Materiały źródłowe

• #1 Prediction of adolescent depression from prenatal and childhood data from ALSPAC using machine learning | Scientific Reports

  https://www.nature.com/articles/s41598-024-72158-9

  Depression is a major cause of disability and mortality for young people worldwide and is typically first diagnosed during adolescence. […] The leading informative features in our predictive models of adolescent depression were female sex, parental depression and anxiety, and exposure to stressful events or environments. […] Early identification by age 10 of children at risk of developing depression during their adolescent years would provide new avenues for preemptive interventions, thereby reducing suffering, adolescent mortality, and treatment costs associated with depression. […] We focused on these time points because the incidence of depression in the population increases steadily from age 12 to 18, with many individuals having their first depression onset within this developmental period.

• #2 Treated depression in adolescents: predictors of outcome at 28 weeks | The British Journal of Psychiatry | Cambridge Core

  https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/treated-depression-in-adolescents-predictors-of-outcome-at-28-weeks/A0426E4E366067AEF1A1FC384E3524EA

  There is great heterogeneity of clinical presentation and outcome in paediatric depression. […] To identify which clinical and environmental risk factors at baseline and during treatment predicted major depression at 28-week follow-up in a sample of adolescents with depression. […] Depression at 28 weeks was predicted by the additive effects of severity, obsessive-compulsive disorder and suicidal ideation at entry together with presence of at least one disappointing life event over the follow-up period. […] Clinicians should assess for severity, suicidality and comorbid obsessive-compulsive disorder at presentation and should monitor closely for subsequent life events during treatment. […] A number of depressive factors at presentation have been associated with lower treatment response and higher risk of recurrence.

• #3 Recovery and Recurrence Following Treatment for Adolescent Major Depression

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3074362/

  Almost all participants (96.4%) recovered from their index episode of MDD during the follow-up period. […] Recovery by two years was significantly more likely for acute treatment responders (96.2%) than for partial or non-responders (79.1%) (p .001), but was not associated with having received the most efficacious acute treatment (COMB). […] Of the 189 participants who recovered, 88 (46.6%) had a recurrence. […] Recurrence was not predicted by full acute treatment response or by original treatment. […] However, full or partial responders were less likely to have a recurrence (42.9%) than were non-responders (67.6%) (p = .03). […] Gender predicted recurrence (57.0% among females and 32.9% among males) (p = .024). […] Almost all depressed adolescents recovered. However, recurrence occurs in almost half of recovered adolescents, with higher probability in females in this age range.

• #4 Recovery and Recurrence Following Treatment for Adolescent Major Depression

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3074362/

  Thus, it is important to investigate not only the efficacy of adolescent MDD treatments, but also whether they reduce risk of subsequent negative outcomes, especially depression recurrence. […] Slightly under half of recovered adolescents experienced a recurrence by five years post-baseline (46.6%). […] Contrary to hypotheses, neither full response to acute treatment nor treatment with COMB reduced risk of recurrence. […] The most robust predictor of recurrence was female gender. […] Further research should investigate whether more frequent MDD recurrence among young women is confirmed and if so, what variables are associated with it.

• #5 Treated depression in adolescents: predictors of outcome at 28 weeks | The British Journal of Psychiatry | Cambridge Core

  https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/treated-depression-in-adolescents-predictors-of-outcome-at-28-weeks/A0426E4E366067AEF1A1FC384E3524EA

  The number of adverse life events over the course of the study increased the chance of end-point depression. […] More specifically, this study replicated prior findings that it is the disappointment and loss by death categories of life events that predict persistence of an episode of depression, independently of severity. […] The most efficient predictor of depression at 28 weeks was overall severity of depressive symptoms, which is also the most reliably found predictor in the literature. […] Within the moderate severity group, the occurrence of at least one unpleasant disappointing life event was an additional predictor of end-point depression. […] Overall, however, the ROC analysis suggests that using this pattern of clinical and social predictors alone will not produce either a highly specific or sensitive model for determining the success of these treatments. […] From the clinical perspective, CAMHS staff should include in their assessments of adolescents with depression a comprehensive understanding of the level of severity, degree of suicidality and the presence of multiple comorbidities, especially obsessive-compulsive disorder, at first assessment.

• #6 Treated depression in adolescents: predictors of outcome at 28 weeks | The British Journal of Psychiatry | Cambridge Core

  https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/treated-depression-in-adolescents-predictors-of-outcome-at-28-weeks/A0426E4E366067AEF1A1FC384E3524EA

  There is great heterogeneity of clinical presentation and outcome in paediatric depression. […] To identify which clinical and environmental risk factors at baseline and during treatment predicted major depression at 28-week follow-up in a sample of adolescents with depression. […] Depression at 28 weeks was predicted by the additive effects of severity, obsessive-compulsive disorder and suicidal ideation at entry together with presence of at least one disappointing life event over the follow-up period. […] Clinicians should assess for severity, suicidality and comorbid obsessive-compulsive disorder at presentation and should monitor closely for subsequent life events during treatment. […] A number of depressive factors at presentation have been associated with lower treatment response and higher risk of recurrence.

• #7 Treated depression in adolescents: predictors of outcome at 28 weeks | The British Journal of Psychiatry | Cambridge Core

  https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/treated-depression-in-adolescents-predictors-of-outcome-at-28-weeks/A0426E4E366067AEF1A1FC384E3524EA

  Non-depressive features may also influence outcome: the presence of two or more comorbid psychiatric disorders is associated with poor treatment response. […] The exception is the presence of concurrent obsessive-compulsive disorder, present in around 20% of adolescents with depression, which has been reported as predicting greater treatment difficulties with more prolonged episodes, independent of severity at presentation. […] One naturalistic study showed that family dysfunction and friendship difficulties at presentation increase risk of persistent depression at 36 weeks. […] Undesirable life events after presentation predict persistent depression at follow-up, in particular personal disappointments in intimate social interactions with friends, even when baseline severity of depression is controlled for.

• #8 Prognosis and improved outcomes in major depression: a review | Translational Psychiatry

  https://www.nature.com/articles/s41398-019-0460-3

  Another important clinical variable is time to antidepressant response. For instance, one meta-analysis found that early improvement was positively linked to antidepressant treatment outcome in 15 of 16 studies. […] This suggests that TRD defined loosely here as non-response to at least two adequate antidepressant trials and chronic depression (roughly defined here as non-response to any treatment) may have similar response slopes in the earliest treatment stages. […] Lower baseline function and quality of life including longer duration of the current index episode have been associated with lower remission rates to various types of antidepressant treatments. […] The influence of sociodemographic factors such as age, age of onset, gender, and number of previous episodes on treatment outcome has been investigated with mixed results.

• #9 Prognosis and improved outcomes in major depression: a review | Translational Psychiatry

  https://www.nature.com/articles/s41398-019-0460-3

  Treatment outcomes for major depressive disorder (MDD) need to be improved. Presently, no clinically relevant tools have been established for stratifying subgroups or predicting outcomes. […] The results show that early recognition and treatment are crucial, as duration of untreated depression correlates with worse outcomes. Early improvement is associated with response and remission, while comorbidities prolong course of illness. […] Clear evidence of an inverse relationship between duration of episode and treatment outcome (either response or remission) underscores the importance of early intervention in MDD. In particular, replicable prospective and retrospective studies indicate that shorter duration of untreated disease both in terms of first and recurrent episodes is a prognostic factor indicating better treatment response and better long-term outcomes.

• #10 One-Year Course and Predictors of Outcome of Adolescent Depression: A Case-Control Study in Finland

  https://www.psychiatrist.com/jcp/course-predictors-outcome-adolescent-depression/

  Clinical studies on the outcome of adolescent depression beyond treatment trials are scarce. […] To investigate the impact of characteristics of the depressive episode and current comorbidity on the 1-year outcome of depression. […] The outpatients had equal recovery rate and episode duration but shorter time to recurrence than the controls. […] Among the outpatients, Axis II comorbidity predicted shorter time to recurrence (p = .02). […] Longer time to recovery was predicted by earlier lifetime age at onset for depression (p = .02), poor psychosocial functioning (p = .003), depressive disorder diagnosis (p = .05), and longer episode duration by study entry (p = .001), with an interaction between episode duration and depressive disorder diagnosis (p = .04). […] Characteristics of depression generally predicted the outcome better than comorbidity. […] Axis II comorbidity has prognostic value in adolescent depression.

• #11 Prediction of adolescent depression from prenatal and childhood data from ALSPAC using machine learning | Scientific Reports

  https://www.nature.com/articles/s41598-024-72158-9

  Overall prediction accuracy was 64%, and female sex, parental depression and anxiety, and exposure to stressful events or environments were identified as leading predictors of adolescent depression. […] Although we predicted adolescent depression with adequate performance, we were unable to reach the recommended level for high clinical relevance as it has been proposed that precision of 80% or more would be necessary to reach high clinical relevance. […] The predictive value of composite variables such as child life events scores supports stress accumulation theories of depression, given that children who accumulated more adverse events were more vulnerable to depression during adolescence. […] Our study revealed multiple statistically significant associations of early life environmental, socio-emotional, cognitive, and biological variables with adolescent depression, several of which lend empirical support, based on a large sample and numerous variables, to the stress accumulation and stress sensitization theories of depression. […] The leading informative features in our predictive models of adolescent depression were sex, parental depression and anxiety, and exposure to stressful events or environments.

• #12 Prediction of Diagnosis and Treatment Response in Adolescents With Depression by Using a Smartphone App and Deep Learning Approaches: Usability Study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10248781/

  Lack of quantifiable biomarkers is a major obstacle in diagnosing and treating depression. In adolescents, increasing suicidality during antidepressant treatment further complicates the problem. […] We sought to evaluate digital biomarkers for the diagnosis and treatment response of depression in adolescents through a newly developed smartphone app. […] We could predict the diagnosis of depression with training accuracy of 96.3% and 3-fold validation accuracy of 77%. Of the 24 adolescents with MDD, 10 responded to antidepressant treatments. We predicted the treatment response of adolescents with MDD with training accuracy of 94.2% and 3-fold validation accuracy of 76%. […] Our smartphone app demonstrated preliminary evidence of predicting diagnosis and treatment response in depressed adolescents. This is the first study to predict the treatment response of adolescents with MDD by examining smartphone-based objective data with deep learning approaches. […] Therefore, early diagnosis and treatment of depression are needed. Early prediction of antidepressant treatment response is also of great importance in order to decrease antidepressant-associated suicidality in depressed adolescents.

• #13

  https://link.springer.com/article/10.1007/s12310-019-09346-w

  In order to offer early and accessible treatment for adolescents with depression, brief and effective treatments in adolescents everyday surroundings are needed. […] Both treatments were effective in reducing depressive disorders and improving adolescents overall functioning and well-being. […] This trial suggests that both IPC and BPS are feasible, acceptable, and effective treatments for mild-to-moderate depression in the school setting. […] Our study shows that brief, structured interventions, such as IPC and BPS, are beneficial in treating mild-to-moderate depression in school settings and can be administered by professionals working at school. […] The results show that a brief, active treatment, either IPC or BPS, is effective in reducing symptoms of mild-to-moderate depression and increasing adolescents functioning and psychological well-being.

• #14

  https://link.springer.com/article/10.1007/s12310-019-09346-w

  Our findings suggest that a supportive intervention with targeted frequent sessions, which include repeated assessment of depressive symptoms, may be sufficient for reducing depression in youth. […] Our findings indicate that short and structured interventions, such as IPC and BPS, delivered by professionals from school-based services are effective in treating mild-to-moderate depression in school settings and yield results that can be maintained 6 months after the intervention.

• #15 Treated depression in adolescents: predictors of outcome at 28 weeks | The British Journal of Psychiatry | Cambridge Core

  https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/treated-depression-in-adolescents-predictors-of-outcome-at-28-weeks/A0426E4E366067AEF1A1FC384E3524EA

  This paper reports the influence of clinical and environmental risk factors at baseline and during treatment on whether a sample of NHS clinic-referred adolescents with depression who formed part of a larger clinical cohort involved in a randomised controlled trial met criteria for major depressive episode at 28-week follow-up. […] At 28 weeks follow-up, 23% of the individuals with unipolar major depression remained resistant to the effects of a comprehensive treatment programme delivered in CAMHS out-patients by trained and supervised mental health staff. […] Whether an adolescent with moderate to severe unipolar major depression in this sample had end-point disorder 28 weeks later was predicted by the additive effects of severity and number of comorbid psychiatric disorders. […] Detailed analysis showed a specific prediction for the additive effects of higher suicidality, obsessive-compulsive disorder and severity on the liability for end-point depression at 28 weeks.

• #16 Prognosis and improved outcomes in major depression: a review | Translational Psychiatry

  https://www.nature.com/articles/s41398-019-0460-3

  High stress levels significantly influence outcomes in MDD patients who are prone to vulnerable states, such as those with high levels of neuroticism. […] Psychiatric comorbidity has been shown to influence outcome in both treated and untreated patients. […] MDD and several physical diseases including cardiovascular disease and diabetes appear to have bidirectional effects on disease trajectory, yet pathophysiologic links are most likely complex and have to be elucidated. […] Structural markers of antidepressant treatment outcomes suggest that hippocampal volumes are related to response and remission. […] Consistent with neuroinflammatory processes, elevated levels of C-reactive protein (CRP), tumor necrosis factor alpha (TNF), and interleukin-6 (IL-6) have been reported in a subset of MDD patients.

• #17 Prognosis and improved outcomes in major depression: a review | Translational Psychiatry

  https://www.nature.com/articles/s41398-019-0460-3

  A large, collaborative genome-wide association study (GWAS) detected 44 significant loci associated with MDD. […] While some studies have suggested that depressive subtypes in MDD including anxious, mixed, melancholic, atypical, and psychotic depression respond differently to antidepressant treatment, this literature is mixed. […] Unsurprisingly, this group of patients has dramatically worse outcomes than those who respond to antidepressants, and factors that are associated with TRD overlap with many of those presented above. […] The studies reviewed above also underscore the manner in which SLEs, as well as physical and psychiatric comorbidities, contribute to impaired outcomes. […] Recent studies have led to important insights into neurobiological disease markers that could result in improved disease stratification and response prediction in the near future.

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