Evidence-Based Interventions for Major Depressive Disorder in Children and Adolescents

Author(s):  
Kevin D. Stark ◽  
Leah A. Wang ◽  
Kelly N. Banneyer
PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 575-575
Author(s):  
R. J. Haggerty

The study reports on 100 children and adolescents evaluated in a pediatric cardiology department. The results state that 13% of the population met the criteria for Major Depressive Disorder based on DSM III. There were four patients who were referred because of chest pain. All of them were found to be free from cardiovascular disorders, but all were found to be in the depressed group. The authors emphasize the importance of chest pain in differential diagnosis of childhood depression.


CNS Spectrums ◽  
2018 ◽  
Vol 24 (5) ◽  
pp. 496-506 ◽  
Author(s):  
Sarah Atkinson ◽  
Louise Thurman ◽  
Sara Ramaker ◽  
Gina Buckley ◽  
Sarah Ruta Jones ◽  
...  

ObjectiveTwo similarly designed extension studies evaluated the long-term safety and tolerability of desvenlafaxine for the treatment of children and adolescents with major depressive disorder (MDD). Efficacy was evaluated as a secondary objective.MethodsBoth 6-month, open-label, flexible-dose extension studies enrolled children and adolescents who had completed one of two double-blind, placebo-controlled, lead-in studies. One lead-in study included a 1-week transition period prior to the extension study. Patients received 26-week treatment with flexible-dose desvenlafaxine (20–50 mg/d). Safety assessments included comprehensive psychiatric evaluations, vital sign assessments, laboratory evaluations, 12-lead electrocardiogram, physical examination with Tanner assessment, and Columbia-Suicide Severity Rating Scale. Adverse events (AEs) were collected throughout the studies. Efficacy was assessed using the Children’s Depression Rating Scale–Revised (CDRS-R).ResultsA total of 552 patients enrolled (completion rates: 66.4 and 69.1%). AEs were reported by 79.4 and 79.1% of patients in the two studies; 8.9 and 5.2% discontinued due to AEs. Treatment-emergent suicidal ideation or behavior was reported for 16.6 and 14.1% of patients in the two studies. Mean (SD) CDRS-R total score decreased from 33.83 (11.93) and 30.92 (10.20) at the extension study baseline to 24.31 (7.48) and 24.92 (8.45), respectively, at week 26.ConclusionDesvenlafaxine 20 to 50 mg/d was generally safe and well tolerated with no new safety signals identified in children and adolescents with MDD who received up to 6 months of treatment in these studies. Patients maintained the reduction in severity of depressive symptoms observed in all treatment groups at the end of the lead-in study.


Author(s):  
Kari M. Eddington ◽  
Timothy J. Strauman ◽  
Angela Z. Vieth ◽  
Gregory G. Kolden

Chapter 1 provides clients with an overview of self-system therapy (SST), which is a structured, short-term, evidence-based treatment approach that targets motivational deficits in depression. Depression robs people of the ability to enjoy the pleasures of life. Because there can be a fine line between a normal sad mood and a diagnosis such as major depressive disorder, a qualified professional is needed to determine whether the symptoms cross that line and whether the client is likely to benefit from SST. The chapter defines the roles of the client and the therapist and explains how the workbook is used in the therapeutic process.


2020 ◽  
pp. 001857872092538
Author(s):  
Ayman Antoun Reyad ◽  
Kiran Plaha ◽  
Eriny Girgis ◽  
Raafat Mishriky

Background: Fluoxetine is a serotonin-specific reuptake inhibitor antidepressant and is the only approved pharmacological treatment for major depressive disorder (MDD) in children and adolescent. Methods: We searched the published randomized controlled-trials to review fluoxetine efficacy and tolerability using the databases PubMed, EudraCT, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials for fluoxetine role in managing MDD in children and adolescents. A meta-analysis was conducted using the identified 7 clinical trials to assess efficacy using the outcomes: Children's Depression Rating Scale–Revised (CDRS-R), Clinical Global Impressions–Severity of Illness (CGI-S) and Clinical Global Impressions–Improvement (CGI-I) response rate. The risk of discontinuation due to adverse effects and common side effects were examined. Results: The mean difference in change from baseline for CDRS-R was −2.72 (95% confidence interval [CI], −3.96, −1.48) favoring fluoxetine treatment ( P < .001). Similarly, mean difference for CGI-S was −0.21 (95% CI, −0.36, −0.06). The risk ratio (RR) of discontinuing due to adverse events was 0.98 (95% CI, 0.54, 1.83), with RR for headache side effects 1.34 (95% CI, 1.03, 1.74) and rash 2.6 (95% CI, 1.32, 5.14). Conclusion: Fluoxetine demonstrates significant improvements in symptom intensity control in young patients suffering from MDD and is considered well tolerated with similar rates of trials discontinuation; however, fluoxetine was associated with a higher risk of headache and rash side effects. These findings will guide psychiatrists and pharmacists in their clinical role for supporting the care of young mental health patients.


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