Article

Longitudinal Course of Adolescent Depression: Neuroendocrine and Psychosocial Predictors

Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9101, USA.
Journal of the American Academy of Child and Adolescent Psychiatry (Impact Factor: 6.35). 02/2010; 49(2):141-51. DOI: 10.1016/j.jaac.2009.09.008
Source: PubMed

ABSTRACT The study examined whether cortisol measures are associated with the clinical course of depression in adolescents. Furthermore, the study evaluated whether the relationship between cortisol and clinical course is moderated by environmental stress and/or social support.
Fifty-five adolescents with depression (age range 13-18 years) were recruited. In addition to a systematic diagnostic assessment, information was obtained on environmental stress and social support. Urinary free cortisol measures were collected on three consecutive nights during the index episode. Clinical follow-up evaluations were conducted at regular intervals over a 5-year period, documenting recovery from the index depressive episode and recurrent episodes. Information on environmental stress and social support also was gathered during each follow-up assessment.
Consistent with prior reports, the majority of adolescents (92.2%) recovered from the initial depressive episode. A substantial proportion of the recovered youth (42.6%) experienced a subsequent episode during the follow-up period. Higher cortisol levels were associated with a longer time to recovery from the index depressive episode. The effect of cortisol on recovery was moderated by social support. The combination of elevated cortisol and recent stressful experiences predicted recurrence, whereas a higher level of social support was protective against recurrence.
These data, in conjunction with prior literature, suggest that depression reflects an underlying neurobiological vulnerability that may predispose individuals with high vulnerability to chronic, recurrent episodes. Psychosocial factors, independently or in combination with an underlying neurobiological vulnerability, also play an important role in determining the clinical course of depression.

0 Followers
 · 
88 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Criteria to define an episode of care in children's mental health services are needed. Various criteria were applied to 5 years of visit data from children 4-11 years (N = 5,206) at their first visit to 1 of 3 children's mental health agencies. A minimum of 3 visits with 180 days between episodes optimized agreement with other dates (e.g., telephone intake assessment) marking the start and end of an episode, and clinician-rated number of episodes. Grouping visits into episodes provides a clearer representation of how services are distributed over extended periods of time, facilitating research and enhancing accuracy in service planning.
    Administration and Policy in Mental Health and Mental Health Services Research 11/2014; DOI:10.1007/s10488-014-0609-6 · 3.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Poor sleep and alterations in the stress-sensitive hypothalamic-pituitary-adrenal (HPA) axis may be mechanisms through which loneliness impacts adolescents' well-being. Few researchers have explored whether daily variation in experiences of social connection predict day-to-day variation in sleep and HPA axis activity among adolescents navigating the college context. Using daily diary reports of social connection, objective measures of sleep (actigraphy), and naturalistic salivary assessment, the present study examined within-person associations between first-year college students' social connection during the day and sleep that night, as well as diurnal cortisol activity the following day. The present study also explored trait-level loneliness as a moderator of these associations after adjusting for baseline loneliness assessed in high school. Seventy-one first-year college students (23 % male; M age = 18.85; 52 % non-Hispanic White) completed daily diary reports, wore a wrist-based accelerometer (actigraph watch), and provided saliva samples five times daily across three consecutive weekdays. The results from hierarchical linear models indicated that within-person increases in daily social connection were significantly associated with longer time spent in bed and more actual time asleep that night only for adolescents high on loneliness. Within-person increases in daily social connection were associated with a greater cortisol awakening response (CAR) the next day, regardless of trait loneliness. These findings illustrate that more daily social connection with others than usual may predict improved sleep quantity for lonely adolescents and a physiological index of anticipating upcoming daily demands (CAR) in general. Future intervention programs might consider including strategies focused on enhancing daily social interactions among adolescents starting college, particularly for lonely adolescents.
    Journal of Youth and Adolescence 12/2014; 44(2). DOI:10.1007/s10964-014-0244-2 · 2.72 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Depressionen zählen zu den häufigen chronischen Erkrankungen des Erwachsenenalters. Erste Anzeichen der Krankheit treten schon im Kindes- und Jugendalter auf. In der Mitte des vorigen Jahrhunderts bezeichnete der Kinderarzt Spitz [4] das Rückzugsverhalten und die Bekümmerung schwer deprivierter Säuglinge als anaklitische Depression. Der Krankheitsverlauf wird durch genetische Disposition, Belastungen und Schutzfaktoren beeinflusst [3]. Kinder sind in stärkerem Maß von ihrer Umgebung abhängig als Erwachsene. Es ist damit zu rechnen, dass in der kinderärztlichen Praxis Kinder und auch Eltern mit einer depressiven Symptomatik anzutreffen sind.Alltägliche Symptome bei Kindern können Ausdruck einer depressiven Verstimmung seinAlltägliche Themen bei Kindern wie Bauchweh und Unaufmerksamkeit können Ausdruck und erste Anzeichen einer depressiven Symptomatik sein. Die hausärztliche Praxis hat die Wächterfunktion („gate keeper“), eine depressive Symptomatik zu erkennen, zu beraten und zu begleit ...
    Monatsschrift Kinderheilkunde 09/2010; 158(9):834-835. DOI:10.1007/s00112-010-2187-3 · 0.28 Impact Factor

Full-text (2 Sources)

Download
52 Downloads
Available from
Jun 5, 2014