[Efficacy of Universal and Selective Prevention on Depression in Children and Adolescents. a Systematic Review].

[Efficacy of universal and selective prevention on depression in children and adolescents. A systematic review].

Filed under: Depression Treatment

Z Kinder Jugendpsychiatr Psychother. 2012 Nov; 40(6): 385-97
Schulte-Körne G, Schiller Y

Objective: Unipolar depressive disorder often begins in childhood, making it essential to prevent the development of depressive disorders early on. The current review describes the evidence of selective, indicated, and universal prevention of depression in children and adolescents based on published, systematic reviews, and metaanalyses. Method: Scientific databases were electronically searched for prevention studies done between 1990 and 2012 with children and adolescents and written in German and English. Ten systematic reviews and metaanalyses were identified as eligible for review. These reviews in turn investigated a total of 121 controlled studies, 52 of which were universal, 46 selective, and 19 targeted prevention studies. Four studies combined selective and indicated prevention. Results: Evidence was found for selective, indicated, and universal prevention in comparison to untreated control groups for efficacy in reducing depressive symptoms in children and adolescents. This was still evident for the follow-up at 3 to 9 months. Evidence for efficacy of selective prevention was still evident at 12 months post-intervention. The effect sizes were mostly low. Compared with placebo the efficacy is considerably lower or no evidence was found. Conclusions: The results of the single reviews were quite heterogeneous. For further research there is an urgent need to identify the factors responsible for effective programs and to test these under real-world conditions.
HubMed – depression


[Cognitive behavior therapy for depression in children and adolescents – procedure, effects, and developments].

Filed under: Depression Treatment

Z Kinder Jugendpsychiatr Psychother. 2012 Nov; 40(6): 373-84
Groen G, Petermann F

Cognitive behavior therapy offers a theoretically and empirically valid therapeutic approach for children and adolescents suffering from depression. It can be recommended according to present guidelines and efficacy studies. Further research and conceptual development, however, is necessary especially regarding the small to moderate effect sizes as well as the lack of long-term efficacy and effect factors. This article gives a short overview of the basics and contents of cognitive behavior therapy for depressive children and adolescents. It furthermore presents the latest findings and an assessment of its efficacy and relevant developments and perspectives.
HubMed – depression


Heterogeneous properties of central lateral and parafascicular thalamic synapses in the striatum.

Filed under: Depression Treatment

J Physiol. 2012 Oct 29;
Ellender TJ, Harwood JR, Kosillo P, Capogna M, Bolam PJ

To understand the principles of operation of the striatum it is critical to elucidate the properties of the main excitatory inputs from cortex and thalamus, as well as their ability to activate the main neurons of the striatum, the medium spiny neurons (MSNs). As the thalamostriatal projection is heterogeneous, we set out to isolate and study the thalamic afferent inputs to MSNs using small localized injections of adeno-associated virus carrying fusion genes for channelrhodopsin-2 and YFP, in either the rostral or caudal regions of the intralaminar thalamic nuclei (i.e. the central lateral or parafascicular nucleus). This enabled optical activation of specific thalamic afferents combined with whole-cell, patch-clamp recordings of MSNs and electrical stimulation of cortical afferents, in adult mice. We found that thalamostriatal synapses differ significantly in their peak amplitude responses, short-term dynamics and expression of ionotropic glutamate receptor subtypes. Our results suggest that central lateral synapses are most efficient in driving MSNs, particularly those of the direct pathway, to depolarization as they exhibit large amplitude responses, short-term facilitation and predominantly express postsynaptic AMPA receptors. In contrast, parafascicular synapses exhibit small amplitude responses, short-term depression and predominantly express postsynaptic NMDA receptors suggesting a modulatory role, e.g. facilitating Ca2+-dependent processes. Indeed, pairing parafascicular, but not central lateral, presynaptic stimulation with action potentials in MSNs, leads to NMDA receptor- and Ca2+-dependent long-term depression at these synapses. We conclude that the main excitatory thalamostriatal afferents differ in many of their characteristics and suggest that they each contribute differentially to striatal information processing.
HubMed – depression



Treatment Resistant Depression Program – Joel L. Young, MD, discusses RCBM’s Treatment-Resistant Depression services. In cases where patients have tried several treatment modalities for their depression and found little or no relief, their depression may be classified as “treatment-resistant.” At RCBM, we address Treatment-Resistant Depression in several ways, including assessment of the patient to ensure that the diagnosis is accurate and that co-morbid diagnoses have not been missed; and working with the patient and their family to explore other treatment methods, including Electro-Convulsive Therapy, Vagus Nerve Stimulation, or Transcranial Magnetic stimulation.


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