1.3 developmental perspectives on depression

Question 1

aim

(Zhou et al, 2020)

Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder

Answer 1

synthesise all the available evidence on commonly used antidepressants, psychotherapies, and their combinations for the acute treatment of depressive disorder in children and adolescents

Question 2

main findings

(Zhou et al, 2020)

Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder

Answer 2

Of all the included active interventions, only fluoxetine plus CBT and fluoxetine were significantly more efficacious than pill placebo in children and adolescents with depressive disorders

Interpersonal psychotherapy was more efficacious than all psychological controls, but with very low CI of evidence

In terms of treatment discontinuation, there was no difference between fluoxetine and psychological treatments, which didn’t differ from placebo

Venlafaxine was significantly associated w/suicidal behaviour and thoughts

Question 3

conclusion

(Zhou et al, 2020)

Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder

Answer 3

The findings in children and adolescents contrast with findings in adults w/MDD for whom all antidepressants were more efficacious than pill placebo and all psychotherapeutic interventions were superior to psychological control conditions

Question 4

activeingredientsMH review

(Harmer, 2020)

Antidepressants and psychotherapy for adolescent depression. Can they be compared?

Answer 4

Four questions asked by this review:
1. Do SSRI antidepressants work in yp with depression and anxiety?
2. For whom and under what contexts do they work best?
3. How do they work?
4. What are the risks?

results:
- Similar to Zhou that SSRIs have therapeutic efficacy in depression and also anxiety in young people - however, they do not work for everyone and more treatment options are needed
- There is limited systematic evidence for whom they work best
- There is little work on mechanisms of antidepressant action in young people
- As in the Zhou et al (2020) review no evidence was found for increased suicide during SSRI treatment in young people