Subthreshold depression in children and adolescents – a systematic review

Wesselhoeft, Rikke; Sørensen, Merete Juul; Heiervang, Einar; Bilenberg, Niels

doi:10.1016/j.jad.2013.06.010

Cited by 164 publications

(141 citation statements)

References 81 publications

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“…This is consistent with epidemiological studies [24,25,27,28,29] that support the value of depressive symptoms as predictive of an eventual first episode of MDD. However, these epidemiological studies cannot track fluctuations of these symptoms in relation to the development of MDD.…”

Section: Discussionsupporting

confidence: 91%

A Qualitative Study of the Prodrome to First-Episode Major Depressive Disorder in Adolescents

Sheriff

McGorry²,

Cotton³

et al. 2015

Psychopathology

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Background: Currently, we lack a clear picture of the evolution of major depressive disorder (MDD) in adolescents. The period of disturbance preceding MDD can be conceptualised as the prodrome. The aim of the study was to explore the prodrome of first-episode MDD retrospectively in a group of help-seeking adolescents using qualitative methodologies. Sampling and Methods: Consecutively referred adolescents (15-18 years of age) with first-episode MDD were recruited for this study from Orygen Youth Health, Melbourne, Vic., Australia. After using quantitative methodologies to confirm the index episode of MDD and measure the extent of recovery, the prodrome was investigated in depth using qualitative techniques. Results: Twenty-nine adolescents (20 females and 9 males) and 7 informants (6 mothers and 1 grandmother) participated. All 29 participants had a prodrome of varying lengths (between 6 days and 4 years). The most noticeable symptoms initially were perplexity and confusion and, thereafter, sadness and irritability. A common pattern was a reduction in their ability to fulfil their role accompanied by guilt, self-blame and reduced self-esteem. Around half of the participants had increased thoughts of suicide and increased anxiety. There were gender differences in the patterns of symptoms noticed, with males more commonly noticing a change in how they related to the world and females more commonly noticing a change in the way that they related to others. All informants noticed a prodrome of varying lengths; in 2 cases longer, in 2 cases shorter and in 3 cases around the same time period as that noticed by the participant. The changes most commonly noticed by informants were sadness, upset, irritability and reduced self-esteem. The symptoms were fewer in number and sometimes varied from those noticed by the adolescents themselves. Conclusions: Whilst we recognise that this study is vulnerable to autobiographical bias, we took all reasonable measures to minimise this. Symptoms not included in the diagnostic criteria for depression were the earliest changes noticed by the adolescents themselves and are, therefore, potentially important in informing prevention strategies, as is the finding that there are gender differences in the patterns of changes noticed. In addition, parents may provide an additional avenue to help seeking.

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Section: Discussionsupporting

confidence: 91%

A Qualitative Study of the Prodrome to First-Episode Major Depressive Disorder in Adolescents

Sheriff

McGorry²,

Cotton³

et al. 2015

Psychopathology

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“…1 To this extent, the prevalence of major depressive disorder (MDD) is now ranging from 4% to 8%, and as many as 12% of children and adolescents may have subthreshold symptoms of depression. 2 Alarmingly, 20% of young people experience at least one episode of major depression before they reach 18 years of age. 3 In recent years, there has been an increased, yet limited, number of studies investigating the effect of physical exercise or physical activity for depression in children and adolescents (physical exercise is defined as a planned, structured, repetitive, and purposive physical activity, aiming to improve or maintain one or more physical fitness components) 4 , and there is some evidence suggesting this may be a promising strategy 5,6 .…”

Section: Introductionmentioning

confidence: 99%

The Effect of Exercise on Depressive Symptoms in Adolescents: A Systematic Review and Meta-Analysis

Carter

Morres

Meade

et al. 2016

Journal of the American Academy of Child & Adolescent Psych

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(2016) The effect of exercise on depressive symptoms in adolescents: a systematic review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 55 (7). pp. 580-590. ISSN 1527-5418Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/35399/1/CarterMorresMeadeCallaghan_Systematic %20review.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the University of Nottingham End User licence and may be reused according to the conditions of the licence. For more details see: http://eprints.nottingham.ac.uk/end_user_agreement.pdf A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.For more information, please contact eprints@nottingham.ac.uk Journal of the American Academy of Child & Adolescent Psychiatry M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 2 AbstractObjective: The purpose of this review was to examine the treatment effect of physical exercise on depressive symptoms for adolescents aged 13-17 years. Method: A systematic search of seven electronic databases identified relevant randomised controlled trials.Following removal of duplicates, 543 texts were screened for eligibility. Screening, data extraction, and trial methodological quality assessment (using the Delphi list) were undertaken by two independent researchers. Standardized mean differences were used for

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“…These simultaneous changes can increase the vulnerability for developing symptoms of depression, known to be prevalent during mid-teens, [1] increasing the risk for negative outcomes, including functional impairment, distress, poorer quality of life, suicidal ideation and the trajectory to a clinical depression in adulthood. [1][2][3] The World Health Organization identified depression as the most common mental health disorder in adolescence [4] with subthreshold depression increasing the risk for a diagnosis of depression in this age group. [5] Understanding depression and identifying symptoms within this age group is very important in order to render preventive measures and treatment strategies.…”

Section: Articlementioning

confidence: 99%

“…Depression is a debilitating diagnosis and a subthreshold depression is known to affect quality of life. [10] For example, some studies show that a diagnosis of depression or a subthreshold depression in adolescence increases the risk for a comorbid psychopathology such as anxiety disorder, bipolar mood disorder, [1] and other functional impairments like poor socialisation skills. [11] In view of the debilitating effects of a subthreshold depression and a major depression diagnosis in adolescence, it is imperative, as a preventive measure, to identify the onset of depressive symptoms early.…”

Section: Articlementioning

confidence: 99%