A Half Century of Research on Childhood and Adolescent Depression: Science Mapping the Literature, 1970 to 2019

The Dynamic Association Between Physical Activity and Psychological Symptoms in Young People With Major Depressive Disorder: An Active and Passive Sensing Longitudinal Cohort Study

PURPOSE

Physical activity could be associated with psychological symptoms in young people with major depressive disorder (MDD). Using actigraphy and ecological momentary assessment (EMA), we investigated the associations between physical activity and stress, anxiety and positive and negative affect in young people with MDD.

METHODS

Actigraphy and EMA were collected daily in 40 young participants (aged 16-25 years) with MDD over 8 weeks. Multi-level linear mixed models were used to examine within- and between-person daily associations between physical activity and symptoms of stress, depression and positive and negative affect.

RESULTS

Participants with at least 14 days of complete data were included in the analysis (n participants = 22; total days = 598). Typical (defined as average across the assessment period) vigorous physical activity was significantly associated with lower daily stress (β[95% CI] = -0.152 [-0.298, -0.007], p = 0.041) and higher daily positive affect (0.526 [0.061, 0.992], p = 0.028). Variability in daily light (0.004 [0.001, 0.006], p = 0.010) and moderate physical activity (0.004 [0.001, 0.007], p = 0.009) were positively associated with daily stress. Variability in daily light (0.003 [0.001, 0.006], p = 0.018) and moderate physical activity (0.004 [0.001, 0.007], p = 0.011) were positively associated with daily anxiety.

CONCLUSIONS

Various intensities of daily physical activities were associated with symptoms of stress, anxiety and positive affect in young people with MDD. Future research on larger samples should validate the causal and daily associations between physical activity and psychological symptoms to promote evidence-based behavioural strategies to improve psychological symptoms in young people with MDD.

The path of depression in rural children: A fuzzy-set qualitative comparative analysis across multiple provinces in China

OBJECTIVES

This study explores the combinations of conditional variables contributing to depressive symptoms in rural children.

METHODS

We analyzed data from 715 children from a rural mental health database, conducting detailed follow-up investigations on 129 children in Zhejiang and Henan provinces. We used fuzzy set Qualitative Comparative Analysis (fsQCA) and regression analysis to identify causal pathways leading to depression.

RESULTS

The results indicate that depression in rural children does not stem from a single, necessary condition but arises from multiple factors. Our findings highlight significant contributions from both maternal and paternal involvement. Specifically, maternal involvement, combined synergistically with peer support and problematic behaviors, as well as paternal involvement, together with peer support and anxiety, significantly affects depressive outcomes. Additionally, anxiety and strong peer relationships independently have a substantial impact on these outcomes. Effective mitigation strategies involve active parental engagement and robust peer support, reducing the influence of risk factors such as problematic behaviors and anxiety.

LIMITATIONS

The generalizability of the results is limited by cultural and geographical variations. The study also does not account for all potential factors influencing depression in rural children.

CONCLUSION

Depression in rural children results from multiple interacting factors. Tailored interventions addressing these specific combinations are recommended.

Trends in Mental Health: A Review of the Most Influential Research on Depression in Children and Adolescents

BACKGROUND

Depression is a common mental disorder in children and adolescents, with a global prevalence of approximately 33%, severely affecting their physical, mental health, and academic performance. This study aims to identify and assess the 100 most-cited articles (T100 articles) on depression in children and adolescents.

METHODS

The T100 articles in the field of depression were retrieved from the SCI-E and SSCI databases. A comprehensive analysis of the T100 articles was conducted, including the number of citations, countries, journals, keywords, authors, and topics.

RESULTS

Between 1981 and 2021, T100 articles in child and adolescent depression received 423 to 3949 citations. Most articles originated from the USA, with Kovacs M as the top-ranked author. The University of Pittsburgh and Columbia University published the top two T100 articles. The T100 articles were published in 36 journals, led by AMA Psychiatry. Co-occurrence keywords analyses reveal six key foci: Pathogenesis of Depression, Treatment of MDD in Children, Early Childhood Treatment, Adolescent Depression Manifestations, Gender and Depression, and Primary Care Considerations, with pathogenesis as a future trend.

CONCLUSIONS

Our research presents an exhaustive list of the most highly cited articles on depression in children and adolescents. Our findings not only underscore the significance of international cooperation but also reveal a pressing need to prioritize and bolster preventive research, particularly the development and refinement of early screening and intervention programs.

Depression and Anxiety Among US Children and Young Adults

Importance

Data from surveys show increased mental health disorders in youths. However, little is known about clinical diagnosis over time.

Objective

To assess the incidence, prevalence, and changes from 2017 to 2021 for depression and anxiety diagnosed clinically among children, adolescents, and young adults and to identify potential disparities.

Design, Setting, and Participants

This cohort study included approximately 1.7 million individuals aged 5 to 22 years in Southern California. Data were extracted from electronic medical records; International Statistical Classification of Diseases, Tenth Revision (ICD-10), codes were used to identify depression and/or anxiety diagnosis for each study year from January 1, 2017, to December 31, 2021. Rates were stratified by age, gender, race and ethnicity, estimated household income, weight status, and comorbidity history. Changes over time and association with these variables were assessed using Poisson regression. Data were analyzed between June 1, 2022, and November 29, 2023.

Main Outcomes and Measures

Clinical diagnosis of (1) depression and (2) anxiety without a depression diagnosis using ICD-10 codes.

Results

Among the 1.7 million participants, mean (SD) age was approximately 14 (5) years, and 51% were male. In terms of race and ethnicity for each study year, approximately 50% of participants were Hispanic; 8%, non-Hispanic Asian; 8%, non-Hispanic Black; and 23%, non-Hispanic White. From 2017 to 2021, depression diagnosis increased by 55.6% (from 1.35% to 2.10%) for incidence and 60.0% (from 2.55% to 4.08%) for prevalence; anxiety without depression diagnosis increased by 31.1% (from 1.77% to 2.32%) for incidence and 35.2% (from 3.13% to 4.22%) for prevalence (P < .001 for trend). The increases in rates were higher during the COVID-19 pandemic (2020-2021) than before the pandemic (2017-2019), except for depression incidence. Rates increased across all subgroups. Rates were highest for subgroups aged 14 to 17 and 18 to 22 years; female participants; those of non-Hispanic American Indian or Alaska Native, non-Hispanic White, or multiple races or ethnicities; and subgroups with higher household income, obesity (and underweight for anxiety without depression), or comorbidities. Among these factors, age was the most important factor for depression diagnosis, whereas weight status was the most important factor for anxiety without depression diagnosis.

Conclusions and Relevance

This cohort study, using electronic medical record data from a large integrated health care system, found an increase in clinically diagnosed depression from 2017 to 2021, with a higher increase during the COVID-19 pandemic and higher rates in some subgroups. Equally important, this study identified high rates and an increase in clinical diagnosis of anxiety without a depression diagnosis. These results support the increased need in public health and health care effort to combat the mental health crisis in youths.

Measurement-Based Care for Depression in Youth: Practical Considerations for Selecting Measures to Assess Depression, Associated Features and Functioning

Identification and management of major depressive disorder (MDD) in children and adolescents remains a significant area of public health need. The process for identifying depression (e.g. screening) and management (e.g. measurement based care [MBC]) is substantially enhanced by utilization of clinical measures and rating scales. Measures can be self- or caregiver reported or clinician rated. They can aid recognition of at-risk individuals for future assessment and assist in clinical diagnosis and management of depression. In addition to assessing symptoms of depression, rating scales can be used to assess important associated features (e.g. anxiety, trauma) and functional outcomes (e.g. quality of life, performance/productivity). In this manuscript, we discuss practical considerations for clinicians and researchers when selecting rating instruments for assessing depression, associated factors, functioning, and treatment outcomes (i.e. adherence and side effects) as part of MBC in youth and provide a summary of rating scales commonly used in research and clinical settings.

Peer effects of depression between left-behind and non-left-behind children: quasi-experimental evidence from rural China

PURPOSE

The aim of the study is to investigate the interactive influence of depression on left-behind (LB) and non-left-behind (NLB) children from the perspective of peer effects. The roles of teachers, parents, and friends are also explored.

METHODS

Data on 1817 children, 1817 parents, and 55 teachers were obtained from a field survey in December 2021. All students in the sample were randomly assigned to classrooms. A peer effect model and OLS methods were used to estimate the peer influence of depression. Robustness tests were conducted by randomly removing schools from the sample.

RESULTS

Depression was contagious among different groups of rural children, and the peer effect of the NLB children's depression played a dominant role. Both LB and NLB children were more affected by their NLB classmates' depression. LB children were not significantly affected by depression in other LB children. This conclusion remains robust after robustness testing. In addition, heterogeneity analysis showed that outgoing and cheerful teachers, effective parent-child communication and high-quality friendship all alleviated peer influence on depression.

CONCLUSIONS

LB children have more severe depression than NLB children, but LB children are more affected by depression in their NLB peers. Policymakers should train teachers to engage in positive communication with students to improve mental health in children. In addition, this article recommends that children move and live with their parents when family conditions permit.

Association between Psychopathological Symptoms and Aggression and Selected Biochemical Parameters in Adolescents with Behavioural and Emotional Disturbances

Behavioural and emotional disturbances (F92.8) are the most recognized disorders in a developmental psychiatry. As the problem is still alarmingly increasing, the searches for their etiopathogenesis and more effective preventing and therapy methods are required. The aim of the study was to assess the association between the quality of life, some psychopathological features, concentrations of selected immunoprotective (brain-derived neurotrophin, BDNF), and endocrine (cortisol, F) factors while adolescent disturbances. The study was performed in 123 inpatients of a psychiatric ward with F92.8 diagnosis, aged 13-18 years. The complete patients' interview, physical examination, and routine laboratory tests, including serum F and BDNF tests, were performed. All patients completed standardized questionnaires to estimate: the severity of psychopathological symptoms (SCL-90), the level of aggression (Buss-Perry). The changes in the plasma BDNF and F concentrations were shown in patients raised in foster homes and institutions. The significantly lower BDNF was observed in youth from foster and suicide-experienced families. The more severe psychopathological symptoms, especially aggression and hostility, were found in these ones, who abused alcohol, attempted suicide, had lower self-esteem and cognitive processes, and were lacking safety in dysfunctional families.

It's not always binary: Connecting the continuum of caregiver depression with child adjustment in children who are high risk for maltreatment

BACKGROUND

Young children living with a depressed parent are at risk for developing social, behavioral, and emotional problems. The purpose of this study was to evaluate whether an increase in subclinical caregiver depression scores was associated with increases in internalizing and externalizing behavior in children who are at high risk for maltreatment.

METHODS

The 1019 U.S.-based dyads consisted of predominantly single (45.53%) and Black/African American (53.29%) caregivers and high-risk 4-year-olds from the LONGSCAN study. Multivariate regression analyzes were used to evaluate the relationship between caregiver Center for Epidemiological Studies-Depression (CES-D) scores, above and below the at-risk for depression CES-D score, and preschooler internalizing, externalizing, and total problem behaviors, measured with the Child Behavior Checklist (CBCL).

RESULTS

Caregiver CES-D score increases, above and below the at-risk for depression score, were significantly associated (p < 0.05) with increased child internalizing, externalizing, and total problem behaviors. After adjusting for covariates, among dyads whose caregivers had subclinical (CES-D < 16) scores, a one-unit score increase was significantly associated with a 0.43 increase (p = 0.00) in children's CBCL internalizing score.

LIMITATIONS

These findings are restricted to preschool children who are at risk for maltreatment, limiting generalizability.

CONCLUSIONS

Low and moderate levels of caregiver depressive symptomatology were associated with a negative influence on preschoolers' adjustment. Practitioners should consider that the link between caregiver depression and child wellbeing may lie on a continuum. With consideration of the full continuum of symptoms, early intervention and anticipatory guidance may decrease the impact of depression on the caregiver, child, and system.