Practitioner Review: Effectiveness of indicated school-based interventions for adolescent depression and anxiety - a meta-analytic review / Brioney GEE in Journal of Child Psychology and Psychiatry, 61-7 (July 2020)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 61-7 (July 2020) . - p.739-756 Titre : Practitioner Review: Effectiveness of indicated school-based interventions for adolescent depression and anxiety - a meta-analytic review Type de document : Texte imprimé et/ou numérique Auteurs : Brioney GEE, Auteur ; Shirley REYNOLDS, Auteur ; Ben CARROLL, Auteur ; Faith ORCHARD, Auteur ; Tim CLARKE, Auteur ; David MARTIN, Auteur ; Jon WILSON, Auteur ; Laura PASS, Auteur Article en page(s) : p.739-756 Langues : Anglais (eng) Mots-clés : Adolescent  anxiety  depression  indicated interventions  school Index. décimale : PER Périodiques Résumé : BACKGROUND: Interest in delivering psychological interventions within schools to facilitate early intervention is increasing. However, most reviews have focused on universal or preventative programmes rather than interventions designed to decrease existing symptoms of depression or anxiety. This paper aims to provide a meta-analytic review of randomised controlled trials of indicated psychological interventions for young people aged 10-19 with elevated symptoms of depression and/or anxiety. METHODS: Eight electronic databases were systematically searched from inception to April 2019 for eligible trials. Study quality was assessed using two scales designed to evaluate psychotherapy intervention trials. Random effects meta-analyses were conducted separately for trials that recruited participants based on symptoms of depression and based on symptoms of anxiety. RESULTS: Data from 45 trials were analysed. Most interventions studied used cognitive and behavioural strategies. Few studies met methodological quality criteria, but effect size was not associated with study quality. Indicated school-based interventions had a small effect on reducing depression symptoms (SMD = .34, 95% CI -0.48, -0.21) and a medium effect on reducing anxiety symptoms (SMD = -.49, 95% CI -0.79, -0.19) immediately postintervention. Subgroup analyses indicated that interventions delivered by internal school staff did not have significant effects on symptoms. Reductions in depression were maintained at short-term (?6 months) but not medium (>6 months ? 12) or long-term (>12-month) follow-up. Reductions in anxiety symptoms were not maintained at any follow-up. CONCLUSIONS: Indicated school-based interventions are effective at reducing symptoms of depression and anxiety in adolescents immediately postintervention but there is little evidence that these reductions are maintained. Interventions delivered by school staff are not supported by the current evidence base. Further high-quality randomised controlled trials incorporating assessment of longer-term outcomes are needed to justify increased investment in school-based interventions for adolescent depression and anxiety. En ligne : http://dx.doi.org/10.1111/jcpp.13209 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=429 [article] Practitioner Review: Effectiveness of indicated school-based interventions for adolescent depression and anxiety - a meta-analytic review [Texte imprimé et/ou numérique] / Brioney GEE, Auteur ; Shirley REYNOLDS, Auteur ; Ben CARROLL, Auteur ; Faith ORCHARD, Auteur ; Tim CLARKE, Auteur ; David MARTIN, Auteur ; Jon WILSON, Auteur ; Laura PASS, Auteur . - p.739-756. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 61-7 (July 2020) . - p.739-756 Mots-clés : Adolescent  anxiety  depression  indicated interventions  school Index. décimale : PER Périodiques Résumé : BACKGROUND: Interest in delivering psychological interventions within schools to facilitate early intervention is increasing. However, most reviews have focused on universal or preventative programmes rather than interventions designed to decrease existing symptoms of depression or anxiety. This paper aims to provide a meta-analytic review of randomised controlled trials of indicated psychological interventions for young people aged 10-19 with elevated symptoms of depression and/or anxiety. METHODS: Eight electronic databases were systematically searched from inception to April 2019 for eligible trials. Study quality was assessed using two scales designed to evaluate psychotherapy intervention trials. Random effects meta-analyses were conducted separately for trials that recruited participants based on symptoms of depression and based on symptoms of anxiety. RESULTS: Data from 45 trials were analysed. Most interventions studied used cognitive and behavioural strategies. Few studies met methodological quality criteria, but effect size was not associated with study quality. Indicated school-based interventions had a small effect on reducing depression symptoms (SMD = .34, 95% CI -0.48, -0.21) and a medium effect on reducing anxiety symptoms (SMD = -.49, 95% CI -0.79, -0.19) immediately postintervention. Subgroup analyses indicated that interventions delivered by internal school staff did not have significant effects on symptoms. Reductions in depression were maintained at short-term (?6 months) but not medium (>6 months ? 12) or long-term (>12-month) follow-up. Reductions in anxiety symptoms were not maintained at any follow-up. CONCLUSIONS: Indicated school-based interventions are effective at reducing symptoms of depression and anxiety in adolescents immediately postintervention but there is little evidence that these reductions are maintained. Interventions delivered by school staff are not supported by the current evidence base. Further high-quality randomised controlled trials incorporating assessment of longer-term outcomes are needed to justify increased investment in school-based interventions for adolescent depression and anxiety. En ligne : http://dx.doi.org/10.1111/jcpp.13209 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=429

Self-reported sleep patterns and quality amongst adolescents: cross-sectional and prospective associations with anxiety and depression / Faith ORCHARD in Journal of Child Psychology and Psychiatry, 61-10 (October 2020)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 61-10 (October 2020) . - p.1126-1137 Titre : Self-reported sleep patterns and quality amongst adolescents: cross-sectional and prospective associations with anxiety and depression Type de document : Texte imprimé et/ou numérique Auteurs : Faith ORCHARD, Auteur ; Alice M. GREGORY, Auteur ; Michael GRADISAR, Auteur ; Shirley REYNOLDS, Auteur Article en page(s) : p.1126-1137 Langues : Anglais (eng) Mots-clés : Adolescence  anxiety  depression  longitudinal studies  sleep Index. décimale : PER Périodiques Résumé : BACKGROUND: Sleep problems are common in adolescence, and frequently comorbid with both anxiety and depression. Research studies have suggested a bidirectional relationship between sleep and psychopathology, which includes evidence that sleep interventions can alleviate symptoms of anxiety and depression. However, little is known about the nature of sleep problems amongst adolescents with anxiety and depression, and whether specific sleeping difficulties are involved in the longitudinal relationship between sleep, anxiety and depression. METHOD: The sample was derived from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based, prospective, birth cohort study of children born in 1991-1992. Data were explored from a subset of participants who took part in a clinical assessment at age 15, on self-report sleep patterns and quality, and diagnostic outcomes of anxiety and depression (N = 5,033). Subsequent diagnostic and symptom severity data on anxiety and depression at ages 17, 21 and 24 were also examined. RESULTS: Cross-sectional and longitudinal analyses were conducted to explore the relationship between sleep problems, anxiety and depression. Results revealed that adolescents aged 15 with depression experience difficulties with both sleep patterns and sleep quality, whereas adolescents with anxiety only reported problems with sleep quality. A range of sleep variables at age 15 predicted the severity of anxiety and depression symptoms and the diagnoses of anxiety and depressive disorders at age 17, 21 and 24 years. CONCLUSIONS: The results provide further insight into the nature of sleep problems amongst adolescents with anxiety and depression, and the prospective relationship between sleep disturbance and future psychopathology. These data suggest that targeting sleep difficulties during adolescence may have long-term mental health benefits. En ligne : http://dx.doi.org/10.1111/jcpp.13288 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=432 [article] Self-reported sleep patterns and quality amongst adolescents: cross-sectional and prospective associations with anxiety and depression [Texte imprimé et/ou numérique] / Faith ORCHARD, Auteur ; Alice M. GREGORY, Auteur ; Michael GRADISAR, Auteur ; Shirley REYNOLDS, Auteur . - p.1126-1137. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 61-10 (October 2020) . - p.1126-1137 Mots-clés : Adolescence  anxiety  depression  longitudinal studies  sleep Index. décimale : PER Périodiques Résumé : BACKGROUND: Sleep problems are common in adolescence, and frequently comorbid with both anxiety and depression. Research studies have suggested a bidirectional relationship between sleep and psychopathology, which includes evidence that sleep interventions can alleviate symptoms of anxiety and depression. However, little is known about the nature of sleep problems amongst adolescents with anxiety and depression, and whether specific sleeping difficulties are involved in the longitudinal relationship between sleep, anxiety and depression. METHOD: The sample was derived from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based, prospective, birth cohort study of children born in 1991-1992. Data were explored from a subset of participants who took part in a clinical assessment at age 15, on self-report sleep patterns and quality, and diagnostic outcomes of anxiety and depression (N = 5,033). Subsequent diagnostic and symptom severity data on anxiety and depression at ages 17, 21 and 24 were also examined. RESULTS: Cross-sectional and longitudinal analyses were conducted to explore the relationship between sleep problems, anxiety and depression. Results revealed that adolescents aged 15 with depression experience difficulties with both sleep patterns and sleep quality, whereas adolescents with anxiety only reported problems with sleep quality. A range of sleep variables at age 15 predicted the severity of anxiety and depression symptoms and the diagnoses of anxiety and depressive disorders at age 17, 21 and 24 years. CONCLUSIONS: The results provide further insight into the nature of sleep problems amongst adolescents with anxiety and depression, and the prospective relationship between sleep disturbance and future psychopathology. These data suggest that targeting sleep difficulties during adolescence may have long-term mental health benefits. En ligne : http://dx.doi.org/10.1111/jcpp.13288 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=432

Toward precision therapeutics: general and specific factors differentiate symptom change in depressed adolescents / Madison AITKEN in Journal of Child Psychology and Psychiatry, 61-9 (September 2020)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 61-9 (September 2020) . - p.998-1008 Titre : Toward precision therapeutics: general and specific factors differentiate symptom change in depressed adolescents Type de document : Texte imprimé et/ou numérique Auteurs : Madison AITKEN, Auteur ; John D. HALTIGAN, Auteur ; Peter SZATMARI, Auteur ; Bernadka DUBICKA, Auteur ; Peter FONAGY, Auteur ; Raphael KELVIN, Auteur ; Nick MIDGLEY, Auteur ; Shirley REYNOLDS, Auteur ; Paul O. WILKINSON, Auteur ; Ian M. GOODYER, Auteur Année de publication : 2020 Article en page(s) : p.998-1008 Langues : Anglais (eng) Mots-clés : Bifactor models  adolescent  depression  psychopathology  psychotherapy Index. décimale : PER Périodiques Résumé : BACKGROUND: The longitudinal course of multiple symptom domains in adolescents treated for major depression is not known. Revealing the temporal course of general and specific psychopathology factors, including potential differences between psychotherapies, may aid therapeutic decision-making. METHODS: Participants were adolescents with major depressive disorder (aged 11-17; 75% female; N = 465) who were part of the IMPACT trial, a randomized controlled trial comparing cognitive behavioral therapy, short-term psychoanalytic psychotherapy, and brief psychosocial intervention. Self-reported symptoms at baseline and 6, 12, 36, 52, and 86 weeks postrandomization were analyzed with bifactor modeling. RESULTS: General psychopathology factor scores decreased across treatment and one-year follow-up. Specific melancholic features and depressive cognitions factors decreased from baseline to 6 weeks. Conduct problems decreased across treatment and follow-up. Anxiety increased by 6 weeks and then reverted to baseline levels. Obsessions-compulsions did not change. Changes in general and specific factors were not significantly different between the three psychotherapies during treatment. During follow-up, however, conduct problems decreased more in brief psychosocial intervention versus cognitive behavioral therapy (1.02, 95% Bayes credible interval 0.25, 1.96), but not versus short-term psychoanalytic psychotherapy. CONCLUSIONS: The clinical response signature in this trial is best revealed by rapid reductions in depression symptoms and general psychopathology. Protracted improvements in general psychopathology and conduct problems subsequently occur. Psychosocial treatments for adolescent depression have comparable effects on general and specific psychopathology, although a psychoeducational, goal-focused approach may be indicated for youth with comorbid conduct problems. En ligne : http://dx.doi.org/10.1111/jcpp.13194 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=430 [article] Toward precision therapeutics: general and specific factors differentiate symptom change in depressed adolescents [Texte imprimé et/ou numérique] / Madison AITKEN, Auteur ; John D. HALTIGAN, Auteur ; Peter SZATMARI, Auteur ; Bernadka DUBICKA, Auteur ; Peter FONAGY, Auteur ; Raphael KELVIN, Auteur ; Nick MIDGLEY, Auteur ; Shirley REYNOLDS, Auteur ; Paul O. WILKINSON, Auteur ; Ian M. GOODYER, Auteur . - 2020 . - p.998-1008. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 61-9 (September 2020) . - p.998-1008 Mots-clés : Bifactor models  adolescent  depression  psychopathology  psychotherapy Index. décimale : PER Périodiques Résumé : BACKGROUND: The longitudinal course of multiple symptom domains in adolescents treated for major depression is not known. Revealing the temporal course of general and specific psychopathology factors, including potential differences between psychotherapies, may aid therapeutic decision-making. METHODS: Participants were adolescents with major depressive disorder (aged 11-17; 75% female; N = 465) who were part of the IMPACT trial, a randomized controlled trial comparing cognitive behavioral therapy, short-term psychoanalytic psychotherapy, and brief psychosocial intervention. Self-reported symptoms at baseline and 6, 12, 36, 52, and 86 weeks postrandomization were analyzed with bifactor modeling. RESULTS: General psychopathology factor scores decreased across treatment and one-year follow-up. Specific melancholic features and depressive cognitions factors decreased from baseline to 6 weeks. Conduct problems decreased across treatment and follow-up. Anxiety increased by 6 weeks and then reverted to baseline levels. Obsessions-compulsions did not change. Changes in general and specific factors were not significantly different between the three psychotherapies during treatment. During follow-up, however, conduct problems decreased more in brief psychosocial intervention versus cognitive behavioral therapy (1.02, 95% Bayes credible interval 0.25, 1.96), but not versus short-term psychoanalytic psychotherapy. CONCLUSIONS: The clinical response signature in this trial is best revealed by rapid reductions in depression symptoms and general psychopathology. Protracted improvements in general psychopathology and conduct problems subsequently occur. Psychosocial treatments for adolescent depression have comparable effects on general and specific psychopathology, although a psychoeducational, goal-focused approach may be indicated for youth with comorbid conduct problems. En ligne : http://dx.doi.org/10.1111/jcpp.13194 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=430

Trajectories of depression symptom change during and following treatment in adolescents with unipolar major depression / Sian Emma DAVIES in Journal of Child Psychology and Psychiatry, 61-5 (May 2020)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 61-5 (May 2020) . - p.565-574 Titre : Trajectories of depression symptom change during and following treatment in adolescents with unipolar major depression Type de document : Texte imprimé et/ou numérique Auteurs : Sian Emma DAVIES, Auteur ; Sharon A. S. NEUFELD, Auteur ; Eleonore VAN SPRANG, Auteur ; Lizanne SCHWEREN, Auteur ; Rogier KEIVIT, Auteur ; Peter FONAGY, Auteur ; Bernadka DUBICKA, Auteur ; Raphael KELVIN, Auteur ; Nick MIDGLEY, Auteur ; Shirley REYNOLDS, Auteur ; Mary TARGET, Auteur ; Paul WILKINSON, Auteur ; Anne Laura VAN HARMELEN, Auteur ; Ian Michael GOODYER, Auteur Article en page(s) : p.565-574 Langues : Anglais (eng) Mots-clés : Depression  longitudinal studies  outcome  therapy Index. décimale : PER Périodiques Résumé : OBJECTIVE: To classify a cohort of depressed adolescents recruited to the UK IMPACT trial, according to trajectories of symptom change. We examined for predictors and compared the data-driven categories of patients with a priori operational definitions of treatment response. METHOD: Secondary data analysis using growth mixture modelling (GMM). Missing data were imputed. Trajectories of self-reported depressive symptoms were plotted using scores taken at six nominal time points over 86 weeks from randomisation in all 465 patients. RESULTS: A piecewise GMM categorised patients into two classes with initially similar and subsequently distinct trajectories. Both groups had a significant decline in depressive symptoms over the first 18 weeks. Eighty-four per cent (84.1%, n = 391) of patients were classed as 'continued-improvers' with symptoms reducing over the duration of the study. A further class of 15.9% (n = 74) of patients were termed 'halted-improvers' with higher baseline depression scores, faster early recovery but no further improvement after 18 weeks. Presence of baseline comorbidity somewhat increased membership to the halted-improvers class (OR = 1.40, CI: 1.00-1.96). By end of study, compared with classes, a clinical remission cut-off score (/=50%) indexing treatment response misclassified 15% and 31% of cases, respectively. CONCLUSIONS: A fast reduction in depressive symptoms in the first few weeks of treatment may not indicate a good prognosis. Halted improvement is only seen after 18 weeks of treatment. Longitudinal modelling may improve the precision of revealing differential responses to treatment. Improvement in depressive symptoms may be somewhat better in the year after treatment than previously considered. En ligne : http://dx.doi.org/10.1111/jcpp.13145 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422 [article] Trajectories of depression symptom change during and following treatment in adolescents with unipolar major depression [Texte imprimé et/ou numérique] / Sian Emma DAVIES, Auteur ; Sharon A. S. NEUFELD, Auteur ; Eleonore VAN SPRANG, Auteur ; Lizanne SCHWEREN, Auteur ; Rogier KEIVIT, Auteur ; Peter FONAGY, Auteur ; Bernadka DUBICKA, Auteur ; Raphael KELVIN, Auteur ; Nick MIDGLEY, Auteur ; Shirley REYNOLDS, Auteur ; Mary TARGET, Auteur ; Paul WILKINSON, Auteur ; Anne Laura VAN HARMELEN, Auteur ; Ian Michael GOODYER, Auteur . - p.565-574. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 61-5 (May 2020) . - p.565-574 Mots-clés : Depression  longitudinal studies  outcome  therapy Index. décimale : PER Périodiques Résumé : OBJECTIVE: To classify a cohort of depressed adolescents recruited to the UK IMPACT trial, according to trajectories of symptom change. We examined for predictors and compared the data-driven categories of patients with a priori operational definitions of treatment response. METHOD: Secondary data analysis using growth mixture modelling (GMM). Missing data were imputed. Trajectories of self-reported depressive symptoms were plotted using scores taken at six nominal time points over 86 weeks from randomisation in all 465 patients. RESULTS: A piecewise GMM categorised patients into two classes with initially similar and subsequently distinct trajectories. Both groups had a significant decline in depressive symptoms over the first 18 weeks. Eighty-four per cent (84.1%, n = 391) of patients were classed as 'continued-improvers' with symptoms reducing over the duration of the study. A further class of 15.9% (n = 74) of patients were termed 'halted-improvers' with higher baseline depression scores, faster early recovery but no further improvement after 18 weeks. Presence of baseline comorbidity somewhat increased membership to the halted-improvers class (OR = 1.40, CI: 1.00-1.96). By end of study, compared with classes, a clinical remission cut-off score (/=50%) indexing treatment response misclassified 15% and 31% of cases, respectively. CONCLUSIONS: A fast reduction in depressive symptoms in the first few weeks of treatment may not indicate a good prognosis. Halted improvement is only seen after 18 weeks of treatment. Longitudinal modelling may improve the precision of revealing differential responses to treatment. Improvement in depressive symptoms may be somewhat better in the year after treatment than previously considered. En ligne : http://dx.doi.org/10.1111/jcpp.13145 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422

---

1 (1 - 4 / 4)