Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents

Cox, Georgina; Callahan, Patch; Churchill, Rachel; Hunot, Vivien; Merry, Sally; Parker, Alexandra G.; Hetrick, Sarah

doi:10.1002/14651858.cd008324.pub2

Cited by 77 publications

(61 citation statements)

References 118 publications

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“…Mental health treatment recommendations and primary care providers' busy schedules seem to move in opposite directions. Even though recent meta-analytic evidence positions psychotherapy as equal to or possibly greater in effectiveness than antidepressant medication for the treatment of depression of youths (36), less than 10% of primary care providers in the private sector delivered psychotherapy in 2009. [A table provided in the online supplement to this article provides further detail.]…”

Section: Discussionmentioning

confidence: 99%

Receipt of Evidence-Based Pharmacotherapy and Psychotherapy Among Children and Adolescents With New Diagnoses of Depression

Soria-Saucedo¹,

Walter²,

Cabral³

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Receipt of Evidence-Based Pharmacotherapy and Psychotherapy Among Children and Adolescents With New Diagnoses of Depression

Soria-Saucedo¹,

Walter²,

Cabral³

et al. 2016

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“…With regards to treatment, psychosocial and pharmacological interventions for youth with OCD and youth with depression are robust in efficacy [52, 53]. Effective treatment of OCD is frequently associated with reductions in depressive symptoms [54, 55] as OCD symptoms improve and become less interfering.…”

Section: Discussionmentioning

confidence: 99%

Frequency and Correlates of Suicidal Ideation in Pediatric Obsessive–Compulsive Disorder

Storch

Bussing

Jacob

et al. 2014

Child Psychiatry Hum Dev

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This study examined the frequency and sociodemographic and clinical correlates of suicidal ideation in a sample of children and adolescents with obsessive-compulsive disorder (OCD). Fifty-four youth with OCD and their parent(s) were administered the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime, Children’s Yale-Brown Obsessive Compulsive Scale, and Children’s Depression Rating Scale-Revised. Children completed the Suicidal Ideation Questionnaire - Junior, Child Obsessive Compulsive Impact Scale–Child, and Multidimensional Anxiety Scale for Children; parents completed the Child Obsessive Compulsive Impact Scale–Parent, Swanson, Nolan, and Pelham–IV Parent Scale, and Young Mania Rating Scale–Parent Version. Seven youth endorsed clinically significant levels of suicidal ideation on the Suicidal Ideation Questionnaire - Junior. Suicidal ideation was significantly related to clinician-rated depressive symptoms, age, child-rated impairment and anxiety symptoms, and symmetry, sexuality/religiosity and miscellaneous symptom dimensions. There was no significant association between suicidal ideation and obsessive-compulsive symptom severity, comorbidity patterns, or several parent-rated indices (e.g., impairment, impulsivity). These results provide initial information regarding the frequency and correlates of suicidal ideation in treatment-seeking youth with OCD. Clinical implications are discussed, as well as directions for future research.

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“…Similarly, psychiatric disorders occurring in young populations need special attentions because major differences between adult and juvenile depression have been well-documented, despite the reasons for such dissimilarities are not clear [25]. Actually, there is very limited evidence upon which to base conclusions about the relative effectiveness of psychological interventions or antidepressant medication, but effectiveness of these interventions cannot be fully established [26]. Finally, the occurrence of depression secondary to a different primary disease, for instance schizophrenia, Alzheimer’s disease (AD), Parkinson’s disease, and CVD, may raise doubts on the pathophysiological mechanisms that cause the depressive symptomatology.…”

Section: Introductionmentioning

confidence: 99%

Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials

et al. 2014

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BackgroundDespite omega-3 polyunsaturated fatty acids (PUFA) supplementation in depressed patients have been suggested to improve depressive symptomatology, previous findings are not univocal.ObjectivesTo conduct an updated meta-analysis of randomized controlled trials (RCTs) of omega-3 PUFA treatment of depressive disorders, taking into account the clinical differences among patients included in the studies.MethodsA search on MEDLINE, EMBASE, PsycInfo, and the Cochrane Database of RCTs using omega-3 PUFA on patients with depressive symptoms published up to August 2013 was performed. Standardized mean difference in clinical measure of depression severity was primary outcome. Type of omega-3 used (particularly eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) and omega-3 as mono- or adjuvant therapy was also examined. Meta-regression analyses assessed the effects of study size, baseline depression severity, trial duration, dose of omega-3, and age of patients.ResultsMeta-analysis of 11 and 8 trials conducted respectively on patients with a DSM-defined diagnosis of major depressive disorder (MDD) and patients with depressive symptomatology but no diagnosis of MDD demonstrated significant clinical benefit of omega-3 PUFA treatment compared to placebo (standardized difference in random-effects model 0.56 SD [95% CI: 0.20, 0.92] and 0.22 SD [95% CI: 0.01, 0.43], respectively; pooled analysis was 0.38 SD [95% CI: 0.18, 0.59]). Use of mainly EPA within the preparation, rather than DHA, influenced final clinical efficacy. Significant clinical efficacy had the use of omega-3 PUFA as adjuvant rather than mono-therapy. No relation between efficacy and study size, baseline depression severity, trial duration, age of patients, and study quality was found. Omega-3 PUFA resulted effective in RCTs on patients with bipolar disorder, whereas no evidence was found for those exploring their efficacy on depressive symptoms in young populations, perinatal depression, primary disease other than depression and healthy subjects.ConclusionsThe use of omega-3 PUFA is effective in patients with diagnosis of MDD and on depressive patients without diagnosis of MDD.

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Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents

Abstract: Analysis 4.3. Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 3 Remission by cutoff (post-intervention).

Cited by 77 publications

References 118 publications

Receipt of Evidence-Based Pharmacotherapy and Psychotherapy Among Children and Adolescents With New Diagnoses of Depression

Receipt of Evidence-Based Pharmacotherapy and Psychotherapy Among Children and Adolescents With New Diagnoses of Depression

Frequency and Correlates of Suicidal Ideation in Pediatric Obsessive–Compulsive Disorder

Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials

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