Adolescent Depressive Disorder Research Articles

Hair androgen concentrations and depressive disorders in adolescents from the general population

Although the link between androgens and depression is well established in adults, the effects of cofactors on this association are less clearly understood, particularly in youth. Epidemiological cohort study of adolescents in Dresden, Germany. Analyses comprised data of 985 individuals assessed at baseline and of 512 individuals at 1-year follow-up. We investigated multivariable regression models for cross-sectional and longitudinal associations of hair testosterone, dehydroepiandrosterone (DHEA), and their cortisol ratios with 12-month diagnoses of major depressive disorder (MDD) and MDD without any anxiety disorder assessed with standardized diagnostic interview (DIA-X-5), and with dimensional depression scores (PHQ-9, PROMIS), separately for males and females. The potential moderating effect of social support was determined. Cross-sectional analyses yielded inverse associations of testosterone and DHEA with MDD and MDD without any anxiety disorders in males. In cross-sectional and longitudinal analyses, baseline ratio cortisol/DHEA was significantly, inversely associated to PROMIS-depression in males. Only cross-sectional associations for ratio cortisol/DHEA and PROMIS-depression remained significant after Bonferroni-Holm correction. No robust associations were observed in female participants. Social support exerted no consistent moderating effect on the investigated association. The present observational cohort study showed no consistent association of hair androgen concentrations with depressive disorders in adolescents. However, findings provide some support for the association between the cortisol/DHEA ratio and depression in males. Longitudinal research designs in large samples are needed to understand the interplay between androgens, depression, and developmental and social factors in youth.

Predictors, Moderators, and Mediators Associated With Treatment Outcome in Randomized Clinical Trials Among Adolescents With Depression

The application of precision medicine principles for the treatment of depressive disorders in adolescents requires an examination of the variables associated with depression outcomes in randomized clinical trials (RCTs). To describe predictors, moderators, and mediators associated with outcomes in RCTs for the treatment of depressive disorders in adolescents. A scoping review of RCTs for the treatment of depression in adolescents was conducted. Databases searched included MEDLINE, Embase, APA PsycInfo, and CINAHL. Included publications tested predictors, moderators, and/or mediators associated with depression symptom outcomes (eg, symptom reduction, response, remission) in RCTs pertaining to the treatment of adolescents, ages 13 to 17 years. Predictors were defined as variables that were associated with depression outcomes, independent of treatment group. Moderators were defined as baseline variables that were associated with differential outcomes between treatment groups. Mediators were defined by a formal mediation analysis. In duplicate, variables were extracted and coded with respect to analysis type (univariable or multivariable), statistical significance, direction of effect size, reporting of a priori hypotheses, and adjustment for multiple comparisons. Aggregated results were summarized by variable domain and RCT sample. Eighty-one articles reporting on variables associated with outcomes across 33 RCTs were identified, including studies of biological (10 RCTs), psychosocial (18 RCTs), and combined (4 RCTs) treatments as well as a service delivery model (1 RCT). Fifty-three variable domains were tested as baseline predictors of depression outcome, 41 as moderators, 19 as postbaseline predictors, and 5 as mediators. Variable domains that were reported as significant in at least 3 RCTs included age, sex/gender, baseline depression severity, early response to treatment, sleep changes, parent-child conflict, overall psychopathology, suicidal ideation, hopelessness, functional impairment, attendance at therapy sessions, and history of trauma. Two publications reported a priori hypotheses and adjustment for multiple comparisons, both finding that baseline depression severity and family conflict were associated with poorer outcomes. This review identified commonly researched variables requiring more scrutiny as well as underresearched variables to inform future study designs. Further efforts to discover predictors, moderators, and mediators associated with treatment response have great potential to optimize care for adolescents with depression.

Family Conflict Associated With Intrinsic Hippocampal-OFC Connectivity in Adolescent Depressive Disorder.

BackgroundFamily environment and life events have long been suggested to be associated with adolescent depression. The hippocampus plays a crucial role in the neural mechanism of major depressive disorder (MDD) through memory during stressful events. However, few studies have explored the exact neural mechanisms underlying these associations. Thus, the current study aimed to explore alterations in hippocampal functional connectivity (FC) in adolescent MDD based on resting-state functional magnetic resonance imaging and further investigate the relationship between hippocampal FC, environmental factors, and clinical symptom severity.MethodsHippocampal FC was calculated using the seed-based approach with the bilateral hippocampus as the seed for 111 adolescents with and without MDD; comparisons were made between participants with MDD and controls. We applied the Chinese version of the Family Environment Scale (FES-CV) and Adolescents Self-Rating Life Events Checklist (ASLEC) to evaluate family environment and life stress. Their relationship with hippocampal FC alterations was also investigated.ResultsWe found that compared to controls, adolescents with MDD showed decreased connectivity between the left hippocampus and bilateral orbital frontal cortex (OFC) and right inferior temporal gyrus. In addition, the hippocampal-OFC connectivity was negatively correlated with conflict scores of the FES-CV in the MDD group and mediated the association between family conflict and depressive and anxiety symptoms.ConclusionOur findings are novel in the field and demonstrate how family conflict contributes to MDD symptomatology through hippocampal-OFC connectivity; these findings may provide potential targets for personalized treatment strategies.

Distinguish bipolar and major depressive disorder in adolescents based on multimodal neuroimaging: Results from the Adolescent Brain Cognitive Development study®.

BackgroundMajor depressive disorder and bipolar disorder in adolescents are prevalent and are associated with cognitive impairment, executive dysfunction, and increased mortality. Early intervention in the initial stages of major depressive disorder and bipolar disorder can significantly improve personal health.MethodsWe collected 309 samples from the Adolescent Brain Cognitive Development study, including 116 adolescents with bipolar disorder, 64 adolescents with major depressive disorder, and 129 healthy adolescents, and employed a support vector machine to develop classification models for identification. We developed a multimodal model, which combined functional connectivity of resting-state functional magnetic resonance imaging and four anatomical measures of structural magnetic resonance imaging (cortical thickness, area, volume, and sulcal depth). We measured the performances of both multimodal and single modality classifiers.ResultsThe multimodal classifiers showed outstanding performance compared with all five single modalities, and they are 100% for major depressive disorder versus healthy controls, 100% for bipolar disorder versus healthy control, 98.5% (95% CI: 95.4–100%) for major depressive disorder versus bipolar disorder, 100% for major depressive disorder versus depressed bipolar disorder and the leave-one-site-out analysis results are 77.4%, 63.3%, 79.4%, and 81.7%, separately.ConclusionsThe study shows that multimodal classifiers show high classification performances. Moreover, cuneus may be a potential biomarker to differentiate major depressive disorder, bipolar disorder, and healthy adolescents. Overall, this study can form multimodal diagnostic prediction workflows for clinically feasible to make more precise diagnose at the early stage and potentially reduce loss of personal pain and public society.

Diagnostic Test Accuracy of the Beck Depression Inventory for Detecting Major Depression in Adolescents: A Systematic Review and Meta-Analysis.

Major depressive disorder in adolescents is closely linked to poor social, cognitive, and academic outcomes, including suicidality. The Beck Depression Inventory (BDI), a screening tool, is one of the most widely used instruments for detecting depression; however, its diagnostic test accuracy has not yet been thoroughly examined. This study, therefore, aimed to systematically review and perform a meta-analysis to evaluate the accuracy of the BDI for detecting depression in adolescents. In August 2020, a search was conducted in the EMBASE, MEDLINE, CINAHL, and PsycArticles databases, and following a review against predefined eligibility criteria, 22 studies were finally included. The quality of the included articles was evaluated, and a hierarchical regression model was used to calculate the pooled estimates of sensitivity and specificity; 73.0% (95% CI; 62.0%, 81.8%) and 80.3% (72.8%, 86.1%) in cutoff 16, respectively. The findings indicated the BDI is a reliable and useful tool to screen adolescents' depression.

Dynamic risk for first onset of depressive disorders in adolescence: does change matter?

Risk factors for depressive disorders (DD) change substantially over time, but the prognostic value of these changes remains unclear. Two basic types of dynamic effects are possible. The 'Risk Escalation hypothesis' posits that worsening of risk levels predicts DD onset above average level of risk factors. Alternatively, the 'Chronic Risk hypothesis' posits that the average level rather than change predicts first-onset DD. We utilized data from the ADEPT project, a cohort of 496 girls (baseline age 13.5-15.5 years) from the community followed for 3 years. Participants underwent five waves of assessments for risk factors and diagnostic interviews for DD. For illustration purposes, we selected 16 well-established dynamic risk factors for adolescent depression, such as depressive and anxiety symptoms, personality traits, clinical traits, and social risk factors. We conducted Cox regression analyses with time-varying covariates to predict first DD onset. Consistently elevated risk factors (i.e. the mean of multiple waves), but not recent escalation, predicted first-onset DD, consistent with the Chronic Risk hypothesis. This hypothesis was supported across all 16 risk factors. Across a range of risk factors, girls who had first-onset DD generally did not experience a sharp increase in risk level shortly before the onset of disorder; rather, for years before onset, they exhibited elevated levels of risk. Our findings suggest that chronicity of risk should be a particular focus in screening high-risk populations to prevent the onset of DDs. In particular, regular monitoring of risk factors in school settings is highly informative.

IRRITABILITY AND REACTIVE AGGRESSION: IMPLICATIONS FOR DIAGNOSIS, TREATMENT, AND EQUITY

This session aims to facilitate discussion regarding irritability and its role in the diagnosis and treatment of childhood mental health disorders. The interpretation of irritability varies among child and adolescent psychiatrists and results in different diagnoses, treatments, and clinical outcomes. This session will describe the concept of irritability as a mood symptom, extrinsic factors that impact diagnostic patterns, considerations for improved diagnostic accuracy and equity, and treatment recommendations. Four presentations will discuss: 1) an overview of irritability as a mood symptom; 2) irritability in ADHD and autism spectrum disorder (ASD); 3) irritability diagnostic patterns in vulnerable and minority youth; and 4) treatment strategies for targeting mood and anxiety symptoms underlying irritability. Irritability is a core feature of externalizing and disruptive disorders, such as ODD and conduct disorder (CD); it is also highly associated with ADHD and adverse childhood experiences including traumatic stress, neglect, and abuse. Diagnostic patterns indicate that irritability is more often interpreted to be “disruptive” in Black and Brown youth, who receive fewer ADHD, DMDD, or affective/anxiety diagnoses than Non-Latinx White (NLW) youth with similar symptoms. Youth diagnosed with ODD are likely to have underlying anxiety or mood symptoms that are predictive of anxiety and depressive disorders in adolescence or adulthood and may therefore be better classified under one of these diagnoses. Similarly, youth with ASD experience irritability that may be best understood through their social communication deficits and impulsivity/anxiety symptoms, rather than through an ODD diagnosis. Treatment approaches that target underlying affective, anxiety, and neurodevelopmental disorders and instruct caregivers in appropriate management strategies may be most effective for these youth. 1) Irritability is a core feature of multiple child and adolescent mental illness diagnoses. 2) The resulting diagnosis is often driven by racial and socioeconomic factors. 3) Youth with co-occurring neurodevelopmental disorders are also at increased risk for misdiagnosis. 4) Targeting underlying mood and anxiety symptoms and bolstering caregiver skills are primary interventions.

28.12 Homicidal Ideation and Psychiatric Comorbidity in Inpatient Adolescents Aged 12 to 17 Years

Adolescents with homicidal tendencies are a serious growing concern in the United States. Research studies in the past have showcased the relationship between homicidal ideation (HI) and mental illnesses, but very limited information is available on the adolescent and inpatient population. We aim to evaluate the difference in the prevalence of demographic characteristics and mental health disorders in adolescents with and without HI. The adolescent population (ages 12-17 years) that admitted to the hospital with the diagnosis of HI was identified from the 2016 to 2018 National (Nationwide) Inpatient Sample dataset. Patients without HI were used as a control group. The prevalence of mental illness comorbidities between the group was compared using the Rao-Scott adjusted χ2 test. A total of 18,935 patients (mean age: 14.5 years) with HI diagnosis were identified in the study. The majority of the patients in the HI group were male compared to the control group (58.7% vs 41.2%; p < 0.001). Racially, it was more prevalent in the White race (56.0% vs 52.6%; p < 0.001) as well as the Black race (22.3% vs 17.8%; p < 0.001). It was less prevalent among the Hispanic race (14.9% vs 21.3%; p < 0.001). MDD prevalence was 48.2% in patients with HI and 22.3% in the control group. Bipolar disorders (17.7% vs 3.8%; p < 0.001), and anxiety disorders (49.5% vs 20.0%; p < 0.001) were highly prevalent among patients with HI. Suicidal ideation/attempt was prevalent in 66.9% of patients with HI. The study found a higher prevalence of mental illnesses such as depression, anxiety, and bipolar disorder in adolescents with HI. The White race was more prevalent in the homicidal group of the study. Further large-scale longitudinal research studies are warranted to establish the causal relationship between mental health disorders and HI among adolescents.

Hair androgen concentrations and depressive disorders in adolescents from the general population

Hair androgen concentrations and depressive disorders in adolescents from the general population

Peripheral biomarkers to predict the diagnosis of bipolar disorder from major depressive disorder in adolescents.

The onset of bipolar disorder (BD) occurs in childhood or adolescence in half of the patients. Early stages of BD usually present depressive episodes, which makes it difficult to be distinguished from major depressive disorder (MDD). Objective biomarkers for discriminating BD from MDD in adolescent patients are limited. We collected basic demographic data and the information of the first blood examination performed after the admission to psychiatry unit of BD and MDD inpatients during 2009-2018. We recruited 261 adolescents (aged from 10 to 18), including 160 MDD and 101 BD. Forward-Stepwise Selection of binary logistic regression was used to construct predictive models for the total sample and subgroups by gender. Independent external validation was made by 255 matched patients from another hospital in China. Regression models of total adolescents, male and female subgroups showed accuracy of 73.3%, 70.6% and 75.2%, with area under curves (AUC) as 0.785, 0.816 and 0.793, respectively. Age, direct bilirubin (DBIL), lactic dehydrogenase (LDH), free triiodothyronine (FT3) and C-reactive protein (CRP) were final factors included into the models. The discrimination was well at external validation (AUC = 0.714). This study offers the evidence that accessible information of common clinical laboratory examination might be valuable in distinguishing BD form MDD in adolescents. With good diagnostic accuracies and external validation, the total regression equation might potentially be applied to individualized clinical inferences on adolescent BD patients.

Psychological Conditions for Correction and Optimization of Personal Development of Adolescents with Depressive Disorders

The article presents a theoretical generalization and a new solution to a scientific problem, expressed in the application of an innovative personal approach to solving the problem of adolescent depressive disorders, the basis of which is the scientific and methodological interpretation of personal development as a defining construct of the system of psychological conditions for the onset of depressive disorders, models of their diagnosis and psychological conditions for overcoming , which ensures the formation of adolescents' ability to effective personal self-regulation and an arbitrary choice of constructive ways of self-realization. The methodological foundations of the study of the personal properties of adolescents with depressive disorders are disclosed, a program for the diagnosis of personal symptoms of depressive disorders of various forms of severity in adolescent schoolchildren is presented; carried out a quantitative and qualitative analysis of the results of the ascertaining experiment on the psychological conditions of the onset of depressive disorders in adolescent schoolchildren and the personality traits of adolescents with depressive disorders; the description of personal phenomenology and symptomatology of depressive disorders in adolescents has been carried out. Theoretical substantiation of the formative experiment is given, the program of correction and optimization of personal development of teenagers as a means of overcoming their depressive disorders is presented, the quantitative and qualitative analysis of the results of its approbation is carried out. A profound restructuring of the structure and qualitative characteristics of the psychological conditions of the personal development of adolescents, their system of personal self-regulation, optimizes the functioning of the mechanism of personal sensitivity - "Ego" -tolerance to destructive influences, is, as the results of the application of the experimental correctional and developmental program, an effective way to overcome depression in adolescents’ disorders.

Relationship between SIRT1 gene and adolescent depressive disorder with nonsuicidal self-injury behavior: Based on gene methylation and mRNA expression.

Objective:The incidence of non-suicidal self-injury (NSSI) behavior in adolescents is increasing year by year. Patients with a history of both depression and NSSI behavior tend to be at greater risk for suicide. At present, the mechanism of adolescent depressive disorder with NSSI behavior is not clear and still in research and exploration. The expression of the Silent Information Regulator 2 Related Enzyme 1 (SIRT1) gene is closely related to the level of serotonin in molecular mechanisms, and may be closely related to the occurrence and development of depressive disorder. This study aimed to explore the relationship between the SIRT1 gene and NSSI behaviors in adolescents with depressive disorder.Methods:A total of 15 adolescent depressed patients with NSSI behavior and 15 healthy controls were enrolled in the study. Bisulfite Sequencing PCR (BSP) was used to test the methylation level of SIRT1 gene promoter region of the participants. The real-time fluorescent quantitative PCR was conducted to measure the mRNA expression level of SIRT1 gene.Results:Our study found that the methylation level of SIRT1 gene promoter region at cytosine-guanine dinucleotide 5 (CpG5) site in depression group was higher than that of control group. Compared with that of control group, the plasma concentration of Sirt1 protein significantly decreased in depression group.Conclusion:Our study investigated the methylation level and the mRNA expression of SIRT1 gene in adolescent depressive patients with NSSI behavior. The study points towards finding an in vivo molecular marker for those adolescent patients.

Psychological Resilience, Symptoms of Depression, Anxiety, and Post-Traumatic Stress Disorder in Children and Adolescents whose Parents With COVID-19

Aralık 2019'da, Çin'de Yeni Koronavirüs (SARS-CoV-2) olarak bilinen bir koronavirüs tespit edilmiş ve dünya çapında bir salgın haline gelmiştir. COVID-19’dan korunmanın temel yolu, izolasyon ve sosyal uzaklaşma stratejileri olmuştur. Bu çalışmada, COVID-19 nedeni ile izole edilen ebeveynlerin çocuklarını depresyon, anksiyete ve travma sonrası stres bozukluğu (TSSB) belirtileri açısından değerlendirdik. Çalışmaya anne ve/veya babası son 3 ay içinde COVID-19 enfeksiyonu geçirmiş 52 çocuk dahil edilmiştir. Çocukların yaşları 7 yaş ile 17 yaş arasındadır ve 27’si kızdır. Tüm çocuklara, Çocuklar için Depresyon Ölçeği, Çocuklar için Travma Sonrası Stres Tepki Ölçeği, Çocukluk Anksiyete Tarama Ölçeği, Psikolojik Sağlamlık Ölçeği uygulanmıştır. Çocukların %19.2’sinde depresif semptomların olduğu, depresyon semptomların kronik hastalığı olanlarda %40, tanı almış psikiyatrik hastalığı olanlarda %50 olduğu tespit edilmiştir. Çocuklarda, değişen düzeylerde TSSB belirtileri saptanmıştır. Annesi izole edilenlerde, ağır TSSB belirtileri oranı %35.1; babası izole edilenlerde %6.7’dir. Her iki ebeveyni de COVID-19 enfeksiyonu geçiren çocuklarda anksiyete puanı en yüksek bulunurken, bunu sırasıyla sadece annesi geçiren çocuklar ve sadece babası geçirenler izlemiştir. Bilim adamlarının koronavirüsü iyi anladıkları, ülkemizde Sağlık Bakanlığı’nın süreci iyi yönettiği, koronavirüsün yayılmasını kısıtlamak için kendi alacağı ve ülkemizde alınacak koruyucu önlemlerin fark oluşturacağı fikrine katılmayan çocuklarda depresyon semptom sıklığı daha yüksek bulunmuştur. Ayrıca, bilim adamlarının koronavirüsü iyi anladıkları fikrine katılmayan ve ülkemizde uygulanan kuralların günlük yaşamlarına çok fazla müdahalede bulunduğunu düşünen çocuklarda, ağır TSSB belirti sıklığının daha yüksek olduğu gösterilmiştir. COVID-19 salgını ile günlük yaşamları kısıtlanmış olan çocukların; bilişsel, duygusal, fiziksel ve psikolojik gelişimlerinin henüz tamamlanmamış olduğu dikkate alındığında, bu süreçte yaşayabilecekleri sorunlara karşı uyumlarını arttırmak, psikolojik dayanıklılıklarını güçlendirmek için ruhsal destek sunulmalı ve etkin stratejiler izlenmelidir.

Stressful Events and Adolescent Psychopathology: A Person-Centred Approach to Expanding Adverse Childhood Experience Categories

Stress from cumulative adverse childhood experiences (ACEs) can pose a serious risk of experiencing anxiety, depression, and other mood disorders in adolescence. However, there is a paucity of research identifying specific profiles or combinations of exposure to other forms of stressful life events and their impact on adolescent psychopathology. This study attempted a conceptual expansion of the ACE checklist by examining these stressful events. The study used cross-sectional data from a modified version of the CASE Study survey where 864 adolescents (56% female, n = 480), aged from 11 – 18 years were recruited from four post-primary schools in the North-West region of NI. Latent class analysis of the 20-item stressful events checklist revealed 3 distinct risk classes: a low-risk class (53.5%), at-risk class (42.7%), and an immediate-risk class (3.8%). Results showed those at most risk of adolescent psychopathology had the highest probability of encountering interpersonal relationship issues, experiencing family dysfunction, and having close friends experiencing psychological difficulties. Findings indicate that the original ten ACE categories may be too narrow in focus and do not capture the wide range of childhood adversity. Expanding the ACE checklist to include other stressful events is discussed as these may also be antecedents to psychopathologic responses.

Neuroendocrine aspects of formation depressive disorder in adolescents

Objective — to study levels of serotonin, melatonin and cortisol in adolescents with depressive and depressive­anxietybehavioral disorders.Materials and methods. Research was conducted on the basis of the PsychiatryDepartment of SI “HCCA NAMN of Ukraine”. Examinations involved 140 patients with depressive disorders and 128 patients with depressive­anxietydisorders. The following investigational methods were used: clinical and psychopathological, pathopsychological, neurohormonal and statistical.Results. It has been established that clinical variants of depression in children in the period of puberty have gender- and age-related differences. The manifestation of the first depressionepisode in early school age, and especially in the prepuberty, is a predictor of depression at subsequent pubertystages. Depressive symptoms in adolescents were associated with internalization and externalization of clinical manifestations. It has been proved that the course of a depressive disorder in children during puberty is launched by the development of a number of neurobiological disorders ­ an increase in the level of cortisol, the dysregulation of neurobiological systems responsible for the development of affective pathology (serotonin, melatonin), somatic and neurologicalweakness.Conclusions. The obtained data suggest the dysregulation of neurohormonal exchange in patients with depressive and depressive­anxiety behavioral disorders. The low excretionlevel of melatoninand rhythm violations in its production can result in the desynchronosis and maladjustment of a child. The nature of changes depends on the nosology and has gender specificities. It has been established that regardless of the nosological form of a depressive disorder, mental disorders in the most of adolescentsare accompanied by the increased serotonin levels, and in the group of patients with depressive disorder of behavior with the reduced melatoninexcretion as well.

Fatores de risco associados a sintomas depressivos em adolescentes de um município de pequeno porte

Introdução: Estimativas da OMS (Organização Mundial da Saúde) apontam que os transtornos depressivos em adolescentes aumentam em todo mundo, indicando que 10% a 20% vivenciam problemas de saúde mental. No Brasil, estudos mostram prevalência de 13,2%, sendo considerado, portanto, um problema de saúde pública. Objetivo: Rastrear a presença de sintomas depressivos e fatores de risco associados em adolescentes de um município de pequeno porte. Metodologia: Estudo transversal, descritivo e analítico com abordagem quantitativa. Os dados foram coletados em uma amostra de 324 estudantes do município de Marialva/PR – Brasil, por meio de questionário sociodemográfico e instrumento de rastreio de episódios depressivos, o PHQ – 9 (Patiente Health Questionnaire – 9). A análise ocorreu por regressão linear, matriz de correlação e análise de redes. Resultados: 64,2% apresentaram sintomas moderado à grave, com maior prevalência em adolescentes do sexo feminino, sendo que 20,1% mostraram sintomas graves. Os fatores de risco associados foram: maior tempo de uso de celular; não frequentar parques; não praticar esportes; usar drogas lícitas; relatar diagnóstico para ansiedade e casos de depressão na família. Adolescentes que jogam no celular sozinho apresentaram 5,1 vezes mais chances de desenvolver sintomas depressivos, e os que usam drogas em grupo, 5,5 vezes mais chance. Conclusão: O estudo sugere que cidades pequenas que apresentam estruturas urbanas inadequadas e não acolhedoras podem acentuar o problema dos transtornos depressivos em adolescentes, o que indica a necessidade de políticas públicas que melhorem as perspectivas de futuro deste público.

Using the 11-item Version of the RCADS to Identify Anxiety and Depressive Disorders in Adolescents

The purpose of this study was to identify items from the Revised Children’s Anxiety and Depression Scale – RCADS-C/P that provided a brief, reliable and valid screen for anxiety and/or depressive disorders in adolescents. In addition, we examined whether adding items assessing suicidal ideation (Moods and Feelings Questionnaire – MFQ- C/P) and symptom impact and duration (items adapted from the Strengths and Difficulties Questionnaire – SDQ) improved the identification of adolescents with anxiety and/or depressive disorders. We compared two samples of adolescents and their parents – a community sample, recruited through secondary schools in England (n = 214) and a clinic-referred sample, who met diagnostic criteria for anxiety and/or depressive disorder and were recruited through a university-based research clinic (n = 246). Participants completed the RCADS-C/P with additional symptom impact and duration items, and the MFQ-C/P. Using ROC curve analyses, we identified a set of 11 RCADS-C/P items (6 addressing anxiety and 5 depression symptoms) for adolescent- and parent-report. This set of 11 symptom items achieved sensitivity/specificity values > .75, which were comparable to corresponding values for the RCADS-47-C/P. Combining adolescent and parent-report improved the identification of anxiety/depression in adolescents compared to using adolescent-report alone. Finally, adding two symptom impact items further improved the sensitivity/specificity of the 11 symptom items, whereas adding suicidal ideation items did not. The 11 RCADS items accurately discriminated between the community and clinic-referred sample with anxiety and/or depressive disorders and have the potential to quickly and accurately identify adolescents with these disorders in community settings.

Depressive Disorder in Adolescents in Terms of Gender and Grade: A Case Study in Thua Thien Hue Province, Vietnam

Adolescents, with rapid but uneven developments in biology as well as psychology, are highly at risk of onset in depression. Depression brings about severe consequences, including social and academic difficulties. However, no previous research has considered using The Beck Depression Inventory to examine major depressive disorder among Vietnamese adolescents, especially the gender and grade aspects. The goal of this research was to evaluate adolescents’ depression in Hue province and consider the differences among grades as well as genders. A cross-sectional study utilising The Beck Depression Inventory was conducted with 1,336 adolescents in Thua Thien Hue province, Vietnam. There was a gender gap in depression among the adolescents in Thua Thien Hue province, Vietnam, and depression in the 9th grade and 12th grade adolescents were more evident than in the others. Therefore, gender disparities vary among age groups in the incidence of depressive disorder.

Structural Connectivity Between Rostral Anterior Cingulate Cortex and Amygdala Predicts First Onset of Depressive Disorders in Adolescence

BackgroundAdolescent-onset depressive disorders (DDs) are associated with deficits in the regulation of negative affect across modalities (self-report, behavioral paradigms, and neuroimaging), which may manifest prior to first-onset DDs. Whether the neurocircuitry governing emotional regulation predates DDs is unclear. This study tested whether a critical pathway for emotion regulation (rostral anterior cingulate cortex–amygdala structural connectivity) predicts first-onset DDs in adolescent females. MethodsDiffusion tensor imaging data were acquired on adolescent females (n = 212) without a history of DDs and the cohort was reassessed for first-onset DDs over the next 27 months. ResultsA total of 26 girls developed first onsets of DDs in the 27 months after imaging. Multivariate logistic regression showed that lower weighted average fractional anisotropy of uncinate fasciculus tracts between the rostral anterior cingulate cortex and amygdala prospectively predicted first onset of DDs (adjusted odds ratio = 0.44, p = .005), above and beyond established risk factors including baseline depression symptom severity, history of anxiety disorders, parental history of depression, parental education, and age. ConclusionsThis study provides evidence for the first time showing that aberrant structural connectivity between the rostral anterior cingulate cortex and amygdala prospectively predates first onset of DDs in adolescent females. These results highlight the importance of a well-established neural circuit implicated in the regulation of negative affect as a likely etiological factor and a promising target for intervention and prevention of DDs.

Body image dissatisfaction and symptoms of depression disorder in adolescents.

The objective of this study was to evaluate the effect of body image dissatisfaction on symptoms of depressive disorder in adolescents. This is a cross-sectional study that included 2,162 adolescents ages 18-19 born in São Luís, Maranhão, Brazil, which was part of the joint RPS cohort (Brazilian birth cohorts of Ribeirão Preto-SP, Pelotas-RS, and São Luís-MA). Socioeconomic characteristics, nutritional status, mental health, and body image characteristics were evaluated. Body image was assessed by Stunkard’s silhouettes scale. The presence of symptoms indicative of depressive disorder was investigated through a diagnostic interview MINI (Mini International Neuropsychiatric Interview). A theoretical model was built in a Directed Acyclic Graph (DAG) in order to investigate the relationship between the variables of the study. The relationship was estimated weighting the inverse probability of selection for the variables of adjustment: sex and nutritional status. Among the dissatisfied adolescents due to overweight, 66.54% were girls, 32.85% were overweight, and 11.99% were obese (P<0.01). There was a significant association between dissatisfaction due to overweight and symptoms of depressive disorder (P=0.01), and there was no evidence of the same association with dissatisfaction due to thinness. Therefore, only dissatisfaction due to overweight was associated with the symptoms of depressive disorder in the evaluated adolescents.