Family Conflict Associated With Intrinsic Hippocampal-OFC Connectivity in Adolescent Depressive Disorder

BackgroundFamily environment and life events have long been suggested to be associated with adolescent depression. The hippocampus plays a crucial role in the neural mechanism of major depressive disorder (MDD) through memory during stressful events. However, few studies have explored the exact neural mechanisms underlying these associations. Thus, the current study aimed to explore alterations in hippocampal functional connectivity (FC) in adolescent MDD based on resting-state functional magnetic resonance imaging and further investigate the relationship between hippocampal FC, environmental factors, and clinical symptom severity.MethodsHippocampal FC was calculated using the seed-based approach with the bilateral hippocampus as the seed for 111 adolescents with and without MDD; comparisons were made between participants with MDD and controls. We applied the Chinese version of the Family Environment Scale (FES-CV) and Adolescents Self-Rating Life Events Checklist (ASLEC) to evaluate family environment and life stress. Their relationship with hippocampal FC alterations was also investigated.ResultsWe found that compared to controls, adolescents with MDD showed decreased connectivity between the left hippocampus and bilateral orbital frontal cortex (OFC) and right inferior temporal gyrus. In addition, the hippocampal-OFC connectivity was negatively correlated with conflict scores of the FES-CV in the MDD group and mediated the association between family conflict and depressive and anxiety symptoms.ConclusionOur findings are novel in the field and demonstrate how family conflict contributes to MDD symptomatology through hippocampal-OFC connectivity; these findings may provide potential targets for personalized treatment strategies.

Efficacy of Sertraline Combined with Cognitive Behavioral Therapy for Adolescent Depression: A Systematic Review and Meta-Analysis

Objective. The efficacy of antidepressant drugs combined with psychotherapy is controversial; hence, this meta-analysis was conducted to assess the efficacy of the combination therapy. Methods. Relevant literature was searched in PubMed, Web of Science and Embase, Chinese databases CNKI, and WanFang Data. We included the literature on the comparison of the sertraline combined with cognitive behavioral therapy (CBT) and each treatment alone for adolescent depression published in 2000-2021. Meta-analysis was performed using Stata16.0 software. Results. A total of 421 relevant articles were retrieved, and 14 studies were finally included. In comparison with the control group (sertraline), sertraline combined with CBT achieved higher response rate ( OR = 5.07 , 95% CI: 3.00, 8.58) and lower incidence of adverse reactions ( OR = 0.43 , 95% CI: 0.24, 0.75). Before treatment, there were no significant differences in depression score, anxiety score, and symptom self-rating scale score between the two groups. After treatment, depression score ( SMD = − 2.79 , 95% CI: -3.64, -1.94), anxiety score ( SMD = − 1.22 , 95% CI: -1.96, -0.47), and symptom self-rating scale score ( SMD = − 1.73 , 95% CI: -3.19, -0.27) were significantly lower in the combined treatment group than in the control group. Conclusion. Although the number of comparative trials is small, this study shows that sertraline is effective for adolescent depression, but sertraline combined with CBT is more effective. The latter can significantly reduce the incidence of depressive symptoms, anxiety, and adverse reactions in patients. Therefore, this combination therapy is recommended for the clinical treatment of adolescent depression.

Parent–adolescent emotion-related behavior during conflict in a clinical sample

Introduction Parents and adolescents often have conflict. Previous research has been inconsistent regarding the association between some parent behaviors during this conflict and adolescent symptoms. This study examines parents’ behaviors during a conflict resolution discussion in a clinical sample, and the relationship between parents’ behaviors and adolescents’ depression and anxiety symptoms. Methods Depression and anxiety symptoms were self-reported by 22 adolescents of ages 13–17 who were diagnosed with depression. They also participated in an observed conflict resolution task with one parent. Using observationally coded data, we utilized two linear multiple regressions to assess how parent and adolescent emotion-related behaviors related to adolescents’ depression and anxiety symptoms. Results Adolescents’ conflict behaviors were not associated with their psychopathology symptoms. Parent conflict behaviors of support and withdrawal were both negatively associated with adolescent depression and anxiety, with parent contempt marginally associated with adolescent depression. Conclusions In this clinical sample, parents of adolescents with low mood or anxiety demonstrated some reduced negative parenting behaviors (i.e., contempt and withdrawal), but also reduced positive parenting behavior (i.e., support). The results suggest that when some negative parenting behaviors are reduced, this may inadvertently reinforce depressive behaviors. The results also indicate the importance of increasing supportive parent behaviors.

The Mediating Effect of Self-Control on Depression and Tendencies of Eating Disorders in Adolescents

Self-control is very important for the adaptation among adolescents. It is associated with depression and tendencies of eating disorders. This study aimed to investigate the relationship between the two and the mediating role of self-control for adolescents. In total, 1,231 adolescents (11–18 years) participated in this study. Self-control, depression, and tendencies of eating disorders were evaluated using the Dual-Mode of Self-Control Scale (DMSC-S), 11-item Kutcher Adolescent Depression Scale (KADS-11), and Eating Attitudes Test (EAT-26). The correlations among these factors were analyzed using mediating effect models. Girls had higher scores on the both subscales (impulse system and control system) of DMSC-S (P < 0.001). Those between 15–18 years had higher scores on impulse system than those between 11–14 years (P < 0.001). A significant mediating effect (12.8%) of the impulse system was observed between depression and tendencies of eating disorders in adolescents.