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Chapter 26 - The Treatment of Mood Disorders in Children and Adolescents

Published online by Cambridge University Press:  16 May 2024

By
Ioanna Douka  and
Argyris Stringaris
Edited by
Allan Young ,
Marsal Sanches ,
Jair C. Soares  and
Mario Juruena
Allan Young
Affiliation:
Institute of Psychiatry, King's College London
Marsal Sanches
Affiliation:
Baylor College of Medicine, Texas
Jair C. Soares
Affiliation:
McGovern Medical School, The University of Texas
Mario Juruena
Affiliation:
King's College London
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Summary

Mood disorders are causes of significant morbidity and mortality and can have their origins in early life and can affect youth development. In this chapter, we describe the significance of depression in children and adolescents, as well as potential management strategies for mood disorders in youth. We describe the establishment of viable treatment plans (including the stages of diagnostic assessment, selection of treatments, and evaluation of treatment response) in collaboration with the patient and their family, as well as the school, and describe how psychopharmacological or psychotherapeutic interventions may be used across unipolar depression and bipolar disorder. We also discuss potential treatment adaptations for pediatric populations, potential adverse effects for children and adolescents, comorbidities, and ways to manage treatment resistance.

Keywords

treatment-resistant depressionTADSTORDIApediatric depressionSSRIs in youthSSRIS-early responseyouth-placebo response
Type
Chapter
Information
Clinical Textbook of Mood Disorders , pp. 277 - 286
Publisher: Cambridge University Press
Print publication year: 2024

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References

Murray, CJL. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 December;380(9859):2197–223.CrossRefGoogle ScholarPubMed
Costello, EJ. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003;60(8):837–44.CrossRefGoogle ScholarPubMed
Thapar, A. Depression in adolescence. Lancet. 2012 March;379(9820):1056–67.CrossRefGoogle ScholarPubMed
Maughan, B, Collishaw, S, Stringaris, A. Depression in childhood and adolescence. J Can Acad Child Adolesc Psychiatry. 2013 February;22(1):35–40.Google ScholarPubMed
Brent, DA. Major depressive disorder. New Dir Ment Health Serv. 1992 Summer;(54):39–44.CrossRefGoogle Scholar
CDC WONDER. About underlying cause of death, 1999–2020. [cited 2021 May 19]. Available from: http://wonder.cdc.gov/ucd-icd10.html.Google Scholar
Goodyer, IM, Wilkinson, PO. Therapeutics of unipolar major depressions in adolescents. J Child Psychol Psychiatry. 2019;60(3):232–43.CrossRefGoogle ScholarPubMed
Birmaher, B, Brent, D; AACAP Work Group on Quality Issues, et al. Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry. 2007;46(11):1503–26.CrossRefGoogle ScholarPubMed
Cheung, AH, Zuckerbrot, RA, Jensen, PS, et al.; GLAD-PC STEERING GROUP. Guidelines for Adolescent Depression in Primary Care (GLAD-PC): part II. Treatment and ongoing management. Pediatrics. 2018;141(3):e20174082CrossRefGoogle ScholarPubMed
Dwyer, JB, Stringaris, A, Brent, DA, Bloch, MH. Annual research review: defining and treating pediatric treatment-resistant depression. J Child Psychol Psychiatry. 2020 March;61(3):312–32.CrossRefGoogle ScholarPubMed
Reyes, ADL, Augenstein, TM, Wang, M, et al. The validity of the multi-informant approach to assessing child and adolescent mental health. Psychol Bull. 2015 July;141(4):858–900.CrossRefGoogle ScholarPubMed
Kaufman, J, Birmaher, B, Brent, D, et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997 July;36(7):980–8.CrossRefGoogle ScholarPubMed
Goodman, R, Ford, T, Richards, H, Gatward, R, Meltzer, H. The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatry. 2000 July;41(5):645–55.CrossRefGoogle ScholarPubMed
Poznanski, EO, Grossman, JA, Buchsbaum, Y, et al. Preliminary studies of the reliability and validity of the Children’s Depression Rating Scale. J Am Acad Child Psychiatry. 1984;23(2):191–7.CrossRefGoogle ScholarPubMed
Daviss, WB, Birmaher, B, Melham, NA, et al. Criterion validity of the Mood and Feelings Questionnaire for depressive episodes in clinic and non-clinic subjects. J Child Psychol Psychiatry. 2006;47(9):927–34.Google ScholarPubMed
National Institute for Health and Clinical Excellence (NICE). Depression in children and young people: NICE guideline. London, 2005. [Cited 2007 August 14.]Google Scholar
Eckshtain, D, Kuppens, S, Ugueto, A, et al. Meta-analysis: 13-year follow-up of psychotherapy effects on youth depression. J Am Acad Child Adolesc Psychiatry. 2020;59(1):45–63.CrossRefGoogle ScholarPubMed
Zhou, X, Hetrick, SE, Cuijpers, P, et al. Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: a systematic review and network meta-analysis. World Psychiatry. 2015;14(2):207–22.CrossRefGoogle ScholarPubMed
Goodyer, IM, Dubicka, B, Wilkinson, P, et al. A randomised controlled trial of cognitive behaviour therapy in adolescents with major depression treated by selective serotonin reuptake inhibitors. The ADAPT trial. Health Technol Assess. 2008;12(14):iii–iv; ix–60.CrossRefGoogle ScholarPubMed
Weisz, J, Southern-Gerow, MA, Gordis, EB, et al. Cognitive-behavioral therapy versus usual clinical care for youth depression: an initial test of transportability to community clinics and clinicians. J Consult Clin Psychol. 2009;77(3):383–96.CrossRefGoogle ScholarPubMed
Bridge, JA, Birmaher, B, Iyengar, S, et al. Placebo response in randomized controlled trials of antidepressants for pediatric major depressive disorder. Am J Psychiatry. 2009 January;166(1):42–9.CrossRefGoogle ScholarPubMed
Walkup, JT. Antidepressant efficacy for depression in children and adolescents: industry- and NIMH-funded studies. Am J Psychiatry. 2017;174: 430–7.CrossRefGoogle ScholarPubMed
Whiteford, HA, Harris, MG, McKeon, G, et al. Estimating remission from untreated major depression: a systematic review and meta-analysis. Psychol Med. 2010 August;43(8):1569–85.Google Scholar
Cipriani, A, Zhou, X, Del Giovana, C, et al. Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: a network meta-analysis. Lancet. 2016;388(10047):881–90.CrossRefGoogle ScholarPubMed
Wilens, TE, Cohen, L, Biederman, J, et al. Fluoxetine pharmacokinetics in pediatric patients. J Clin Psychopharmacol. 2002;22(6):568–75.CrossRefGoogle ScholarPubMed
Findling, RL, McNamara, NK, Stansbrey, RJ, et al. The relevance of pharmacokinetic studies in designing efficacy trials in juvenile major depression. J Child Adolesc Psychopharmacol. 2006;16:131–45.CrossRefGoogle ScholarPubMed
Emslie, GJ, Ventura, D, Korotzer, A, Turkodimitris, S. Escitalopram in the treatment of adolescent depression: a randomized placebo-controlled multisite trial. J Am Acad Child Adolesc Psychiatry. 2009;48(7):721–9.CrossRefGoogle ScholarPubMed
Hetrick, SE, McKenzie, JE, Cox, GR, et al. Newer generation antidepressants for depressive disorders in children and adolescents. Cochrane Database Syst Rev. 2012 Nov 14;11(11):CD004851.Google ScholarPubMed
Wagner, KD, Ambrosini, P, Rynn, M, et al. Efficacy of sertraline in the treatment of children and adolescents with major depressive disorder: two randomized controlled trials. JAMA. 2003;290(8):1033–41.CrossRefGoogle ScholarPubMed
Hetrick, SE, McKenzie, JE, Bailey, AP, et al. Newer generation antidepressants for depressive disorders in children and adolescents: a network meta-analysis. Cochrane Database Syst Rev. 2021;2021(5): CD013674.Google Scholar
Emslie, GJ. Venlafaxine ER for the treatment of pediatric subjects with depression: results of two placebo-controlled trials. J Am Acad Child Adolesc Psychiatry. 2007;46:479–88.CrossRefGoogle ScholarPubMed
Hazell, P, Mirzaie, M. Tricyclic drugs for depression in children and adolescents. Cochrane Database Syst Rev. 2013; June18;2013(6):CD002317.Google ScholarPubMed
Tsapakis, EM, Soldani, F, Tondo, L, Baldessanni, RJ. Efficacy of antidepressants in juvenile depression: meta-analysis. Br J Psychiatry. 2008 July;193(1): 10–17.CrossRefGoogle ScholarPubMed
Bridge, JA, Iyengar, S, Salary, CB, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA. 2007;297:1683–96.CrossRefGoogle ScholarPubMed
Cohen, D, Deniau, E, Maturana, A, et al. Are child and adolescent responses to placebo higher in major depression than in anxiety disorders? A systematic review of placebo-controlled trials. PLoS One. 2008; 3(7):e2632.CrossRefGoogle ScholarPubMed
Cohen, D, Consoli, A, Bodeau, N, et al. Predictors of placebo response in randomized controlled trials of psychotropic drugs for children and adolescents with internalizing disorders. J Child Adolesc Psychopharmacol. 2010;20:39–47.CrossRefGoogle ScholarPubMed
Wilkinson, P, Kelvin, R, Roberts, C, et al. Clinical and psychosocial predictors of suicide attempts and nonsuicidal self-injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT). Am J Psychiatry. 2011 May;168(5):495–501.CrossRefGoogle ScholarPubMed
Walkup, J, Labellarte, M. Complications of SSRI treatment. J Child Adolesc Psychopharmacol. 2001; 11: 1–4.CrossRefGoogle ScholarPubMed
Safer, DJ, Magno Zito, J. Treatment-emergent adverse events from selective serotonin reuptake inhibitors by age group: children versus adolescents. J Child Adolesc Psychopharmacol. 2006;16:159–69.CrossRefGoogle ScholarPubMed
Dwyer, JB, Bloch, MH. Antidepressants for pediatric patients. Curr Psychiatr. 2019;18:26–42 F.Google ScholarPubMed
Dobry, Y, Rice, T, Sher, L. Ecstasy use and serotonin syndrome: a neglected danger to adolescents and young adults prescribed selective serotonin reuptake inhibitors. Int J Adolesc Med Health. 2013;25:193–9.CrossRefGoogle Scholar
Nilsson, M, Joliat, MJ, Miner, CM, et al. Safety of subchronic treatment with fluoxetine for major depressive disorder in children and adolescents. J Child Adolesc Psychopharmacol. 2004;14:412–17.CrossRefGoogle ScholarPubMed
Hammad, TA, Laughren, T, Racoosin, J. Suicidality in pediatric patients treated with antidepressant drugs. Arch Gen Psychiatry. 2006;63:332–9.CrossRefGoogle ScholarPubMed
Fornaro, M, Anastasia, A, Valchera, A, et al. The FDA “black box” warning on antidepressant suicide risk in young adults: more harm than benefits? Front Psychiatry. 2019;10:294.CrossRefGoogle ScholarPubMed
Garland, EJ, Kutcher, S, Virani, A, et al. Update on the use of SSRIs and SNRIs with children and adolescents in clinical practice. J Can Acad Child Adolesc Psychiatry. 2016;25:4–10.Google Scholar
Olfson, M, Shafer, D, Marcus, SC, Greenbergt, T. Relationship between antidepressant medication treatment and suicide in adolescents. Arch Gen Psychiatry. 2003;60:978–82.CrossRefGoogle ScholarPubMed
Baldessarini, RJ, Faedda, GL, Offidani, E, et al. Antidepressant-associated mood-switching and transition from unipolar major depression to bipolar disorder: a review. J Affect Disord. 2013;148:129–35.CrossRefGoogle ScholarPubMed
Nierenberg, AA, Farabaugh, AH, Alpert, JE, et al. Timing of onset of antidepressant response with fluoxetine treatment. Am J Psychiatry. 2000 September;157(9):1423–8.CrossRefGoogle ScholarPubMed
Taylor, MJ, Freemantle, N, Geddes, JR, Bhagwagar, Z. Early onset of selective serotonin reuptake inhibitor antidepressant action: systematic review and meta-analysis. Arch Gen Psychiatry. 2006 November; 63(11):1217–23.CrossRefGoogle ScholarPubMed
Varigonda, AL, Jakobovski, E, Taylor, MJ, et al. Systematic review and meta-analysis: early treatment responses of selective serotonin reuptake inhibitors in pediatric major depressive disorder. J Am Acad Child Adolesc Psychiatry. 2015;54:557–64.CrossRefGoogle ScholarPubMed
Murphy, SE, Capitão, LP, Giles, SLC, et al. The knowns and unknowns of SSRI treatment in young people with depression and anxiety: efficacy, predictors, and mechanisms of action. Lancet Psychiatry. 2021 September;8(9):824–35.CrossRefGoogle ScholarPubMed
Dwyer, JB, Stringaris, A, Brent, DA, Bloch, MH. Annual research review: defining and treating pediatric treatment‐resistant depression. J Child Psychol Psychiatry. 2020 Mar;61(3):312–32.CrossRefGoogle ScholarPubMed
Jakubovski, E, Varigonda, Al, Freemantle, N, et al. Systematic review and meta-analysis: dose-response relationship of selective serotonin reuptake inhibitors in major depressive disorder. Am J Psychiatry. 2016; 173:174–83.CrossRefGoogle ScholarPubMed
McMakin, DL, Olino, TM, Porta, G., et al. Anhedonia predicts poorer recovery among youth with selective serotonin reuptake inhibitor treatment-resistant depression. J Am Acad Child Adolesc Psychiatry. 2012; 51:404–11.CrossRefGoogle ScholarPubMed
Vitiello, B, Emslie, G, Clarke, G, et al. Long-term outcome of adolescent depression initially resistant to selective serotonin reuptake inhibitor treatment: a follow-up study of the TORDIA sample. J Clin Psychiatry. 2011;72(3):388–96.CrossRefGoogle ScholarPubMed
Maalouf, FT, Porta, G, Vitiello, B, et al. Do sub-syndromal manic symptoms influence outcome in treatment resistant depression in adolescents? A latent class analysis from the TORDIA study. J Affect Disord. 2012;138:86–95.CrossRefGoogle ScholarPubMed
Dwyer, JB, Landeros-Weisenberger, A, Johnson, JA, et al. Efficacy of intravenous ketamine in adolescent treatment-resistant depression: a randomized midazolam-controlled trial. Am J Psychiatry. 2021 April 1;178(4):x.CrossRefGoogle ScholarPubMed
Sanacora, G, Frye, MA, McDonald, W, et al. A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA Psychiatry. 2017 April;74(4):399–405.CrossRefGoogle ScholarPubMed
Daly, EJ, Singh, JB, Fedgchin, M, et al. Efficacy and safety of intranasal esketamine adjunctive to oral antidepressant therapy in treatment-resistant depression: a randomized clinical trial. JAMA Psychiatry. 2018 February;75(2):139–48.Google ScholarPubMed
Ghaziuddin, N, Kutcher, SP, Knapp, P, et al. Practice parameter for use of electroconvulsive therapy with adolescents. J Am Acad Child Adolesc Psychiatry. 2004;43:1521–39.CrossRefGoogle ScholarPubMed
Carton, L, Pignon, B, Baguet, A, et al. Influence of comorbid alcohol use disorders on the clinical patterns of major depressive disorder: a general population-based study. Drug Alcohol Depend. 2018 June;187:40–7.CrossRefGoogle ScholarPubMed
Puccio, F, Fuller-Tyszkiewicz, M, Ong, D, Krug, I. A systematic review and meta-analysis on the longitudinal relationship between eating pathology and depression. Int J Eat Disord. 2016 February;49(5): 439–54.CrossRefGoogle ScholarPubMed

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