Predicting the One-Year Course of Adolescent Major Depression

Sanford, Mark; Szatmári, Péter; Spinner, Miriam R.; Munroe-Blum, Heather; Jamieson, Ellen; Walsh, Christine A.; Jones, Deborah

doi:10.1097/00004583-199512000-00012

Cited by 98 publications

(74 citation statements)

References 39 publications

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“…Other studies have also reported the presence of protracted depression in 6% to 10% of depressed children and adolescents. 25,26,[60][61][62] Consistent with the literature, [1][2][3][4][5][6][7][8]27 initial severity, failure to respond to treatment, and presence of ongoing self-reported parent-child conflict predicted persistent depression. Therefore, the presence at baseline and at the end of acute treatment of a cluster of these risk factors should alert the clinician and parents to the possibility of a more long-term course and may provide the clinician with a strategy for altering this course for the better.…”

Section: Commentsupporting

confidence: 59%

Clinical Outcome After Short-term Psychotherapy for Adolescents With Major Depressive Disorder

Birmaher

Brent²,

Kolko³

et al. 2000

Arch Gen Psychiatry

347

229

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Section: Commentsupporting

confidence: 59%

Clinical Outcome After Short-term Psychotherapy for Adolescents With Major Depressive Disorder

Birmaher

Brent²,

Kolko³

et al. 2000

Arch Gen Psychiatry

347

229

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“…In a study conducted by Sanford et al (1995), parent variables were studied in relation to the course of adolescent depression over a 1-year period, with family relationships measured from a semistructured interview about social and academic functioning. Results suggested that paternal and maternal variables contributed in separate ways to the adolescent's depression status at 1-year follow-up.…”

Section: Parent and Family Risk Factors For Youth Depression Parent Fmentioning

confidence: 99%

“…According to Sanford and his colleagues, less positive involvement of fathers and higher conflict with fathers distinguished adolescents who had persistent depressive symptoms from those with remitted depressive symptoms at follow-up. Youth who had persistent depression at follow-up were also less likely to be responsive to both paternal and maternal discipline (Sanford et al, 1995). Kane and Garber (2004) recently conducted an important meta-analysis of paternal factors in youth psychopathology.…”

Section: Parent and Family Risk Factors For Youth Depression Parent Fmentioning

confidence: 99%

Youth Depression in the Family Context: Familial Risk Factors and Models of Treatment

Sander

McCarty

2005

Clin Child Fam Psychol Rev

180

127

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Research on parent risk factors, family environment, and familial involvement in the treatment of depression in children and adolescents is integrated, providing an update to prior reviews on the topic. First, the psychosocial parent and family factors associated with youth depression are examined. The literature indicates that a broad array of parent and family factors is associated with youth risk for depression, ranging from parental pathology to parental cognitive style to family emotional climate. Next, treatment approaches for youth depression that have been empirically tested are described and then summarized in terms of their level of parent inclusion, including cognitivebehavioral therapy, interpersonal therapy, and family systems approaches. Families have mostly not been incorporated into clinical treatment research with depressed adolescents, with only 32% of treatments including parents in treatment in any capacity. Nonetheless, the overall effectiveness of treatments that involve children and adolescents exclusively is very similar to that of treatments that include parents as agents or facilitators of change. The article concludes with a discussion of the implications of these findings and directions for further research. Keywordsdepression; adolescence; childhood; treatment; parent factors; family risk factors Developmentally, youth are known to have close ties to their families of origin (Diamond, Siqueland, & Diamond, 2003;Steinberg, 2005). As a result, there is a general belief in the field of psychology that it is important to include parents and families in the treatment of depressed youth (Clark, Beck, & Alford, 1999;Curry, 2001) however, empirical guidelines for how to do so are lacking. Consensus about the need for, and how to measure the effects of, parental involvement in treatment is elusive (Goodman & Gotlib, 1999). Still, achieving a better understanding of the multidimensional nature of risks for depression and how parent involvement in treatment relates to those risks are the priorities for the area of youth depression.Recently, a national group of experts was called to summarize and prioritize the state of research on risk and treatment for youth depression. Specifically, the National Institutes of Mental Health (NIMH) invited a workgroup of leaders in the field of depression to clarify the state of information about the risks for and treatment of depression, and to make recommendations on where the field needs to focus research endeavors (Costello et al., 2002). Regarding risks for depression, the workgroup recommended further research into both family environment and genetics. As summarized by Costello and the NIMH workgroup, multiple pathways to depression are evident. The workgroup emphasized the multidimensional NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript nature of depression, along with the paucity of research into the early pathways and interactions that cause depression. Although research has not identified all of the parent or family ...

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“…Other predictors of persistence that have been identified in at least 1 study of depressed adolescents in mental health specialty settings include female gender, 18 older age, 17 comorbid anxiety, 17,19 substance abuse, 17 and poor support from peers 20 or family. 17,21 In our study, each of these variables was associated with the presence of a positive depression screen at baseline, but none were associated with depression persistence.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Persistence After a Positive Depression Screen Among Adolescents

2012

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Adolescents have high placebo response rates in depression treatment trials. Screening for depression will likely detect youth with a broad range of symptom severity, including some who would benefit from watchful waiting but might not require active treatment. WHAT THIS STUDY ADDS:The strongest predictors of symptom persistence are depressive symptom severity at presentation and continued symptoms on repeat screening 6 weeks later. These results provide important information for the development of postscreening management protocols in the primary care setting. abstract OBJECTIVE: To examine predictors of depression persistence after a positive screening test to inform management protocols for screened youth. METHODS:We conducted a cohort study of 444 youth (aged 13-17 years) from a large health care delivery system. Youth with depressive symptoms, based on a 2-item depression screen, were oversampled for the baseline interview. Baseline assessments included the Patient Health Questionnaire 9-item (PHQ-9) depression screen as well as clinical factors that were hypothesized to influence depression persistence (family history of depression, functional impairment, perceived social support, anxiety symptoms, externalizing symptoms, and medical comorbidity). Logistic regression analysis was used to examine factors associated with the persistence of depression at 6 months postbaseline. RESULTS:Of 113 youth with a positive baseline screen (PHQ-9 $11), 47% and 35% continued to be positive at 6-week and 6-month followup, respectively. After controlling for treatment status, only 2 factors were significantly associated with depression persistence at 6 months: baseline depressive symptom score and continuing to have a positive screen at 6 weeks. For each 1-point increase on the PHQ-9 score at baseline, youth had a 16% increased odds of continuing to be depressed at 6 months (odds ratio: 1.16, 95% confidence interval: 1.01-1.34). Youth who continued to screen positive 6 weeks later had almost 3 times the odds of being depressed at 6 months (odds ratio: 2.89, 95% confidence interval: 1.09-7.61). CONCLUSIONS:Depressive symptom severity at presentation and continued symptoms at 6 weeks postscreening are the strongest predictors of depression persistence. Patients with high depressive symptom scores and continued symptoms at 6 weeks should receive active treatment. Pediatrics 2012;130:e1541-e1548 AUTHORS:

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Predicting the One-Year Course of Adolescent Major Depression

Cited by 98 publications

References 39 publications

Clinical Outcome After Short-term Psychotherapy for Adolescents With Major Depressive Disorder

Clinical Outcome After Short-term Psychotherapy for Adolescents With Major Depressive Disorder

Youth Depression in the Family Context: Familial Risk Factors and Models of Treatment

Predictors of Persistence After a Positive Depression Screen Among Adolescents

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