Treatment Of Depression In Children Research Articles

Understanding Silent Eruptions of Depression among Youngsters and Adolescents

A calm insanity of any kind was included in the original broad definition of melancholia along with the present idea of affective illnesses, which today views mood as the primary disturbance, the term depression first appeared in the nineteenth century. A very complicated mental illness, major depressive disorder (MDD) is commonly referred to as depression. It is marked by a depressed mood, diminished interests, and disinterest in routine tasks, feelings of loneliness, impaired cognitive function, and vegetative symptoms like disturbed sleep or appetite and a lack of desire. Research illustrating the frequency of depression in kids and teens reveals that a sizable portion of kids in both age groups experience symptoms of despair. According to the analysis, there are no differences between the adult and child depression constructs in terms of mental classifications, and a comprehensive understanding of depression. Considering the child's developmental stage and cognitive and linguistic abilities, children with MDD share many of the same key characteristics as adults and adolescents. Research on the general population is the only source of information on many significant issues regarding depression in young people. Teens suffering from mental illnesses are a vulnerable population that requires more care. It takes equilibrium between feelings, ideas, and behavior to maintain mental health. An important source of morbidity and death in children and adolescents is depression disorders, which are frequent and repeated illnesses. Adult psychopathology has been linked to early trauma in the form of physical or sexual abuse experienced as a kid. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed as the initial treatment for depression in children and adolescents. Fluoxetine offers the strongest safety and effectiveness data when compared to other antidepressants, especially when used in teenagers who are 12 years of age or older. Adolescents' self-reports of attachment anxiety and avoidance can be effectively addressed through Interpersonal Psychotherapy for Adolescents (IPT-A). This therapy appears particularly beneficial for those exhibiting high levels of avoidant attachment. The study highlights that attachment anxiety and avoidance are modifiable during adolescence and can be viable treatment targets. IPT-A has proven effective in treating attachment-related issues, with reductions in attachment anxiety and avoidance correlating with decreases in depressive symptoms. This supports the use of IPT-A for depressed adolescents struggling with attachment security, especially those with an avoidant attachment style who tend to shy away from intimacy. Keywords Depression, Adolescents, Youngsters, Child maltreatment, Suicide, Abuse, Fluoxetine

Psychological interventions for depression in children and adolescents: A bibliometric analysis.

Depression has gradually become a common psychological disorder among children and adolescents. Depression in children and adolescents affects their physical and mental development. Psychotherapy is considered to be one of the main treatment options for depressed children and adolescents. However, our understanding of the global performance and progress of psychological interventions for depression in children and adolescents (PIDCA) research is limited. To identify collaborative research networks in this field and explore the current research status and hotspots through bibliometrics. Articles and reviews related to PIDCA from January 2010 to April 2023 were identified from the Web of Science Core Collection database. The Charticulator website, CiteSpace and VOSviewer software were used to visualize the trends in publications and citations, the collaborative research networks (countries, institutions, and authors), and the current research status and hotspots. Until April 16, 2023, 1482 publications were identified. The number of documents published each year and citations had increased rapidly in this field. The United States had the highest productivity in this field. The most prolific institution was the University of London. Pim Cuijpers was the most prolific author. In the context of research related to PIDCA, both reference co-citation analysis and keywords co-occurrence analysis identified 10 research hotspots, including third-wave cognitive behavior therapy, short-term psychoanalytic psychotherapy, cognitive behavioral analysis system of psychotherapy, family element in psychotherapy, modular treatment, mobile-health, emotion-regulation-based transdiagnostic intervention program, dementia risk in later life, predictors of the efficacy of psychological intervention, and risks of psychological intervention. This bibliometric study provides a comprehensive overview of PIDCA from 2010 to present. Psychological intervention characterized as psychological-process-focused, short, family-involved, modular, internet-based, emotion-regulation-based, and personalized may benefit more young people.

A paucity of evidence in youth: The curious case of transcranial direct current stimulation for depression

A significant proportion of youth with depression do not respond to available treatment. Transcranial direct current stimulation (tDCS) is a promising third-line treatment in depressed adults, but evidence in youth seems scarce. Following the PRISMA guidelines, we conducted a systematic literature review on tDCS treatment for depression in children and adolescents. No published studies were found on the use of tDCS in youth with depression. Given the null-findings, no conclusion can be drawn about the effectiveness of tDCS treatment for adolescent depression. The reasons for this paucity of evidence in light of existing regulatory frameworks and technical challenges are discussed.

The Role of Omega-3 Fatty Acids in the Treatment of Depression in Children and Adolescents: A Literature Review.

Depression is one of the most common mental disorders diagnosed in children and adolescents. Many individuals benefit from pharmacotherapy including antidepressants, however, there is a fair likelihood of remission and recurrence.Of the several pathophysiologies, depression has been linked to inflammation. Complementary and alternative medications such as the use of omega-3 fatty acids are gaining popularity given their anti-inflammatory properties. The goal of this literature review is to assess the efficacy and the clinical use of omega-3 fatty acids in children and adolescents with depression. We conducted an extensive literature search on PubMed, Ovid MEDLINE, and PsycINFO from January 1, 2005, to September 2021, for published articles (case reports, systematic review, RCT) in any language. A total of seven published studies were included in our literature review.Results indicated a huge heterogenicity in the studies and hence the clinical use of omega-3 fatty acids as monotherapyin depression was not determined. However, it was well tolerated with an extremely low side effect profile. Further research on the use of omega-3 fatty acids as an adjunct to antidepressants would be valuable.

Effectiveness of family-based therapy for depressive symptoms in children and adolescents: A systematic review and meta-analysis.

Early-onset depression contributes significantly to the global health burden and has long-term negative effects. This meta-analysis collates and examines the effectiveness of family-based interventions, where family members are involved in the treatment of depression in children and adolescents. A literature search was performed up to 8th March 2023. Randomised controlled trials of family-based interventions were included for participants aged 3-18 years with a diagnosis of major depressive disorder or dysthymia, according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) or with a score above a cut-off on a standardised self-report depression measure. The overall effect size for treatment versus active control was g = 0.22 (95% confidence interval [CI]: -0.05-0.50) (nine studies; 659 participants), and for treatment versus non-active control it was g = 0.46 (95% CI: -0.09-1.01) (four studies; 385 participants). Effect sizes were not statistically significant, and heterogeneity was high, ranging between I2 = 64.3-81.1%. Subgroup analysis comparing attachment-based family therapy with family therapy using other theoretical frameworks did not yield a significant difference between the two. The effects of family-based therapies were larger than those in the comparison groups, but family-based therapy did not demonstrate a significant treatment benefit compared to the controls. More randomised controlled trials are warranted, considering that evidence for other psychotherapies for depression in children and adolescents, indicates modest effects. Family-based therapy may be an alternative for children and adolescents whose needs are not addressed by these treatments.

Current Treatment of Depression in Children with Autism and Intellectual and Developmental Disabilities

There are no evidence-based guidelines for the treatment of depression in Autism Spectrum Disorder (ASD). We describe prescribing practices for youth with depression

Effectiveness of Emotion-Focused Cognitive-Behavioral Therapy in Depression and Its Components in Children with Social Anxiety

Background and Objective: Depression in children is especially related to social anxiety. The present study aimed to investigate the effectiveness of emotion-focused cognitive-behavioral therapy (ECBT) in depression and its components in children with social anxiety. Materials and Methods: This research was a quasi-experimental study with a pretest-posttest control group design. Among the primary school students of Qom in the 2019 academic year, 46 students whose score was higher than 29.5 on the Liebowitz Social Anxiety Scale for Children and Adolescents were selected and randomly assigned to experimental (n=23) and control (n=23) groups. Firstly, both groups responded to Children's Depression Inventory as the pre-test. Thereafter, the experimental group participated in the 16 sessions of ECBT, and the control group remained on the waiting list. Finally, the two groups were administered the post-test. Results: The results of Multivariate analysis of covariance (MANCOVA) demonstrated that after the control of pre-test effects, there was a significant difference in the linear combination of depression components of the two groups (Wilks' lambda= 0.065, F33,5= 94.662, P= 0.001). The results of univariate tests of ANCOVA also showed a significant decrease (P<0.01) in all depression components (and also the total score) in children of the experimental group after the ECBT sessions. Conclusion: As evidenced by the results of this study, ECBT is an effective treatment for depression in children with social anxiety. It is suggested that mental health professionals prioritize this treatment in their therapeutic programs.

Effectiveness of psychological treatments for depression in childhood and adolescence: A review of reviews

Depression in childhood and adolescence is a public health problem due to its high prevalence and the impact it has in the individual development. There is clear evidence of the efficacy of Interpersonal Therapy (IPT) and Cognitive-Behavioural Therapy (CBT) in the treatment of depression in children and adolescents; however, recent reviews and meta-analyses provide new perspectives for treatment. The purpose of this work is to synthesize the bibliography available through a systematic review of systematic reviews and meta-analysis that summarizes in a comprehensive way the evidence of the last two decades on the effectiveness of psychological interventions for infant-juvenile depression. A systematic review of systematic reviews and meta-analyses was performed. A search was conducted in the Web of Science and Scopus databases. Eight records met the inclusion criteria, 2 were analysed in their entirety and from the remaining 6 the information needed for independent analysis was extracted. Seven different psychotherapies were studied: CBT and IPT were the most studied (n=7; 87.5%), followed by family therapy (n=5; 62.5%), psychodynamic therapy (n=3; 37.5%), behavioural therapy (n=3; 37.5%), computerised CBT (n=2; 25%), problem-solving therapy (n=1; 12.5%) and supportive therapy (n=1; 12.5%). IPT and CBT were shown to be effective in the treatment of adolescent depression. Half of the reviews (n=4; 50%) had a low methodological quality and the other half (n=4; 50%) were classified as critically low. In general, psychological interventions for child and adolescent depression produce significant, but modest effects. Specifically, IPT and CBT can be considered the main treatment alternatives for adolescent depression. There is insufficient data of specific psychological treatment for children diagnosed with a depressive disorder. It is suggested that research should be increased to improve the methodological quality and increase the number of studies aimed at the children population.

Efficacy and tolerability of antidepressant drugs in treatment of depression in children and adolescents: a network meta-analysis.

To evaluate the efficacy and safety of antidepressants in treatment of depression disorder in children and adolescents by network meta-analysis. Databases of PubMed, Cochrane Library, EMBASE, Web of Science, PsycINFO, CBM, CNKI and Wanfang Data were searched for randomized controlled trials (RCT) related to antidepressants in treatment of children and adolescents with depression from inception to December 2021. Quality assessment and data extraction from the included RCTs were performed. Statistical analyses of efficacy and tolerability were conducted with Stata 15.1 software. Surface under the cumulative ranking (SUCAR) was used to rank the value of the antidepressants. A total of 33 RCTs were included in 32 articles, involving 6949 patients. There are 13 antidepressants used in total, including amitriptyline, vilazodone, fluoxetine, selegiline, paroxetine, imipramine, desipramine, sertraline, nortriptyline, escitalopram, citalopram, venlafaxine and duloxetine. The results of network meta-analysis showed that the efficacy of duloxetine ( OR=1.95, 95% CI: 1.41-2.69), fluoxetine ( OR=1.73, 95% CI: 1.40-2.14), venlafaxine ( OR=1.37, 95% CI: 1.04-1.80) and escitalopram ( OR=1.48, 95% CI: 1.12-1.95) were significantly higher than that of placebos (all P<0.05); the probability cumulative ranks were duloxetine (87.0%), amitriptyline (83.3%), fluoxetine (79.0%), escitalopram (62.7%), etc. The results showed that the intolerability of patients receiving imipramine ( OR=0.15, 95% CI: 0.08-0.27), sertraline ( OR=0.33, 95% CI: 0.16-0.71), venlafaxine ( OR=0.35, 95% CI: 0.17-0.72), duloxetine ( OR=0.35, 95% CI: 0.17-0.73) and paroxetine ( OR=0.52, 95% CI: 0.30-0.88) were significantly higher than that of placebos (all P<0.05), and the probability cumulative ranks were imipramine (95.7%), sertraline (69.6%), venlafaxine (68.6%), duloxetine (68.2%), etc. Conclusion: Among 13 antidepressants, duloxetine, fluoxetine, escitalopram and venlafaxine are significantly better than placebo in terms of efficacy, but duloxetine and venlafaxine are less well tolerated.

CHILD DEPRESSION IN BRAZIL - A LITERATURE REVIEW

Background: Childhood depression is a very prevalent mental health condition in today's society. Its debate began to become relevant in the 1960s and, although there is no doubt about its existence, the subject is still little discussed. Aim: The purpose of this paper is to demonstrate the relevance of the subject due to its high prevalence and underdiagnosis. Methods: A literature review on Childhood Depression in Brazil was carried out based on researches in Pubmed, Scielo and Google Scholar databases, between 1989 and 2020, in Portuguese and English, using the descriptors: “child depression” , “symptoms of depression” and “treatment of childhood depression” combined together. Textbooks, data from Ministério da saúde, the World Health Organization (WHO) and key articles selected from citations in other articles were used to composse the paper. From the analysis of the data found, twenty-two titles that are directly related to the current work were selected. Results and discussion: In Brazil, girls and children between thirteen and fourteen years old are the most affected by the disease. Currently, the DSM does not differentiate it from adult depression, despite the atypical manifestations of its symptoms in children. Families still have great difficulty on identifying this disorder the biggest obstacle is understanding and accepting that behavioral changes can be part of a depressive condition.Conclusions: Normalizing the discussion of the topic is important so that there is more information about the disease and, consequently, more knowledge is disseminated both to the medical community and the families of affected children. This way, it will be possible to prevent its appearance and, when present, facilitate its detection, improving life quality of those involved and avoiding negative outcomes such as child suicide.

A sensitive HILIC-MS/MS method for quantification of theanine in rat plasma and tissues: Application to preclinical pharmacokinetic study

Adolescent depression is a significant public health problem, with the major depressive disorder having been the leading risk factor for suicide and death amongst children and adolescents. For treating depression, antidepressants are used with minimal clinical evidence data and uncertain efficacy in children. L-theanine has anti-depression and other physiological functions. However, few reports are available on the pharmacokinetics of L-theanine, especially in children and adolescents. In this study, a rapid and sensitive hydrophilic interaction liquid chromatography-tandem mass spectrometry method was established and validated for the quantification of L-theanine in juvenile rat plasma and tissues. Chromatographic separation was conducted via an Agilent ZORBAX HILIC plus column in gradient elution mode. L-theanine and [2H5]-L-glutamic acid (internal standard) were determined under the multi-reaction monitoring mode transitions of m/z 175.0 → 157.9 and m/z 153.0 → 88.2 in positive ionisation mode, respectively, and completed methodology verification. In addition, 10 and 35 mg kg−1 of L-theanine were given by intragastric administration to determine the brain and plasma pharmacokinetic characteristics in healthy and chronic unpredictable mild stress rats, respectively. The distribution of tissues and the limbic system were measured at the same time. The results showed that juvenile and diseased rats have higher absorption than adult rats, and age, dosage and health status could affect the process of L-theanine in vivo. L-theanine also has a high degree of tissue distribution. This study lays a foundation for the clinical treatment of depression in children and adolescents.

Evidence for machine learning guided early prediction of acute outcomes in the treatment of depressed children and adolescents with antidepressants.

The treatment of depression in children and adolescents is a substantial public health challenge. This study examined artificial intelligence tools for the prediction of early outcomes in depressed children and adolescents treated with fluoxetine, duloxetine, or placebo. The study samples included training datasets (N = 271) from patients with major depressive disorder (MDD) treated with fluoxetine and testing datasets from patients with MDD treated with duloxetine (N = 255) or placebo (N = 265). Treatment trajectories were generated using probabilistic graphical models (PGMs). Unsupervised machine learning identified specific depressive symptom profiles and related thresholds of improvement during acute treatment. Variation in six depressive symptoms (difficulty having fun, social withdrawal, excessive fatigue, irritability, low self-esteem, and depressed feelings) assessed with the Children's Depression Rating Scale-Revised at 4-6 weeks predicted treatment outcomes with fluoxetine at 10-12 weeks with an average accuracy of 73% in the training dataset. The same six symptoms predicted 10-12 week outcomes at 4-6 weeks in (a) duloxetine testing datasets with an average accuracy of 76% and (b) placebo-treated patients with accuracies of 67%. In placebo-treated patients, the accuracies of predicting response and remission were similar to antidepressants. Accuracies for predicting nonresponse to placebo treatment were significantly lower than antidepressants. PGMs provided clinically meaningful predictions in samples of depressed children and adolescents treated with fluoxetine or duloxetine. Future work should augment PGMs with biological data for refined predictions to guide the selection of pharmacological and psychotherapeutic treatment in children and adolescents with depression.

The effects of psychological treatments of depression in children and adolescents on response, reliable change, and deterioration: a systematic review and meta-analysis

Meta-analyses show that psychotherapies are effective in the treatment of depression in children and adolescents. However, these effects are usually reported in terms of effect sizes. For patients and clinicians, it is important to know whether patients achieve a clinically significant improvement or deterioration. We conducted such a meta-analysis to examine response, clinically significant change, clinically significant deterioration and recovery as outcomes. We searched four bibliographic databases and included 40 randomised trials comparing psychotherapy for youth depression against control conditions. We used a validated method to estimate outcome rates, based on means, standard deviation and N at baseline and post-test. We also calculated numbers-need-to- treat (NNT). The overall response rate in psychotherapies at 2 (±1) months after baseline was 39% (95% CI: 34–45) and 24% (95% CI: 0.19–28) in control conditions (NNT: 6.2). The difference between therapy and control was still significant at 6–12 months after baseline (NNT=7.8). Clinically significant improvement was found in 54% of youth in therapy, compared with 32% in control groups (NNT=5.3); clinically significant deterioration was 6% in therapy, 13% in controls (NNT=5.1); recovery was 58% in therapy, 36% in controls (NNT=3.3). Smaller effects were found in studies with low risk of bias. Psychotherapies for depression in youth are effective compared to control conditions, but more than 60% of youth receiving therapy do not respond. More effective treatments and treatment strategies are clearly needed. Trial registrationhttps://osf.io/84xka

Updates in treatment of depression in children and adolescents.

To examine recent evidence that informs the treatment of depression in children and adolescents. There are no new leads in the prevention and early intervention of depression in children and adolescents. For acute treatment of major depressive disorder, talking therapies are moving increasingly to internet-based platforms. Family therapy may have a slight edge over individual psychotherapy in the short-term. Patients with severe depression with endogenous features have a more robust response to pharmacotherapy than do patients with mild-to-moderate depression. Findings in relation to reward sensitivity and changes in brain-derived neurotrophic factor levels contradict research conducted in adults, suggesting developmental differences in the mechanisms underlying depression. Ketamine infusion could have a role for adolescents with treatment refractory depression. There was no new evidence concerning relapse prevention. Most new findings have been concerned with moderators and mediators of treatment.

Psychological interventions for depression in children and young people with an intellectual disability and/or autism: systematic review.

Children and young people with intellectual disability and/or Autism Spectrum Disorder (autism) experience higher rates of mental health problems, including depression, than their typically developing peers. Although international guidelines suggest psychological therapies as first-line intervention for children and young people, there is limited evidence for psychological therapy for depression in children and young people with intellectual disability and/or autism. To evaluate the current evidence base for psychological interventions for depression in children and young people with intellectual disability and/or autism, and examine the experiences of children and young people with intellectual disability and/or autism, their families and therapists, in receiving and delivering psychological treatment for depression. Databases were searched up to 30 April 2020 using pre-defined search terms and criteria. Articles were independently screened and assessed for risk of bias. Data were synthesised and reported in a narrative review format. A total of 10 studies met the inclusion criteria. Four identified studies were clinical case reports and six were quasi-experimental or experimental studies. All studies were assessed as being of moderate or high risk of bias. Participants with intellectual disability were included in four studies. There was limited data on the experiences of young people, their families or therapists in receiving or delivering psychological treatment for depression. Well-designed, randomised controlled trials are critical to develop an evidence base for psychological treatment for young people with intellectual disability and/or autism with depression. Future research should evaluate the treatment experiences of young people, their families and therapists.

Depression and its characteristics in childhood and adolescence

Currently the accelerated and troubled routine ends up also affecting children and adolescents, who are still unable to develop, express and assimilate what happens to them, internally and externally, understand their pains and suffering; thus, they end up developing mental disorders, such as depression. Given the importance of seeking more information about depression, this study aimed to produce a bibliographic review article on depression in childhood and adolescence and its characteristics. The databases Pubmed (US National Library of Medicine), Scielo (Scientific Electronic Library Online), and Google ScholarⓇ were used in the present study, using the descriptors: depression, psychotropic drugs, mental disorders and psychotherapy. The articles analyzed were written in Portuguese, English and Spanish, for the past 22 years. For the diagnosis of children or adolescents, the clinical investigation has its particularities, the anamnesis must be more in-depth and it must go beyond the parents' complaint and the history of the child or adolescent. During treatments, psychopharmaceuticals can be used, as well as alternative therapies, such as supportive psychotherapy, interpersonal therapy, brief dynamic psychotherapy, behavioral therapy, among others. However, according to studies carried out recently, the use of psychotropic drugs in children and adolescents brings worrying revelations. It is concluded, through the study, that care must be taken both in the diagnosis and in the treatment of depression in children and adolescents.

Implementing the Patient Health Questionnaire Modified for Adolescents to improve screening for depression among adolescents in a Federally Qualified Health Centre

BackgroundDepression, which is a serious medical illness, is prevalent worldwide and it negatively impacts the adolescent lifestyle. Adolescent depression is associated with adverse emotional and functional outcomes and suboptimal physical...

Adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review

ObjectivesTo analyse to what extent clinical practice guidelines on drug treatment of depression in children and adolescents mention the risk of adverse effects, to characterise the citations in the guidelines...

Secondary care specialist visits made by children and young people prescribed antidepressants in primary care: a descriptive study using the QResearch database

BackgroundAntidepressants may be used to manage a number of conditions in children and young people including depression, anxiety, and obsessive-compulsive disorder. UK guidelines for the treatment of depression in children and young people recommend that antidepressants should only be initiated following assessment and diagnosis by a child and adolescent psychiatrist. The aim of this study was to summarise visits to mental health specialists and indications recorded around the time of antidepressant initiation in children and young people in UK primary care.MethodsThe study used linked English primary care electronic health records and Hospital Episode Statistics secondary care data. The study included 5–17-year-olds first prescribed antidepressants between January 2006 and December 2017. Records of visits to paediatric or psychiatric specialists and potential indications (from a pre-specified list) were extracted. Events were counted if recorded less than 12 months before or 6 months after the first antidepressant prescription. Results were stratified by first antidepressant type (all, selective serotonin reuptake inhibitors (SSRIs), tricyclic and related antidepressants) and by age group (5–11 years, 12–17 years).ResultsIn total, 33,031 5–17-year-olds were included. Of these, 12,149 (37%) had a record of visiting a paediatrician or a psychiatric specialist in the specified time window. The majority of recorded visits (7154, 22%) were to paediatricians. Of those prescribed SSRIs, 5463/22,130 (25%) had a record of visiting a child and adolescent psychiatrist. Overall, 17,972 (54%) patients had a record of at least one of the pre-specified indications. Depression was the most frequently recorded indication (12,501, 38%), followed by anxiety (4155, 13%).ConclusionsThe results suggest many children and young people are being prescribed antidepressants without the recommended involvement of a relevant specialist. These findings may justify both greater training for GPs in child and adolescent mental health and greater access to specialist care and non-pharmacological treatments. Further research is needed to explore factors that influence how and why GPs prescribe antidepressants to children and young people and the real-world practice barriers to adherence to clinical guidelines.

Technology Matters: The human touch in a digital age - a blended approach in mental healthcare delivery with children and young people.

Online psychological interventions have the potential to address many current issues facing service provision in child and adolescent mental health, not least improving access to evidence-based therapies and providing greater patient choice. Recognising this, the National Institute for Health and Care Excellence (NICE) now recommend digitally delivered therapy in the treatment of depression in children and young people (CYP). However, despite the virtual ubiquity of technology in young people's lives, and good evidence that online treatments can be effective, there remain barriers to real-world implementation. We argue that remote therapist support and blended approaches to therapy will be important models in harnessing the potential of digital technology in CYP mental health.