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Screening for depression in adolescence: Who is positive?
IACAPAP 2012 – 20th World congress / Neuropsychiatrie de l’enfance et de l’adolescence 60S (2012) S140–S196 Mo-P-1125
Screening for depression in adolescence: Who is positive? D. Stevanovic a,∗ , A. Lakic b General Hospital Sombor, Serbia, Sombor, Serbia b Clinic for Neurology and Psychiatry for children and adolescents Belgrade, Belgrade, Serbia ∗ Corresponding author.
a
Aims.– To compare psychometrically defined cut-offs with T score 65 for depression screening in adolescence using the Short Mood and Feeling Questionnaire (SMFQ), Children’s Depression Inventory – Short form (CDI), and Kutcher Adolescent Depression Scale Short (KADS). Methods.– The SMFQ, CDI, and KADS completed 117 adolescents (55 (47%) males/62 (52%) females, age mean was 14.6 (1.61) years). The psychometric cut-off values of 8 for the SMFQ and 6 for CDI and KADS were suggested as indicative for possible depression. T score 65 was considered indicative of subclinical depressive symptoms needing further assessments. Results.– Using the psychometric cut-offs, 39 (33.3%) were positively screened with the SMFQ, 13 (11.1%) with the CDI, and 3 (2.6%) with the KADS. Considering T score 65, 10 (8.6%) were positively screened with the SMFQ, 8 (6.8%) with the CDI, and 10 (8.6%) with the KADS. Conclusions.– T score 65 of the SMFQ, CDI, and KADS had greater screening utility than their psychometric cut-offs considering that it is safely identified adolescents with depression, because the percentages of positively screened approached the point prevalence rates in adolescence of 3 to 8% (Rutter et al., 2008). http://dx.doi.org/10.1016/j.neurenf.2012.04.237 Mo-P-1126
Psychosocial and clinical characteristics of depressed adolescents with a history of non-suicidal self-injury D. Ye a , J. Song a,∗ , H.J. Hong b , J. Lee c , K. Yook c Psychiatry, Kwandong University College of Medicine, Myongji Hospital, Goyang-si, Korea b Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, Korea c Department of Psychiatry, School of Medicine, CHA university, CHA Bundang medical center, Seongnam, Korea ∗ Corresponding author.
a
Objective.– The object of our study was to explore the psychosocial and clinical characteristics of depressed adolescents with a history of Non-suicidal selfinjury (NSSI). Method.– We recruited 63 subjects, age 13–18 adolescents who were diagnosed as depressive disorders. 46 subjects had a history of NSSI and 17 did not. They completed Beck depression inventory, Revised children’s manifest anxiety scale, Beck suicidal ideation Scale, physical abuse and emotional abuse scale and emotional neglect scale. Results.– Results showed that suicidal ideation score (21.88, P = 0.01), emotional (32.62, P = 0.003) and physical (31.70, P = 0.001) abuse score were higher in adolescents with a history of NSSI than those without a history of NSSI. Regression analysis indicated that suicidal ideation had a small but significant influence on NSSI event (beta = 0.144, P = 0.017). Conclusion.– These findings suggested that clinicians should consider the possibility of being abused and suicidality in depressed adolescents with a history of NSSI. http://dx.doi.org/10.1016/j.neurenf.2012.04.238 Mo-P-1127
Retrospective analysis of the effectivity and side effects of treatment with amitriptyline and fluoxetine in child and adolescent psychiatry
J. Mayer , H.W. Clement ∗ , C. Fleischhaker , K. Hennighausen , E. Schulz Department Child and Adolescent Psychiatry, University Hospital Freiburg, Freiburg, Germany ∗ Corresponding author.
S167
Aim.– To the present, there have been no trials drawing direct comparisons between amitriptyline and fluoxetine. Therefore, the aim of this work was to compare both antidepressants in a naturalistic setting. Material/Methods.– A retrospective comparison of 13 patients with amitriptyline and 10 patients with fluoxetine was carried out. Instruments used: DOTES, BPRS, CGI, GAF, and serum levels. Results.– In both groups, a therapeutic success was reached by two thirds of patients. The in-patient stay of the fluoxetine group was comparatively shorter by on average 38%. In this group, one third of patients completed the therapeutic regime, while for another third medication had to be changed. For amitriptyline a significant to very good therapeutic effect could be shown. Conclusions.– We found mostly positive therapeutic effects under treatment with amitriptyline. At the same time, we could not confirm a superiority of fluoxetine over amitriptyline. Randomized, placebo-controlled studies will be required for validation. http://dx.doi.org/10.1016/j.neurenf.2012.04.239 Mo-P-1128
Symptoms of depression in children and adolescents in relation to psychiatric comorbidities I. Baji a,∗ , J. Gádoros a , E. Kiss b , L. Mayer b , I. Benák b , E. Kovács b , A. Vetró b a Vadaskert Hospital, Budapest, Hungary b Child and Adolescent Psychiatry, Scientific University, Szeged, Hungary ∗ Corresponding author. The incidence of MDD is 1–2% among children, 3–8% among adolescents. The comorbidities are high between major depression, anxiety and disruptive disorders. Method: We examined 649 children in a depressive episode diagnosed by ISCA-D semi-structured interview, 45,9% were girls, 54,1% were boys, the mean age was 11,7 years. The participants were enrolled into three groups according to their comorbidities: group with only depression, anxiety comorbidities group, disruptive comorbidities group. We compared the three groups according to the frequency of their depressive symptoms. Results: Among the criteria symptoms the irritability is the most frequent independently from the comorbidities, the depressed mood is the most frequent within the anxiety group. In the anxiety group the vegetative symptoms, in the disruptive group psychomotor agitation and worthlessness are the most frequent symptoms. Comorbidities are increasing the incidence of the suicide symptoms. The incidence of impaired decision-making was high in each group. http://dx.doi.org/10.1016/j.neurenf.2012.04.240 Mo-P-1129
Study of the dynamic functional connectivity between brain regions for adolescents with depression L. Yuan a,∗ , Z. Bi b , J. Wang c , Y. Zhu b , K. Ying b Biomedical Engineering, Tsinghua University, Beijing, China b Beijing, China c New York, USA ∗ Corresponding author.
a
The objective of this study was to explore the dynamic functional connectivity between brain regions for depressed adolescents using resting-state fMRI. Eleven depression patients and nine healthy controls participated in this research. Pre-processing procedures included slice acquisition time correction, within subject realignment, spatial normalization, and smoothing. We used SlidingWindow Pearson Correlation analysis (window size = 2 min) to observe the variations in functional connectivity between whole brain voxels and posterior cingulated cortex (PCC) of depressed and healthy subjects, respectively. Stability maps were created by calculating the standard deviation values across the brain for each subject, and group analysis was performed by averaging the spatiallynormalized single-subject maps. We then used wavelet transform coherence (WTC) method to depict the time-frequency features of functional connectivity. The depression group displayed weaker connectivity between prefrontal lobe and PCC and stronger connectivity between temporal lobe and PCC than
Screening for depression in adolescence: Who is positive? D. Stevanovic a,∗ , A. Lakic b General Hospital Sombor, Serbia, Sombor, Serbia b Clinic for Neurology and Psychiatry for children and adolescents Belgrade, Belgrade, Serbia ∗ Corresponding author.
a
Aims.– To compare psychometrically defined cut-offs with T score 65 for depression screening in adolescence using the Short Mood and Feeling Questionnaire (SMFQ), Children’s Depression Inventory – Short form (CDI), and Kutcher Adolescent Depression Scale Short (KADS). Methods.– The SMFQ, CDI, and KADS completed 117 adolescents (55 (47%) males/62 (52%) females, age mean was 14.6 (1.61) years). The psychometric cut-off values of 8 for the SMFQ and 6 for CDI and KADS were suggested as indicative for possible depression. T score 65 was considered indicative of subclinical depressive symptoms needing further assessments. Results.– Using the psychometric cut-offs, 39 (33.3%) were positively screened with the SMFQ, 13 (11.1%) with the CDI, and 3 (2.6%) with the KADS. Considering T score 65, 10 (8.6%) were positively screened with the SMFQ, 8 (6.8%) with the CDI, and 10 (8.6%) with the KADS. Conclusions.– T score 65 of the SMFQ, CDI, and KADS had greater screening utility than their psychometric cut-offs considering that it is safely identified adolescents with depression, because the percentages of positively screened approached the point prevalence rates in adolescence of 3 to 8% (Rutter et al., 2008). http://dx.doi.org/10.1016/j.neurenf.2012.04.237 Mo-P-1126
Psychosocial and clinical characteristics of depressed adolescents with a history of non-suicidal self-injury D. Ye a , J. Song a,∗ , H.J. Hong b , J. Lee c , K. Yook c Psychiatry, Kwandong University College of Medicine, Myongji Hospital, Goyang-si, Korea b Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, Korea c Department of Psychiatry, School of Medicine, CHA university, CHA Bundang medical center, Seongnam, Korea ∗ Corresponding author.
a
Objective.– The object of our study was to explore the psychosocial and clinical characteristics of depressed adolescents with a history of Non-suicidal selfinjury (NSSI). Method.– We recruited 63 subjects, age 13–18 adolescents who were diagnosed as depressive disorders. 46 subjects had a history of NSSI and 17 did not. They completed Beck depression inventory, Revised children’s manifest anxiety scale, Beck suicidal ideation Scale, physical abuse and emotional abuse scale and emotional neglect scale. Results.– Results showed that suicidal ideation score (21.88, P = 0.01), emotional (32.62, P = 0.003) and physical (31.70, P = 0.001) abuse score were higher in adolescents with a history of NSSI than those without a history of NSSI. Regression analysis indicated that suicidal ideation had a small but significant influence on NSSI event (beta = 0.144, P = 0.017). Conclusion.– These findings suggested that clinicians should consider the possibility of being abused and suicidality in depressed adolescents with a history of NSSI. http://dx.doi.org/10.1016/j.neurenf.2012.04.238 Mo-P-1127
Retrospective analysis of the effectivity and side effects of treatment with amitriptyline and fluoxetine in child and adolescent psychiatry
J. Mayer , H.W. Clement ∗ , C. Fleischhaker , K. Hennighausen , E. Schulz Department Child and Adolescent Psychiatry, University Hospital Freiburg, Freiburg, Germany ∗ Corresponding author.
S167
Aim.– To the present, there have been no trials drawing direct comparisons between amitriptyline and fluoxetine. Therefore, the aim of this work was to compare both antidepressants in a naturalistic setting. Material/Methods.– A retrospective comparison of 13 patients with amitriptyline and 10 patients with fluoxetine was carried out. Instruments used: DOTES, BPRS, CGI, GAF, and serum levels. Results.– In both groups, a therapeutic success was reached by two thirds of patients. The in-patient stay of the fluoxetine group was comparatively shorter by on average 38%. In this group, one third of patients completed the therapeutic regime, while for another third medication had to be changed. For amitriptyline a significant to very good therapeutic effect could be shown. Conclusions.– We found mostly positive therapeutic effects under treatment with amitriptyline. At the same time, we could not confirm a superiority of fluoxetine over amitriptyline. Randomized, placebo-controlled studies will be required for validation. http://dx.doi.org/10.1016/j.neurenf.2012.04.239 Mo-P-1128
Symptoms of depression in children and adolescents in relation to psychiatric comorbidities I. Baji a,∗ , J. Gádoros a , E. Kiss b , L. Mayer b , I. Benák b , E. Kovács b , A. Vetró b a Vadaskert Hospital, Budapest, Hungary b Child and Adolescent Psychiatry, Scientific University, Szeged, Hungary ∗ Corresponding author. The incidence of MDD is 1–2% among children, 3–8% among adolescents. The comorbidities are high between major depression, anxiety and disruptive disorders. Method: We examined 649 children in a depressive episode diagnosed by ISCA-D semi-structured interview, 45,9% were girls, 54,1% were boys, the mean age was 11,7 years. The participants were enrolled into three groups according to their comorbidities: group with only depression, anxiety comorbidities group, disruptive comorbidities group. We compared the three groups according to the frequency of their depressive symptoms. Results: Among the criteria symptoms the irritability is the most frequent independently from the comorbidities, the depressed mood is the most frequent within the anxiety group. In the anxiety group the vegetative symptoms, in the disruptive group psychomotor agitation and worthlessness are the most frequent symptoms. Comorbidities are increasing the incidence of the suicide symptoms. The incidence of impaired decision-making was high in each group. http://dx.doi.org/10.1016/j.neurenf.2012.04.240 Mo-P-1129
Study of the dynamic functional connectivity between brain regions for adolescents with depression L. Yuan a,∗ , Z. Bi b , J. Wang c , Y. Zhu b , K. Ying b Biomedical Engineering, Tsinghua University, Beijing, China b Beijing, China c New York, USA ∗ Corresponding author.
a
The objective of this study was to explore the dynamic functional connectivity between brain regions for depressed adolescents using resting-state fMRI. Eleven depression patients and nine healthy controls participated in this research. Pre-processing procedures included slice acquisition time correction, within subject realignment, spatial normalization, and smoothing. We used SlidingWindow Pearson Correlation analysis (window size = 2 min) to observe the variations in functional connectivity between whole brain voxels and posterior cingulated cortex (PCC) of depressed and healthy subjects, respectively. Stability maps were created by calculating the standard deviation values across the brain for each subject, and group analysis was performed by averaging the spatiallynormalized single-subject maps. We then used wavelet transform coherence (WTC) method to depict the time-frequency features of functional connectivity. The depression group displayed weaker connectivity between prefrontal lobe and PCC and stronger connectivity between temporal lobe and PCC than