors (SSRIs) and psychotherapy, yet a significant proportion of this population exhibits treatment-resistant depression (TRD). In adults, interventional therapies like Electroconvulsive Therapy (ECT), repetitive Transcranial Magnetic Stimulation (rTMS), and ketamine have shown promise for TRD, but their comparative efficacy remains underexplored in Adolescent and pediatric population. This systematic review and meta-analysis aims to assess the relative effectiveness of ECT, rTMS, and ketamine in treating TRD among adolescents. MethodsFollowing PRISMA guidelines, we systematically searched databases for studies of ECT, rTMS, or ketamine for treatment-resistant depression in youth ages 10–24. Three reviewers independently screened for inclusion based on predefined criteria. Included observational and randomized controlled trials reported depression symptoms with measures like HDRS and MADRS in youth treated with ECT, rTMS, or ketamine. Two reviewers extracted data on interventions, patients, and depression symptom outcomes. Chance-adjusted inter-reviewer agreement was calculated. For meta-analysis, we pooled standardized mean differences (SMDs) in depression scores using random effects models and assessed heterogeneity with I2 statistics. ResultsMeta-analysis of 10 observational studies examined SMD in depression scores for treatment resistant depression patients treated with ECT, ketamine, or rTMS. Patients treated with ECT had a significantly lower SMD of 1.99 (95 % CI 0.92–3.05, p < 0.001) compared to baseline. Patients treated with ketamine also had a significantly lower SMD of 1.58 (95 % CI 1.04–2.12, p < 0.001). Patients treated with rTMS had the lowest SMD of 2.79 (95 % CI 0.79–4.80, p = 0.006). There was no significant difference between the three groups overall (p > 0.05). Comparative analysis between ECT and ketamine found no significant difference in SMD (p = 0.387). Comparison of ECT versus rTMS found a significant difference in SMD favoring rTMS (p = 0.004). Comparison of ketamine versus rTMS suggested a potential difference in SMD favoring rTMS (p = 0.058). In summary, rTMS resulted in significantly larger reductions in depression scores than ECT, and potentially larger reductions than ketamine. ConclusionsThis meta-analysis illustrates the ability of rTMS, ECT, and ketamine to improve depression in youth. rTMS resulted in the largest improvements, highlighting its potential as a first-line treatment for pediatric treatment-resistant depression given its favorable side effect profile compared to ECT. Further research directly comparing these modalities is needed.

Defense mechanisms mediate associations between exposure to adverse childhood experiences and anxiety and depression in Kenyan adolescents.

Defense mechanisms mediate associations between exposure to adverse childhood experiences and anxiety and depression in Kenyan adolescents.

Adverse childhood experiences and depression, anxiety, and eating disorders: The mediating role of intolerance of uncertainty and emotion regulation difficulty.

Adverse childhood experiences and depression, anxiety, and eating disorders: The mediating role of intolerance of uncertainty and emotion regulation difficulty.

Heterogeneity in trajectories of traumatic distress at the start of the COVID-19 pandemic.

The COVID-19 outbreak has led to an increase in posttraumatic stress symptoms (PTSSs; Prout et al., 2020) for some individuals, whereas others appeared to be more resilient. It remains relatively unclear what characterizes these potentially different response trajectories ( Chen & Bonanno, 2020). This study sought to (a) assess individuals' PTSS levels at the start of the pandemic and at two subsequent timepoints 3 and 6 months later, (b) identify different trajectories of PTSSs over time, and (c) describe which individual characteristics influenced the likelihood of each of these different trajectories to occur. A community sample (n = 317) responded to an online survey during the first weeks of the pandemic, 3 and 6 months later. Among those who reported acute levels of PTSSs, latent class growth analyses identified three different resilience trajectories-resilient (low baseline PTSSs and a slight decrease over time), chronic (severe PTSSs at baseline and no change over time), and recovered (severe PTSSs at baseline but a sharp improvement over time). Baseline childhood adversity, depression, anxiety, defensive functioning, and somatization predicted trajectories. Demographics (age, gender, preexisting chronic illness) and COVID-related factors (knowing someone diagnosed with or who died of COVID-19) were unrelated to trajectories. Results suggest that although high PTSS levels decreased over time on average, heterogenous change trajectories can be identified based on baseline psychological characteristics. This implies that mental health, including past and present experiences, as well as adaptational mechanisms may shape individuals' experiences with pandemic-related ongoing stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Effect of Adolescent Therapeutic Group Therapy and Cognitive Behavioral Therapy in the Occurrence of Depression

Adolescents are tasked with developing identity vs. role confusion, where the search for identity will shape the individual's character. There has been an increase in the use of social media among adolescents, causing an increase in the number of depression in adolescents. The need for promotive and preventive efforts to prevent depression in adolescents. This study aims to determine the effect of therapeutic group therapy and cognitive behavioral therapy in preventing depression in adolescent social media users. This study was conducted on 70 students aged 15-18 years old using a purposive sampling technique according to inclusion and exclusion criteria. This study uses a quasi-experimental pre-post-test design with intervention and control groups. The intervention group was given therapeutic and cognitive behavioral therapy, and the control group was given therapeutic group therapy without cognitive behavioral therapy. The results of this study indicate a significant effect on the control group. The combination of therapeutic group therapy therapy and cognitive behavioral therapy can be recommended as a therapy for reducing depression in adolescent social media users.

Microglial PCGF1 alleviates neuroinflammation associated depressive behavior in adolescent mice.

Epigenetics plays a crucial role in regulating gene expression during adolescent brain maturation. In adolescents with depression, microglia-mediated chronic neuroinflammation may contribute to the activation of cellular signaling cascades and cause central synapse loss. However, the exact mechanisms underlying the epigenetic regulation of neuroinflammation leading to adolescent depression remain unclear. In this study, we found that the expression of polycomb group 1 (PCGF1), an important epigenetic regulator, was decreased both in the plasma of adolescent major depressive disorder (MDD) patients and in the microglia of adolescent mice in a mouse model of depression. We demonstrated that PCGF1 alleviates neuroinflammation mediated by microglia in vivo and in vitro, reducing neuronal damage and improving depression-like behavior in adolescent mice. Mechanistically, PCGF1 inhibits the transcription of MMP10 by upregulating RING1B/H2AK119ub and EZH2/H3K27me3 in the MMP10 promoter region, specifically inhibiting microglia-mediated neuroinflammation. These results provide valuable insights into the pathogenesis of adolescent depression, highlighting potential links between histone modifications, neuroinflammation and nerve damage. Potential mechanisms of microglial PCGF1 regulates depression-like behavior in adolescent mice. Microglial PCGF1 inhibits NF-κB/MAPK pathway activation through regulation of RING1B/H2AK119ub and EZH2/H3K27me3 in the MMP10 promoter region, which attenuates neuroinflammation and ameliorates depression-like behaviors in adolescent mice.

Effects of a Parent-Child Single-Session Growth Mindset Intervention on Adolescent Depression and Anxiety Symptoms: Protocol of a 3-Arm Waitlist Randomized Controlled Trial.

Depression and anxiety are common mental health problems among adolescents worldwide. Extant research has found that intelligence, emotion, and failure-is-debilitating beliefs (fixed mindsets) are closely related to more depression and anxiety symptoms, hopelessness, and suicidality. Recent research also points to the importance of parental mindset, which can strongly influence children's affect, behavior, and mental health. However, the effects of parent-child mindset interventions on a child's internalizing problems have not yet been empirically examined. As recent evidence has shown the promise of single-session interventions in reducing and preventing youth internalizing problems, this study develops and examines a parent and child single-session intervention on mindsets of intelligence, failure, and emotion (PC-SMILE) to tackle depression and anxiety in young people. Using a 3-arm randomized controlled trial, this study will examine the effectiveness of PC-SMILE in reducing depression and anxiety symptoms among children. We hypothesize that compared to the waitlist control group, the PC-SMILE group and child single-session intervention on mindsets of intelligence, failure, and emotion (C-SMILE) group will significantly improve child depression and anxiety (primary outcome) and significantly improve secondary outcomes, including children's academic self-efficacy, hopelessness, psychological well-being, and parent-child interactions and relationships, and the PC-SMILE is more effective than the C-SMILE. A total of 549 parent-child dyads will be recruited from 8 secondary schools and randomly assigned to either the PC-SMILE intervention group, the C-SMILE intervention group, or the no-intervention waitlist control group. The 45-minute interventions include parent-version and child-version. Both parents and students in the PC-SMILE group receive the intervention. Students in C-SMILE group receive intervention and their parents will receive intervention after all follow-up ends. Students in 3 groups will be assessed at 3 time points, baseline before intervention, 2 weeks post intervention, and 3 months post intervention, and parents will be assessed in baseline and 3-month follow-up. The intention-to-treat principle and linear-regression-based maximum likelihood multilevel models will be used for data analysis. Recruitment started in September 2023. The first cohort of data collection is expected to begin in May 2024 and the second cohort will begin in September 2024. The final wave of data is expected to be collected by the end of the first quarter of 2025. The results are expected to demonstrate improved anxiety and depression among students assigned to the intervention condition, as well as the secondary outcomes compared to those in the control group. The efficacy and effectiveness of the intervention will be discussed. This study is the first attempt to develop a web-based single-session intervention for students and their parents to enhance their well-being in Hong Kong and beyond, which potentially contributes to providing evidence-based recommendations for the implementation of brief digital parent-child interventions. PRR1-10.2196/63220.

Ziziphus Jujube Polysaccharides inhibit over-abundance of fecal butyric acid in mildly stressed growing mice to ameliorate depression-like behavior

The microbial-gut-brain axis is the main pathway that induces depression in adolescents. In Chinese medicine, Ziziphus Jujube Polysaccharides (ZJP) are recognized for their capacity to modulate gut microbiota and bolster immune function, suggesting their potential as a therapeutic agent for mitigating youth depression. In this study, a 44 d chronic unpredictable mild stress (CUMS) model was used to investigate how ZJP alleviates depression-like behavior in male C57BL/6 mice. The administration of ZJP ameliorated depression-like behavior, down-regulated serum levels of TNF-α, IL-1β, IL-2, IL-6, and up-regulated hippocampal 5-HT. Correlation analysis revealed that fecal butyric acid (BA) concentration was positively correlated with depression-like behavior index (P＜0.05). ZJP modified the gut microbiota by replenishing deficient saccharides (fructose, galactose, rhamnose, arabinose), diminishing the prevalence of SCFA-producing bacteria (Alistipes, Lachnospiraceae, Colidextribacter). Additionally, ZJP decreased the gene abundance of the sugar and SCFA metabolism pathways, and related enzymes in the gut of model mice, thereby reversing butyrate enrichment and ameliorating associated depression-like behavior. In summary, ZJP stabilized the intestinal microbiota structure and balanced the BA metabolism in CUMS mice by regulating the metabolism of gut microbiota-sugar-SCFAs, thereby improving depression-like behavior.

The unmet mental health needs of adolescents with HIV in eastern Tanzania: Experiences of healthcare providers, adolescents, and caregivers.

Adolescents with Human Immunodeficiency Virus (HIV) are at greater risk for mental health problems than their HIV-negative counterparts. However, there is a dearth of evidence on the need for mental health services, including interventions for depression in adolescents with HIV (AWHIV), in most low- and middle-income countries (LMICs). This study's objective was to explore the unmet mental health needs of AWHIV to inform the development and implementation of a psychological intervention for depression in AWHIV in Dar es Salaam, Tanzania. A descriptive phenomenological qualitative study design was used. Consultative meetings with providers and 45 in-depth interviews were conducted with AWHIV, caregivers, and healthcare providers (HCPs) to explore their experiences and unmet mental health needs for AWHIV. Data from the consultative meetings were triangulated to validate the obtained information with those from interviews. Data were organized and managed with the aid of NVIvo-11. The thematic analysis framework guided data analysis. Five major themes emerged: Experience of complex symptoms, unmet need for services, impact of the unmet needs, ways utilized in managing symptoms, and preferred intervention. Complex depressive symptoms expressed as physical, behavioral, or somatic complaints adversely affected ART adherence and academic performance, led to substance use, and compromised overall quality of life in AWHIV. HIV-Care and Treatment Centers (HIV-CTCs) did not conduct formal mental health screenings. Instead, caregivers and HCPs addressed the symptoms of mental health problems with death threats and corporal punishments. No evidence-based depression interventions existed in HIV-CTCs for observed symptoms. This study reports on unmet mental health needs with a clear impact on the lives of AWHIV, which may have significant implications for treatment adherence. There is an urgent need to develop and implement effective and scalable interventions to address these mental health needs.

Depression and anxiety in transgender and non-binary adolescents: prevalence and associations between adolescent and caregiver reports.

Though adolescent and caregiver reports were low to moderately correlated, youth reports were consistently higher, suggesting the importance of interventions to increase caregiver understanding of TNB adolescent mental health. • Transgender/non-binary adolescents are at high risk for mental health concerns and caregivers are essential to coordinate care. • This study expands the diagnostic mental health sub-categories examined in transgender/non-binary adolescents, noting elevated symptoms of separation and social anxiety. • Transgender/non-binary adolescents reported more symptoms of depression, generalized anxiety, separation anxiety, and social anxiety than caregivers.

Mirtazapine as a Treatment for Adolescent Depression and PTSD in Juvenile Detention Settings: A Case Report.

Mirtazapine as a Treatment for Adolescent Depression and PTSD in Juvenile Detention Settings: A Case Report.

Exploring the sports participation, muscle-strengthening exercise and active commuting with comorbidity of depression and anxiety among Chinese children and adolescents: a cross-sectional study.

Hence, the primary objective of this study was to examine the relationship between sport participation, muscle-strengthening exercise (MSE), and active commuting (AC) in the co-occurrence of depression and anxiety in Chinese children and adolescents. This cross-sectional investigation occurred in various cities across the southeastern region of China between March 2021 and October 2021. A convenient sampling method was utilized. We invited children and adolescents to participate in the questionnaire survey. A total of 1,996 participants completed the questionnaires with the endorsement of their parents or guardians under the supervision of schoolteachers and headmasters. Girls comprised 47.5% of the participants, and the average age of participants was 14.8 ± 2.0 years. We conducted a logistic regression analysis, including 95% confidence intervals, to explore the association between sports participation, MSE, AC, and the co-occurrence of depression and anxiety. No significant association was observed between weekday active commuting for travelling to and from school and MSE and the comorbidity of depression and anxiety in children and adolescents. A negative association was only detected for those who engaged in muscle-strengthening exercises 4 days a week (OR = 0.540, 95% CI = 0.345-0.845) compared to those who did not partake in such exercises. The present study has provided evidence of the connection between sports participation and the co-occurrence of depression and anxiety among Chinese children and adolescents. Sports participation is more likely to help adolescents relieve anxiety and depression than AC, MSE. In forthcoming research, it is imperative to delve deeper into strategies that enhance the impact of sports on the mental well-being of children and young individuals. Furthermore, optimizing the magnitude of this effect may be achievable by focusing on neurobiological, behavioral, and psychosocial mechanisms.

Prevalence and risk factors of depression in juvenile systemic lupus erythematosus

Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organ systems, including the central nervous system. Depression is one of the neuropsychiatric manifestations of juvenile SLE . Objective To estimate the prevalence of depressive disorders in juvenile SLE and identify its potential risk factors. Methods This cross-sectional study was conducted in juvenile SLE patients at Dr. Mohammad Hoesin General Hospital, Palembang. Sociodemographic data and medications were recorded. Disease activity of SLE was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Physical activity was measured using the Physical Activity Questionnaire for Children (PAQ-C) and the Physical Activity Questionnaire for Adolescents (PAQ-A). All subjects were screened for depression using the Childhood Depression Inventory (CDI) questionnaire. Multiple linear regression analyses were used to determine risk factors for depressive disorders. Results We included 72 patients, of whom 67 (93.1%) were female. Mean age of the patients was 12 years 4 months (SD 2 years 6 months); most (67; 93.1%) were 10-18 years of age. Depression was found in 24 patients (33.3%). SLEDAI scores of ?3 (flare) were found in 54 patients (75%) and low physical activity was found in 62 (86.1%) patients. The prevalence of depression based on the Children's Depression Inventory was 33.3%. A SLEDAI score of ?3 and low physical activity were significantly associated with depression (P=0.009 and P=0.025, respectively). On multiple linear regression analysis, only SLEDAI score of ?3 remained significantly associated with depression (P= 0.017; OR 12.6; 95%CI 1.6–101.7). Gender, age, family economic status, father's education, mother's education, family history of depression, and duration of illness were not associated with depression. Conclusion A SLEDAI score indicating flare (?3) and low physical activity are significantly associated with an increased risk of depression. A SLEDAI score is an independent risk factor for depression when all other significant risk factors are considered.

Body weight and eating attitudes influence improvement of depressive symptoms in children and pre-adolescents with eating disorders: a prospective multicenter cohort study

BackgroundPediatric patients with eating disorders in a multicenter joint study on 11 facilities were enrolled and prospectively investigated to determine whether improvement in body weight, eating attitudes, and psychosocial factors in children with eating disorders would also improve depressive symptoms.MethodsIn this study, 91 patients were enrolled between April 2014 and March 2016. The severity of underweight was assessed using the body mass index-standard deviation score (BMI-SDS), eating behavior was assessed using the children's eating attitude test (ChEAT26), the outcome of childhood eating disorders was assessed using the childhood eating disorder outcome scale, and depressive symptoms were assessed using the Children's Depression Inventory (CDI) score.ResultsAfter 12 months of treatment, depressive symptoms were evaluated in 62 of the 91 cases where it was evaluated at the initial phase. There was no difference in background characteristics between the included patients and the 29 patients who dropped out. A paired-sample t-test revealed a significant decrease in CDI scores after 12 months of treatment (p < 0.001, 95% CI: 2.401–7.373) and a significant increase in the BMI-SDS (p < 0.001, 95% CI: − 2.41973–1.45321). Multiple regression analysis revealed that BMI-SDS and ChEAT26 scores at the initial phase were beneficial in CDI recovery. In addition, BMI-SDS at the initial phase was useful for predicting BMI-SDS recovery after 12 months of treatment.ConclusionsDepressive symptoms in children with eating disorders improved with therapeutic intervention on body weight and eating attitudes.Trial registrationThe Clinical Trial Number for this study is UMIN000055004.

Developing An Engaging Computerized Cognitive Behavioural Therapy for Adolescent Depression

The implementation of computerized cognitive behavioural therapy (cCBT) among adult patients has been proven effective but the effectiveness of using cCBT to treat depression among adolescents is still not clear to date. The problem lies in the failure to engage adolescents with the computerized therapy. Engagement with computerized therapy is deemed as crucial as the outcome of the therapy relies on the engagement between patients and the cCBT. In order to ensure the engagement, the cCBT has to be usable and fulfil the adolescents’ needs and requirements. Hence, this study designs and develops a cCBT for adolescent depression based on an engagement model proposed. The results showed that the engagement between adolescents and the cCBT is satisfactory despites having some limitations. This shows that adolescent’s engagement with cCBT can be maintained effectively if the cCBT is designed and developed to meet their needs and requirements.

Symptoms of Depression, Eating Disorders, and Binge Eating in Adolescents With Obesity

Depression and eating disorders are heightened for adolescents with obesity. Clinical reviews alongside self-report questionnaires are important to ensure appropriate intervention. To evaluate changes in self-report symptoms of depression, eating disorders, and binge eating in adolescents with obesity during the Fast Track to Health trial. This was a randomized clinical trial conducted from 2018 to 2023. It was a multisite trial conducted at children's hospitals in Sydney, New South Wales, and Melbourne, Victoria, Australia, and included adolescents (13-17 years) with obesity (defined as adult equivalent body mass index ≥30; calculated as weight in kilograms divided by height in meters squared) and 1 or more related complications. Duration was 52 weeks including a very low energy diet for 4 weeks followed by intermittent energy restriction (IER) or continuous energy restriction (CER). Self-report symptoms of depression (Center for Epidemiologic Studies Depression Scale-Revised 10-Item Version for Adolescents [CESDR-10]; scores 0-30), eating disorders (Eating Disorder Examination Questionnaire [EDE-Q]; scores 0-6), and binge eating (Binge Eating Scale [BES]; scores 0-46) were assessed. Adolescents were screened for depression and eating disorders (weeks 0, 4, 16, and 52) and monitored for the onset of new symptoms of disordered eating during dietetic consults. Of 141 adolescents (median [IQR] age, 14.8 [12.9-17.9] years; 71 male [50.4%]) enrolled, median baseline EDE-Q score was 2.28 (IQR, 1.43-3.14), median baseline CESDR-10 score was 9.00 (IQR, 4.00-14.50), and median baseline BES score was 11.00 (IQR, 5.00-17.00). There were no differences between groups for change in CESDR-10 (mean difference at week 52, 0.75; 95% CI, -1.86 to 3.37), EDE-Q (mean difference at week 52, 0.02; 95% CI, -0.41 to 0.45), or BES (mean difference at week 52, -2.91; 95% CI, -5.87 to 0.05). The within-group reductions at week 4 were maintained at week 52, for CESDR-10 and EDE-Q, indicating reduced symptoms of depression and eating disorders. Within-group reductions on the BES were maintained in the IER group only. Seventeen adolescents (12.1%) required support or referral for depression and/or disordered eating, including 7 (5%; 5 IER, 2 CER) adolescents who experienced the onset or reemergence of symptoms during the intervention. Results suggest that many treatment-seeking adolescents with obesity self-reported symptoms of depression and eating disorders. Although symptoms reduced for most, some required additional support. Obesity treatment is an opportune time to screen and monitor for depression and disordered eating. Australian New Zealand Clinical Trials Registry: ACTRN12617001630303.