Diagnosis Of Adolescent Depression Research Articles

NEFA can serve as good biological markers for the diagnosis of depression in adolescents

BackgroundThe incidence of adolescent depression has markedly risen in recent years, with a high recurrence rate into adulthood. Diagnosis in adolescents is challenging due to subjective factors, highlighting the crucial need for objective diagnostic markers. MethodsOur study enrolled 204 participants, including healthy controls (n = 88) and first-episode adolescent depression patients (n = 116). Serum samples underwent gas chromatography–mass spectrometry (GC–MS) analysis to assess non-esterified fatty acids (NEFA) expression. Machine learning and ROC analysis were employed to identify potential biomarkers, followed by bioinformatics analysis to explore underlying mechanisms. ResultsNearly all differentially expressed NEFA exhibited significant downregulation. Notably, nonanoic acid, cis-10-pentadecenoic acid, cis-10-carboenoic acid, and cis-11-eicosenoic acid demonstrated excellent performance in distinguishing adolescent depression patients. Metabolite-gene interaction analysis revealed these NEFAs interacted with multiple genes. KEGG pathway analysis on these genes suggested that differentially expressed NEFA may impact PPAR and cAMP signaling pathways. LimitationsInclusion of diverse populations for evaluation is warranted. Biomarkers identified in this study require samples that are more in line with the experimental design for external validation, and further basic research is necessary to validate the potential depressive mechanisms of NEFA. ConclusionsThe overall reduction in NEFA expression in first-episode adolescent depression patients suggests a potential mediation of depression symptoms through cAMP and PPAR signaling pathways. NEFA levels show promise as a diagnostic tool for identifying first-episode adolescent depression patients.

Socio-Economic Status and Depression Amongst the Urban Adolescents

Background: Depression is a state of low mood and aversion to activity that can affect a person's thought, behavior feelings and physical wellbeing. Mental health of adolescents has been drawn going attention due to sustain increase in adolescent depression as well as suicidal incidence. The study aimed to determine the level of depression among the urban adolescents and its association with socio-economic status (SES).
 Methods: A descriptive cross-sectional study was carried out among 384 adolescent students of selected English and Bangla medium school of Dhaka city during January to December 2016. A semi-structured questionnaire and convenience sampling technique were used for data collection. Data were analyzed using SPSS software.
 Results: The study findings revealed that a large number of adolescents (34.11%) had depression and females are more (80%) prone to be depressed. Socio-economic status had significant association with the level of depression (p- 0.000). Out of 131 depressed respondents, 58.77%, 28.24%, 12.97% were in middle, upper and lower class respectively. Among all the depressed adolescents, 67.93% found significant depression and (32.06%) found cutoff score of depression.
 Conclusion: This study showed that depression is remained uncared health problem among the adolescents due to socio-economic problem. More attention and awareness need at the national level for early diagnosis of Adolescent depression.
 JOPSOM 2020; 39(1): 21-25

The validity of child and adolescent depression diagnoses in the Danish psychiatric central research register.

This study examined the validity of childhood depression diagnoses in the Danish Psychiatric Central Research Register (DPCRR) and identified predictors of validity. A nationwide random sample of 500 children (6-17years) diagnosed with depression between 1996 and 2016 was identified in the DPCRR. Psychiatric hospital records were reviewed and rated using an online checklist. The primary outcome was whether depressive symptoms and functional impairment documented in hospital records justified a depressive disorder diagnosis based on ICD-10 or DSM-5 diagnostic criteria. Diagnostic validity was calculated as the positive predictive value. Binary logistic regression analysis was used to identify potential predictors of diagnostic validity, and these were included in a multiple logistic regression. Psychiatric hospital records were available for 393 patients (78.6%). The documentation in the records justified an ICD-10 depressive episode diagnosis in 72.8%, and DSM-5 major depressive disorder in 73.3% of the patients registered with a depression diagnosis. We identified three predictors of diagnostic validity: (i) The validity increased almost linearly from 2000 to 2016 (OR 1.14, 95% CI 1.07-1.20, p<0.001), (ii) antidepressant use was associated with increased diagnostic validity (OR 2.27, 95% CI 1.35-3.82, p=0.002) and (iii) emergency department admission predicted low diagnostic validity (OR 0.33, 95% CI 0.12-0.93, p=0.036). Childhood depression diagnoses registered in the DPCRR show a satisfactory validity according to both ICD-10 and DSM-5 diagnostic criteria. Diagnostic validity increased steadily from 2000 to 2016 and was positively correlated with antidepressant use. Depression diagnoses assigned in emergency departments had low diagnostic validity.

Study on classification and identification of depressed patients and healthy people among adolescents based on optimization of brain characteristics of network

To enhance the accuracy of computer-aided diagnosis of adolescent depression based on electroencephalogram signals, this study collected signals of 32 female adolescents (16 depressed and 16 healthy, age: 16.3 ± 1.3) with eyes colsed for 4 min in a resting state. First, based on the phase synchronization between the signals, the phase-locked value (PLV) method was used to calculate brain functional connectivity in the θ and α frequency bands, respectively. Then based on the graph theory method, the network parameters, such as strength of the weighted network, average characteristic path length, and average clustering coefficient, were calculated separately ( P < 0.05). Next, using the relationship between multiple thresholds and network parameters, the area under the curve (AUC) of each network parameter was extracted as new features ( P < 0.05). Finally, support vector machine (SVM) was used to classify the two groups with the network parameters and their AUC as features. The study results show that with strength, average characteristic path length, and average clustering coefficient as features, the classification accuracy in the θ band is increased from 69% to 71%, 66% to 77%, and 50% to 68%, respectively. In the α band, the accuracy is increased from 72% to 79%, 69% to 82%, and 65% to 75%, respectively. And from overall view, when AUC of network parameters was used as a feature in the α band, the classification accuracy is improved compared to the network parameter feature. In the θ band, only the AUC of average clustering coefficient was applied to classification, and the accuracy is improved by 17.6%. The study proved that based on graph theory, the method of feature optimization of brain function network could provide some theoretical support for the computer-aided diagnosis of adolescent depression.

Training Pediatricians to Identify and Manage Adolescent Depression and Post-Traumatic Stress Disorder Following the Parkland Gun Violence Tragedy

Purpose: Youth who are exposed to gun violence, including school shootings, are at increased risk for developing major depression and post-traumatic stress disorder (PTSD) leading to an increase in suicide. Primary care providers (PCPs) are uniquely positioned to be able to identify early signs of mental health problems and intervene, yet they lack appropriate training in identifying signs of depression and of PTSD. Experiential training for PCPs using standardized patients has shown promise in improving screening for and diagnosis of adolescent depression. However, this training had not previously …

42.3 PARTNERING WITH PEDIATRICIANS: IMPACT OF EXPERIENTIAL TRAINING WITH STANDARDIZED PATIENTS ON SCREENING AND DIAGNOSIS OF ADOLESCENT DEPRESSION IN PRIMARY CARE

Although primary care providers (PCPs) could achieve early identification of adolescent depression, they report inadequate training in depression care. This session describes a model for experiential depression training using standardized patients and demonstrates the long-term impact of this PCP training on the screening and diagnosis of adolescent depression in primary care.

3.14 POST-PARKLAND: TRAINING PEDIATRICIANS TO IDENTIFY AND MANAGE ADOLESCENT DEPRESSION AND PTSD FOLLOWING THE PARKLAND SCHOOL SHOOTING

Youth exposed to school shootings are at increased risk for developing depression and PTSD. Primary care providers (PCPs) are uniquely positioned to identify the early signs of these mental illnesses and intervene, yet they lack appropriate training. Experiential training using standardized patients has shown promise in improving PCPs’ screening for and diagnosis of adolescent depression; however, this screening process had not previously been piloted with a population affected by school shootings. The study aims were to: 1) adapt training for PCPs who serve the population affected by the Parkland school shootings; and 2) examine the effectiveness of training on PCP confidence and practices relevant to caring for youth with depression and PTSD.

Examining parent and child agreement in the diagnosis of adolescent depression.

The diagnosis of depression in adolescents relies on identifying the presence of specific core and additional symptoms. Symptoms can be identified using structured or unstructured interviews and a range of questionnaire measures, which are completed by the young person and by a parent or carer. The aim of this research was to examine the inter- and intra-rater reliability of parent report and adolescent self-report of depression symptoms. In a sample of parent-child dyads, where young people aged 13-17 were referred to a mental health service for depression, we examined adolescents' (n=46) and parents' (n=46) independent responses to the Schedule for Affective Disorders and Schizophrenia in School-Age Children (Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1997, 980) and the Mood and Feelings Questionnaire (Journal of the American Academy of Child and Adolescent Psychiatry, 27, 1988, 726). In the clinical interview, diagnostic criteria were more often met based on the adolescent's report, and adolescents endorsed more symptoms of depression than their parents. Tentative results also suggest that parent-child agreement about specific symptoms was low. Comparing different measures of depression revealed that adolescent report on the questionnaire and interview was significantly correlated. However, there was no significant correlation between parent questionnaire and interview report. These results suggest that relying solely on parents to identify depression in their children may result in young people with depression being missed and therefore untreated. Young people themselves should be encouraged and enabled to recognise the symptoms of depression and have an established pathway to services that offer assessment and treatment. Key Practitioner Message Diagnosis of depression in adolescents requires the identification of specific symptoms and can be identified using interviews or questionnaires. Previous research has suggested that parents and young people provide differing reports regarding symptoms of adolescent depression. Results indicated that diagnostic criteria were more often met based on young person report and that parents reported significantly less symptoms. Parent-child agreement about specific symptoms was found to be low. Assessment of adolescent depression should not rely solely on parental report. Young people should be encouraged and enabled to recognise symptoms of depression and be able to access mental health services.

Depressive symptoms among adolescents in non-clinical Krakow's population - thirty years' follow-up.

Assessment of predictive value of the occurrence of depressive symptoms during adolescence. For this purpose,the life history of untreated adolescents screened for the presence of depressive symptoms was assessed twice, at intervals of fifteen years, including an assessment of their health history, their family-related, occupational, material and social situation. The comparison of the fate of depressive adolescents with the fate of their non-depressive peers was aimed at answering the question about the influence of adolescent depression on health in adulthood. In 1985, a random sample of 1,035 people - students aged 15 and 17 - was examined for a screening diagnosis of adolescent depression. The Krakow Depression Inventory (KID) questionnaires version for 15-year-olds ("IOB1") and for 17-year-olds ("IOC1") were used. After 15 years, data on 238 people (23%) were obtained. In 2015, responses were obtained from 101 people (9.8% of those surveyed in 1985). An analysis of the results of a 30-year prospective study of the relationship between depressiveness in adolescence, in untreated adolescents, and the health and functioning in adulthood indicates that, contrary to predictions, the appearance of depression in this phase of development cannot be treated as a predictor of mental disorders later in life. Long-term observation in our prospective study supports the hypothesis of a developmental character of adolescent depression.

Impact of Experiential Training With Standardized Patients on Screening and Diagnosis of Adolescent Depression in Primary Care

PurposePrimary care providers (PCPs) report inadequate training in depression care. The objective of this study was to examine the long-term impact of PCP training with standardized patients on screening and diagnosis of adolescent depression in primary care. MethodsA retrospective review of electronic medical and billing records for adolescent (aged 12–18 years) well-visits assessed the frequency of screening and new diagnoses of depression. Twenty-five PCPs participated in training. The study included all adolescent well-visits in the 12 months before and after PCP training. Adolescents with a previous diagnosis of depression were excluded from the sample. Univariate and multivariable analyses were used to assess associations with screening. Odds ratios were used to describe the magnitude of associations. ResultsThe analysis included 7,108 well-visits for adolescents (mean age 14.5 years, standard deviation 1.7 years; gender: 52% male; race: 65% white, 13% black, 22% other races; ethnicity: 25% Hispanic; insurance: 67% commercial). Depression screening rate increased significantly after training from 51% to 80% of adolescents seen at well-visits (adjusted odds ratio 40.8, 95% confidence interval 32.6–51.0, p < .0001). Although the likelihood of being screened for depression increased post-training, there was variation based on patient's insurance. A significantly greater percentage of adolescents were newly diagnosed with depression after training (2.22% vs. .89%, p < .0001). ConclusionsPCPs who participated in experiential training using standardized patients were more likely to screen for and diagnose adolescent depression in the 12 months after training. Future studies are needed to examine the effects of PCP training on patient outcomes.

Increasing Recognition and Diagnosis of Adolescent Depression: Project RedDE: A Cluster Randomized Trial.

During a cluster-randomized clinical trial, a national cohort of primary care pediatric practices worked in different orders based on randomization to improve performance on each of three different diagnoses; one was increasing adolescent depression diagnoses. While improving their first diagnosis during an 8-month action period, practices collected control data for a different diagnosis. In two subsequent 8-month periods, practices worked to improve two additional diagnoses and continued to provide data on the ability to sustain and maintain improvements. The QIC intervention included day-long video conferences, transparent data sharing, analysis of failures, QI coaching, and tools to help improve diagnostic performance, including the Patient Health Questionnaire-9 Modified. The primary outcome was the measured frequency of depression diagnoses in adolescent health supervision visits compared via generalized mixed-effects regression models. Forty-three practices were randomized with 31 in the final analysis. We included 3,394 patient visits in the control and 4,114 in the intervention phases. The adjusted percentage of patients with depression diagnoses increased from 6.6% in the control to 10.5% in intervention phase (Risk Difference (RD) 3.9%; 95% CI 2.4%, 5.3%). Practices sustained these increases while working on different diagnoses during the second (RD -0.4%; 95% CI -2.3, 1.4%), and third action periods (RD -0.1%; 95% CI -2.7%, 2.4%). A QIC intervention can sustainably increase adolescent depression diagnoses.

Diagnosis of Depression in Adolescents Following Traumatic Fracture

To assess how frequently adolescents are clinically diagnosed with depression following hospitalization for traumatic fracture, with the assumption that a retrospective approach would yield lower rates of depression compared to those reported previously in prospective studies. We hypothesized that depression would be less common among adolescents whose injuries were primarily limited to fractures of the appendicular skeleton, vertebral column, and/or thoracic cage compared to those sustaining concomitant spinal cord and/or brain injuries and those suffering from facial/skull fractures. A patient population of 1,121 adolescents, aged 12 to 19 years, who were hospitalized overnight at the University of Virginia (UVA) Health System, Charlottesville, for fractures between 2000 and 2009, was generated using the health system's Clinical Data Repository. The number of these adolescents who received a new diagnosis of depression (per ICD-9 codes) at the UVA Health System within the first year following their injury was determined. By the end of the first year, 37 of 913 adolescents (4.1%) who had at least 1 follow-up visit after their fracture were diagnosed with depression. When patients with a concomitant spinal cord injury and those with a facial/skull fracture with or without an associated brain injury were excluded, this percentage dropped to 3.2% and 1.1%, respectively. The results support our initial hypothesis that the percentage of adolescents diagnosed with depression following a traumatic fracture determined retrospectively would be lower than the percentages previously reported in related prospective studies. This finding adds to the growing concern that depression in youth is underdiagnosed, even among youth who have contact with health care providers. When compared to our own retrospectively determined data, the much higher rates of depression reported in several prospective studies indicate that more proactive, routine implementation of depression screening tools in the postinjury period is likely to improve identification of at-risk youth.

Differential Diagnosis of Adolescent Depression

Differential Diagnosis of Adolescent Depression

The specific features of adolescent depression - from developmental reaction to clinical syndrome

The specific features of adolescent depression - from developmental reaction to clinical syndrome Depression belongs to the most common mental disorders of young people. Yet, its analysis has given rise to many controversies among specialists. One of the crucial raised issues is the question whether it is justified to apply the diagnosis of depression in this age group, considering the fact that intrapsychic mechanisms in adolescents are not yet mature. The theoretical problem arises: to what degree adolescent depression ought to be considered a clinical disorder, rather than a specific developmental reaction. In the present paper, the attempt has been undertaken to tackle the issue. It has been found that the diagnosis of adolescent depression cannot rely on clear-cut diagnostic criteria. Instead, it should rely on clinical assessment of an individual patient.

Changes in the rate of diagnosis of major depression in adolescents following routine use of a depression rating scale.

Because major depression in adolescents often goes undiagnosed, it is useful to establish whether clinicians' rates of making this diagnosis in a specialist adolescent mental health service change when a self-rating depression scale is routinely administered. A retrospective, naturalistic study examining the rate of diagnosis of major depression in a mental health service between 1993 and 1997. The intervention was the administration of the Center for Epidemiological Studies Depression Scale (CES-D)prior to initial assessment from September 1995 onwards. The proportion of clinical diagnoses of DSM-III-R or DSM-IV major depression was the outcome measure. Age, gender, ratings of depression and other confounding variables were used to control for changes in patient population over time. One thousand three hundred and ten adolescents aged 12 to 17 years assessed between 1993 and 1997 were included. After taking into account potential confounders, diagnosis of major depression was 2.8 times (95% confidence interval 1.8, 4.3) as likely when the CES-D was in use. Increase was more marked when adolescents were more disturbed overall. There was no evidence suggesting this was due to changes in diagnostic practices or in the patient population. Availability to clinicians of a self-rating depression scale completed prior to assessment was associated with an increase in the frequency of diagnosis of depression in a specialist mental health service for adolescents.

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The Dexamethasone Suppression Test in Adolescent Depression

The data on the dexamethasone suppression test (DST) in a consecutive series of 101 adolescent inpatients are presented. In those with a diagnosis of major depression according to DSM-III criteira, 64% showed nonsuppression. In contrast, only 15% of conduct disorder patients showed nonsuppression. The authors conclude that the DST was useful in confirming a diagnosis of major depression in adolescents.

Clinical Effects of Amitriptyline in Adolescent Depression: A Pilot Study

To determine the effects of antidepressant medication on adolescent depression, we compared the efficacy of amitriptyline (200 mg daily) with placebo in a double-blind experimental design. Diagnosis of adolescent depression (n = 20) was achieved using the psychiatric interview, psychiatric rating scales, and psychometric instruments. No significant differences were reported between the amitriptyline and placebo groups on the Psychiatric Rating Scale or the Minnesota Multiphasic Personality Inventory. There were differences between groups at week 6 on the Depression Adjective Check List. Within group significance occurred from onset of treatment to conclusion on all instruments. The results suggest that prescription of amitriptyline for treatment of adolescent depression may be no more efficacious than the use of placebo.