Major depressive disorder in children and adolescents

Mullen, Sandra

doi:10.9740/mhc.2018.11.275

Cited by 145 publications

(118 citation statements)

References 45 publications

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“…Major depressive disorder (MDD) is one of the most common psychiatric disorders of childhood and adolescence (Mullen, 2018). It has been estimated that 14% to 25% of adolescents experience at least one episode of a depressive disorder before entering adulthood (Ryan, 2005).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of trauma-focused treatment for adolescents with major depressive disorder

Paauw

Roos

Tummers

et al. 2019

European Journal of Psychotraumatology

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Background: Major Depressive Disorder (MDD) in adolescence has a high prevalence and risk of disability, but current treatments show limited effectiveness and high drop-out and relapse rates. Although the role of distressing experiences that relate to the development and maintenance of MDD has been recognized for decades, the efficacy of a trauma-focused treatment approach for MDD has hardly been studied. Objective: To determine the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy as a stand-alone intervention in adolescents diagnosed with MDD. We hypothesized that reprocessing core memories related to the onset and maintenance of MDD using EMDR therapy would be associated with a significant decrease in depressive and comorbid symptoms. Method: We recruited 32 adolescents (12-18 years) fulfilling DSM-IV criteria for mild to moderate-severe MDD from an outpatient youth mental health care unit. Treatment consisted of six weekly 60-min individual sessions. Presence or absence of MDD classification (ADIS-C), symptoms of depression (CDI), symptoms of posttraumatic stress (UCLA), anxiety (SCARED), somatic complaints (CSI), and overall social-emotional functioning (SDQ) were assessed pre and post-treatment and 3 months after treatment. Results: 60.9% of the adolescents completing treatment no longer met DSM-IV criteria for MDD after treatment anymore, and 69.8% at follow-up. Multilevel analyses demonstrated significant posttreatment reductions of depressive symptoms (CDI: Cohen's d = 0.72), comorbid posttraumatic stress, anxiety and somatic complaints, while overall socialemotional functioning improved. These gains were maintained at 3-month follow-up (Cohen's d = 1.11). Severity of posttraumatic stress reactions significantly predicted the posttreatment outcome; however, duration of MDD, number of comorbid disorders, or having a history of emotional abuse, emotional neglect or physical neglect were not predictive for outcome. Conclusions: This is the first study suggesting that EMDR therapy is associated with a significant reduction of depressive symptoms and comorbid psychiatric problems in adolescents with mild to moderate-severe MDD.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of trauma-focused treatment for adolescents with major depressive disorder

Paauw

Roos

Tummers

et al. 2019

European Journal of Psychotraumatology

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“…Poor recognition of BD in adolescence may be partly explained by overlapping symptoms of BD and comorbid disorders such as attention-deficit hyperactivity disorder 48. In addition, clinical presentation of UD in adolescence may differ from UD in adults, resulting in misdiagnosis of UD in young people 49. Therefore, exclusion of all psychiatric hospitalizations before the first inpatient treatment due to UD may underestimate the effect of age on conversion.…”

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confidence: 99%

Diagnostic conversion from unipolar depression to bipolar disorder, schizophrenia, or schizoaffective disorder: A nationwide prospective 15‐year register study on 43 495 inpatients

et al. 2020

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Objective To examine temporal patterns and predictors for diagnostic conversion from unipolar depression (UD) to bipolar disorder (BD), schizophrenia, and schizoaffective disorder (SAD). Methods A prospective nationwide register‐based cohort (n = 43 495) of all first psychiatric hospitalizations due to UD during 1996‐2011 was followed up to 15 years. We used cumulative incidence function (CIF) analyses and the Fine‐Gray subdistribution model to define the cumulative incidence of the conversions and subdistribution hazard ratios (SHRs) for predictors. Results The overall 15‐year cumulative incidence of conversion was 11.1% (95% CI 10.7‐11.6): 7.4% (95% CI 7.0‐7.8) for BD, 2.5% (95% CI 2.3‐2.7) for schizophrenia, and 1.3% (95% CI 1.1‐1.4) for SAD. The highest crude incidence rate emerged during the first year. Psychotic depression predicted higher conversion risk to BD (SHR = 2.0, 95% CI 1.5‐2.7), schizophrenia (SHR = 5.3, 95% CI 3.3‐8.7), and SAD (SHR = 10.6, 95% CI 4.0‐28.4) than mild depression. Female sex, greater overall disturbance, and comorbid personality disorder predicted conversion to BD, whereas young age and male sex to psychotic disorders. Conclusions Among patients with first hospitalization due to UD, approximately one in nine converts to another major psychiatric disorder during 15 years, with the highest risk occurring within the first year. Patients with psychotic depression are particularly vulnerable for conversion to other major psychiatric disorders. Conversion to psychotic disorders occurs earlier than to BD. Males are at higher risk for progression to psychotic disorders, whereas females, patients with recurrent depressive episodes, severe disturbance of overall functioning, and personality disorder are at higher risk for converting to BD.

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“…Depression is a complex condition of unclear causation. 24 Deficiency of certain neurotransmitters have been reported to play a role in causing or contributing to depression. Serotonin has attracted the most attention, but many others including norepinephrine and dopamine have also been considered as mediators (Table II; available at www.jpeds.…”

Section: The Value Of a Multidisciplinary Team Approachmentioning

confidence: 99%

“…com). 24 However, the current consensus is that there is no exclusive causative element such as neurotransmitter deficiency; instead, several different contributing factors may lead to depression, including psychological or social factors, life-changing events, and biological factors such as genetics, physical illness, and chemical imbalance. 24 Therefore, a multidisciplinary team approach is widely adopted in the management of depression during the developmental years.…”

Section: The Value Of a Multidisciplinary Team Approachmentioning

confidence: 99%

The Burden of Depression in Adolescents and the Importance of Early Recognition

Petito

Pop

Namazova-Baranova³

et al. 2020

The Journal of Pediatrics

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ental health disorders are frequent during the developmental years, particularly in adolescents. The leading cause of disability in young people are neuropsychiatric conditions, which if left untreated may severely affect development, including educational and social achievements. It has been reported that 10%-20% of individuals experience a form of mental disorder during childhood and adolescence worldwide. 1 One-half of them arise by 14 years of age. 2 Among adolescent mental health disorders, depression is one of the most frequent conditions, and it is indicated as one of the most alarming "new morbidities." 3,4 The onset of depression is typically around mid-to-late adolescence, and it important to recognize its early warning signs and symptoms. Early intervention can often prevent the later development of a severe depressive illness. For instance, in adolescents, depression is a major risk factor for suicide, and more than one-half of adolescent suicide victims were reported to have a depressive disorder at the time of death. 5 Depression also leads to serious social and educational maladjustments in this age group, such as an increased rate of smoking, substance misuse, eating disorders, and obesity. 6,7 This commentary aims to further raise awareness of pediatricians on the burden and risks faced by adolescents developing depression. In particular, we emphasize that new morbidities should be part of the formal training in pediatrics worldwide, enabling the new generations of pediatricians to recognize these pathologic conditions in a timely manner and effectively deal with them.

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Major depressive disorder in children and adolescents

Cited by 145 publications

References 45 publications

Effectiveness of trauma-focused treatment for adolescents with major depressive disorder

Effectiveness of trauma-focused treatment for adolescents with major depressive disorder

Diagnostic conversion from unipolar depression to bipolar disorder, schizophrenia, or schizoaffective disorder: A nationwide prospective 15‐year register study on 43 495 inpatients

The Burden of Depression in Adolescents and the Importance of Early Recognition

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