Adolescent Depressive Disorder Research Articles

Early onset major depressive disorder

The present paper provides an overview of the clinical diagnosis and presentation, epidemiology, coexisting problems, and treatment issues of child and adolescent depressive disorders, with a focus on major depressive disorder (MDD). Depression is a common and potentially debilitating disorder for youth; has significant comorbid, behavioural and systemic sequelae; and is associated with a significant suicidal risk. Although rigorous study of psychosocial and pharmacological treatment modalities is in its infancy, current treatment is also informed by judicious and patient-specific clinical judgment. In view of the duration of MDD, remission and recurrence rates, morbidity, and potential chronicity of impaired psychosocial functioning, both active treatment and research involving MDD are indicated.

Longitudinal Clinical Course of Early Onset DepressiveDisorders: Treatment Implications

Free AccessLongitudinal Clinical Course of Early Onset DepressiveDisorders: Treatment ImplicationsUma RaoUma Rao1. Department of Psychiatry and Biobehavioral Sciences and the Brain Research Institute, UCLA School of Medicine, Los Angeles, California.Search for more papers by this authorPublished Online:June 2005https://doi.org/10.1521/capn.6.4.6.22466PDFPDF PLUS ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations AboutReferencesBirmaher , B., Ryan, N. D., Williamson, D. E., Brent, D. A. & Kaufman, J. (1996). Childhood and adolescent depression: A review of the past 10 years. Part II. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 1575–1583. Crossref, Google ScholarEmslie , G. J., et al. (1998). Fluoxetine in child and adolescent depression: Acute and maintenance treatment. Depression and Anxiety, 7, 32–39. Crossref, Google ScholarHarrington , R., Fudge, H., Rutter, M., Pickles, A. & Hill, J. (1990). Adult out comes of childhood and adolescent depression.I. Psychiatric status. Archives of General Psychiatry, 47, 465–473. Crossref, Google ScholarHarrington , R., Fudge, H., Rutter, M., Pickles, A., & Hill, J. (1991). Adult outcomes of childhood and adolescent depression: II. Links with antisocial disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 30, 434–439. Crossref, Google ScholarKovacs , M. (1996). Presentation and course of major depressive disorder during childhood and later years of the life span. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 705–715. Crossref, Google ScholarLewinsohn , P. M., Rohde, P., Klein, D. N. & Seeley, J. R. (1999). Natural course of adolescent major depressive disorder.I. Continuity into young adulthood. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 56–63. Crossref, Google ScholarMurray , C. J. L., & Lopez, A. D. (1996). The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Disease, Injuries and Risk Factors in 1990 and Project to 2020. Global Burden of Disease and Injury Series (Vol 1). Boston, MA: Harvard University Press. Google ScholarRao , U. (2000). Continuities and discontinuities between adolescent and adult depression: clinical and policy implications. The Economics of Neuroscience, 2, 34–40. Google ScholarRao , U., Hammen, C. & Daley, S. E. (1999). Continuity of depression during the transition to adulthood: A 5-year longitudinal study of young women. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 908–915. Crossref, Google ScholarStrober , M., Lampert, C., Schmidt, S. & Morrell W. (1993). The course of major depressive disorder in adolescents: I. Recovery and risk of manic switching in a follow-up of psychotic and nonpsychotic subtypes. Journal of the American Academy of Child & Adolescent Psychiatry, 32, 34–42. Crossref, Google ScholarWeissman , M. M., et al. (1999). Depressed adolescents grown up. Journal of the American Medical Association, 281, 1707–1713. Crossref, Google Scholar Previous article Next article FiguresReferencesRelatedDetails Cited byCited by1. Depression in children and adolescentsOnline publication date: 30 June 2015. Go to citation Crossref Google Scholar Volume 6Issue 4Aug 2001 Information© Guilford Publications Inc.PDF download

Evaluation of cognitive diathesis-stress models in predicting major depressive disorder in adolescents.

Evaluation of cognitive diathesis-stress models in predicting major depressive disorder in adolescents.

Adolescent depression: the role of discontinuities in life course and social support

Objective: To study sociodemographic determinants of depression among 14–16 years old girls and boys, and the role of perceived social support in mediating the effects of the background variables. Method: 16464 adolescents aged 14–16 participated the School Health Promotion Study, a survey about health, health behaviour and school behaviour. Depression was measured by the Finnish modification of the 13-item Beck Depression Inventory. Moderate to severe symptoms in this scale were recorded as depression. Results: Depression was associated with family structure in both sexes. Among girls, having moved recently and low parental education increased the risk for depression, among boys, unemployment in the family. Accumulating number of discontinuities in life course increased the proportion of the depressed among both girls and boys. Perceived lack of social support had the same effect. Lack of support did not explain the effect on depression of the discontinuities in life course. Conclusion: To detect risk groups for adolescent depressive disorders, health services should pay attention to adolescents who have experienced life changes. Perceived social support should be enquired.

Depression, drinking, and substance use among 14- to 16-year-old Finnish adolescents

Our aim was to assess the relationship between self-reported depression, alcohol consumption, and substance use among 14- to 16-year-olds. A school survey was conducted of 16,464 14- to 16-year-olds in two regions of Finland. Alcohol and other substance use were found to be significantly associated with depression. Of girls (boys) who reported drinking weekly, 24% (13%) scored as depressed, compared with 7% (4%) of those not drinking. Of girls (boys) who reported having experimented with substances five times or more, 37% (28%) scored as depressed compared with 8% (5%) of those who reported never having experimented with substances. These associations persisted in multivariate analyses controlling for sociodemographic background. In conclusion, frequent drinking and experimenting with substances indicate a risk for adolescent depressive disorders, and depressive adolescents are at risk for substance use. Health services should pay attention to the identified depressive adolescents to prevent the possibly subsequent substance use problems among them and also pay attention to frequently drinking adolescents and substance experimenters, to increase identification of depressive disorder and possibilities for early interventions.

Gender differences in depression. Critical review.

With few exceptions, the prevalence, incidence and morbidity risk of depressive disorders are higher in females than in males, beginning at mid-puberty and persisting through adult life. To review putative risk factors leading to gender differences in depressive disorders. A critical review of the literature, dealing separately with artefactual and genuine determinants of gender differences in depressive disorders. Although artefactual determinants may enhance a female preponderance to some extent, gender differences in depressive disorders are genuine. At present, adverse experiences in childhood, depression and anxiety disorders in childhood and adolescence, sociocultural roles with related adverse experiences, and psychological attributes related to vulnerability to life events and coping skills are likely to be involved. Genetic and biological factors and poor social support, however, have few or no effects in the emergence of gender differences. Determinants of gender differences in depressive disorders are far from being established and their combination into integrated aetiological models continues to be lacking.

Cognitive behavioural therapy, systemic behavioural family therapy, and non-directive supportive therapy had similar long term effectiveness for major depressive disorder in adolescents

Cognitive behavioural therapy, systemic behavioural family therapy, and non-directive supportive therapy had similar long term effectiveness for major depressive disorder in adolescents

Adolescent depressive disorder: a population-based study of ICD-10 symptoms

Objective: Earlier studies have suggested that symptoms of depressive disorder in adolescents may differ from those found in adults. Even so, diagnostic criteria developed in adults have come to be widely applied to younger subjects. This study examines the frequency of ICD-10 symptoms in depressive disorder and their association with severity in a large community sample of adolescents aged 15 to 18 years.Method: A six-wave prospective study of adolescent health and emotional wellbeing in 2032 Australian secondary school students provided an opportunity to conduct a two-phase study of adolescent onset depression. A self-administered computerised form of the revised Clinical Interview Schedule (CIS-R) was used as a first phase diagnostic measure. Second phase assessment using the Composite International Diagnostic Interview (CIDI) allowed the delineation of a group fulfilling criteria on both instruments. The ICD-10 symptoms and severity profiles for depression were generated with standard algorithms.Results: 1947 (95.8%) out of 2032 subjects in the designated sample completed phase 1 assessment at least once. Participation rates at phase 2 interviews were 93%. Over the 30-month study period 69 subjects (10 male, 59 female) fulfilled criteria for ICD-10 depressive episodes on both the CIS-R and CIDI. Thirty-one per cent (n = 21) had experienced a severe episode, 46% (n = 32) moderate and 23% (n = 16) mild episodes. Loss of interest and pleasure, decreased energy and fatigue, sleep disturbance, suicidal ideation and diminished concentration most clearly distinguished adolescents with depressive disorder from controls. Self-reproach and guilt, psycho-motor agitation and/or retardation and appetite disturbance with weight change showed the clearest increase in frequency with increasing severity of episode. The somatic syndrome was reported by close to one in three of those with a severe depressive episode, but was uncommon in those with mild and moderate episodes.Conclusions: The ICD-10 diagnostic criteria are applicable to depressive disorder in older adolescents. With the exception of depressed mood, found in one in five non-cases, all other symptoms were common in cases and uncommon in non-cases. Practitioner awareness of symptoms indicating the presence and severity of disorder should enhance early identification and choice of treatment in adolescent depression.

Adolescent depressive disorder: a population-based study of ICD-10 symptoms.

Earlier studies have suggested that symptoms of depressive disorder in adolescents may differ from those found in adults. Even so, diagnostic criteria developed in adults have come to be widely applied to younger subjects. This study examines the frequency of ICD-10 symptoms in depressive disorder and their association with severity in a large community sample of adolescents aged 15 to 18 years. A six-wave prospective study of adolescent health and emotional wellbeing in 2032 Australian secondary school students provided an opportunity to conduct a two-phase study of adolescent onset depression. A self-administered computerised form of the revised Clinical Interview Schedule (CIS-R) was used as a first phase diagnostic measure. Second phase assessment using the Composite International Diagnostic Interview (CIDI) allowed the delineation of a group fulfilling criteria on both instruments. The ICD-10 symptoms and severity profiles for depression were generated with standard algorithms. 1947 (95.8%) out of 2032 subjects in the designated sample completed phase 1 assessment at least once. Participation rates at phase 2 interviews were 93%. Over the 30-month study period 69 subjects (10 male, 59 female) fulfilled criteria for ICD-10 depressive episodes on both the CIS-R and CIDI. Thirty-one per cent (n = 21) had experienced a severe episode, 46% (n = 32) moderate and 23% (n = 16) mild episodes. Loss of interest and pleasure, decreased energy and fatigue, sleep disturbance, suicidal ideation and diminished concentration most clearly distinguished adolescents with depressive disorder from controls. Self-reproach and guilt, psychomotor agitation and/or retardation and appetite disturbance with weight change showed the clearest increase in frequency with increasing severity of episode. The somatic syndrome was reported by close to one in three of those with a severe depressive episode, but was uncommon in those with mild and moderate episodes. The ICD-10 diagnostic criteria are applicable to depressive disorder in older adolescents. With the exception of depressed mood, found in one in five non-cases, all other symptoms were common in cases and uncommon in non-cases. Practitioner awareness of symptoms indicating the presence and severity of disorder should enhance early identification and choice of treatment in adolescent depression.

Natural Course of Adolescent Major Depressive Disorder in a Community Sample: Predictors of Recurrence in Young Adults

The primary purpose was to identify factors related to the recurrence of major depressive disorder during young adulthood (19-23 years of age) in a community sample of formerly depressed adolescents. A total of 274 participants with adolescent-onset major depressive disorder were assessed twice during adolescence and again after their 24th birthday. Lifetime psychiatric information was obtained from their first-degree relatives. Adolescent predictor variables included demographic characteristics, psychosocial variables, characteristics of adolescent major depressive disorder, comorbidity, family history of major depressive disorder and nonmood disorder, and antisocial and borderline personality disorder symptoms. Low levels of excessive emotional reliance, a single episode of major depressive disorder in adolescence, low proportion of family members with recurrent major depressive disorder, low levels of antisocial and borderline personality disorder symptoms, and a positive attributional style (males only) independently predicted which formerly depressed adolescents would remain free of future psychopathology. Female gender, multiple major depressive disorder episodes in adolescence, higher proportion of family members with recurrent major depressive disorder, elevated borderline personality disorder symptoms, and conflict with parents (females only) independently predicted recurrent major depressive disorder. Comorbid anxiety and substance use disorders in adolescence and elevated antisocial personality disorder symptoms independently distinguished adolescents who developed recurrent major depressive disorder comorbid with nonmood disorder from those who developed pure major depressive disorder. Formerly depressed adolescents with the risk factors identified in this study are at elevated risk for recurrence of major depressive disorder during young adulthood and therefore warrant continued monitoring and preventive or prophylactic treatment.

Associations between bipolar disorder and other psychiatric disorders during adolescence and early adulthood: a community-based longitudinal investigation.

The study investigated cross-sectional and longitudinal associations between bipolar disorder and other psychiatric disorders during adolescence and early adulthood. Psychiatric interviews were administered to a representative community sample of 717 youths and their mothers in 1983 (mean age of youths=14 years) and again in 1985-1986, and 1991-1993. A wide range of psychiatric disorders co-occurred with bipolar disorder during adolescence and early adulthood. Adolescent anxiety disorders were uniquely associated with increased risk for early adulthood bipolar disorder after adolescent bipolar disorder was accounted for. Manic symptoms during adolescence were associated with increased risk for anxiety and depressive disorders during early adulthood after adolescent anxiety and depressive disorders were accounted for. Adolescents with anxiety disorders may be at increased risk for bipolar disorder or clinically significant manic symptoms during early adulthood. Adolescents with manic symptoms may be at increased risk for anxiety and depressive disorders during early adulthood.

Frequency, Comorbidity, and Psychosocial Impairment of Depressive Disorders in Adolescents

The frequency, comorbidity, and psychosocial impairment of depressive disorders among adolescents was estimated from a survey of 1,035 students aged 12 to 17 years. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Depressive disorders and other psychiatric disorders were coded based on DSM-IV criteria using the computerized Munich version of the Composite International Diagnostic Interview. A high proportion of our adolescents met the lifetime criteria for depressive disorders according to DSM-IV criteria, with a rate of 17.9%. Depressive disorders were significantly higher in females than in males. The rates for all of the disorders increased with age, with the greatest increase occurring mostly between the ages of 14 and 15; such increase was more prominent in females than in males. Our results imply the importance of identifying depressive disorders in adolescence and the need for preventive and intervention strategies.

A risk-benefit assessment of pharmacotherapies for clinical depression in children and adolescents.

Child and adolescent major depressive disorders are common and recurrent disorders. The prevalence of major depressive disorders is estimated to be approximately 2% in children and 4 to 8% in adolescents. Major depressive disorders in children are frequently accompanied by other psychiatric disorders, poor psychosocial outcome and a high risk of suicide and substance abuse, indicating the need for effective treatment and prevention. The use of antidepressant medications as the first line of treatment for children and adolescents with mild to moderate major depressive disorders has been questioned. However, some subgroups of patients may benefit from initial treatment with antidepressants. These subgroups may include patients who are unwilling or unable to undergo psychotherapy, have not responded to at least 8 to 12 sessions of psychotherapy, have bipolar, atypical or severe depression or have recurrent depression. Currently, the selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors are the first medication choice because of their efficacy, benign adverse effect profile, ease of use and low risk of death following an overdose. Further research in continuation and maintenance treatments, treatment of comorbid conditions, subtypes of depression, e.g. bipolar, atypical, seasonal, and combinations of pharmacotherapy and psychotherapy are needed. In addition, studies of the pharmacokinetics, pharmacodynamics and long term adverse effects of antidepressant medications in children and adolescents are warranted.

Review: cognitive behaviour therapy facilitates recovery from depressive disorders in children and adolescents

Harrington R, Whittaker J, Shoebridge P , et al. Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder. BMJ1998 May 23; 316 : 1559 -63....

The treatment of cognitive symptoms of adolescent endogenous depressive disorders

The treatment of cognitive symptoms of adolescent endogenous depressive disorders

Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder

Objective: To determine whether cognitive behaviour therapy is an effective treatment for childhood and adolescent depressive disorder.Design: Systematic review of six randomised trials comparing the efficacy of cognitive behaviour therapy...

Low family cohesion was associated with the incidence of major depressive disorder in adolescents

The weighted 1 year incidence was 3.3% (95% CI 0.0% to 8.9%) for MDD, 3.4% (CI 0.0% to 9.1%) for dysthymia, and 1.0% (CI 0.0% to 2.8%) for any other...

The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders.

Various studies find relationships among anxiety and depressive disorders of adolescence and adulthood. This study prospectively examines the magnitude of longitudinal associations between adolescent and adult anxiety or depressive disorders. An epidemiologically selected sample of 776 young people living in upstate New York received DSM-based psychiatric assessments in 1983, 1985, and 1992 using structured interviews. The magnitude of the association between adolescent and adult anxiety or depressive disorders was quantified using odds ratios generated from logistic regression analyses and from a set of latent Markov analyses. We focus on longitudinal associations among narrowly defined DSM anxiety or depressive disorders. In simple logistic models, adolescent anxiety or depressive disorders predicted an approximate 2- to 3-fold increased risk for adulthood anxiety or depressive disorders. There was evidence of specificity in the course of simple and social phobia but less specificity in the course of other disorders. Results from the analyses using latent variables suggested that while most adolescent disorders were no longer present in young adulthood, most adult disorders were preceded by adolescent disorders. An anxiety or depressive disorder during adolescence confers a strong risk for recurrent anxiety or depressive disorders during early adulthood. Most anxiety and depressive disorders in young adults may be preceded by anxiety or depression in adolescence.

Depressive disorder in adolescents

Depressive disorder in adolescents

Half a century of ECT use in young people.

Pharmacological treatments for certain psychiatric disorders in young people are often ineffective and may cause major side effects; thus, it is important to investigate other treatments. This article reviews the literature on the efficacy and safety of ECT in this age group and examines the evidence for the suggestion that it may be used inappropriately. All studies published in English and other languages on the use of ECT in persons 18 years of age or younger were obtained. The reports were systematically reviewed and rated according to the quality of the information in several domains, yielding an overall quality score for each study. Individual cases from each report were then examined and grouped according to diagnosis and response to ECT. Sixty reports describing ECT in 396 patients were identified; most (63%) were single case reports. The overall quality was poor but improved in the more recent studies. There were no controlled trials. Rates of improvement across studies were 63% for depression, 80% for mania, 42% for schizophrenia, and 80% for catatonia. Serious complications were very rare, whereas minor, transient side effects appeared common. ECT in the young seems similar in effectiveness and side effects to ECT in adults. However, this conclusion is qualified by the lack of systematic evidence. More research and education of professionals and the public are needed. It is suggested that ECT registers be set up, that surveys and controlled trials be conducted, and that seizure thresholds, the optimal anesthetic, effects of concurrent medications, and cognitive consequences of ECT in the young be investigated.