JAACAP open最新文献

{"title":"Combining Motivational Interviewing and Cognitive Bias Modification Training for Substances in Detained Youth","authors":"Hans S. van der Baan PhD ,&nbsp;Annematt L. Collot D'Escury-Koenigs PhD ,&nbsp;Raoul P.P.P. Grasman PhD ,&nbsp;Gerard M. Schippers PhD ,&nbsp;Reinout W. Wiers PhD","doi":"10.1016/j.jaacop.2024.08.003","DOIUrl":"10.1016/j.jaacop.2024.08.003","url":null,"abstract":"<div><h3>Objective</h3><div>Motivation is considered a key factor in successful treatment. Unfortunately, detained youth typically show lower motivation for treatment and behavioral change. This pilot study examined the effects of a brief Motivational Interviewing (MI) protocol in conjunction with a Cognitive Bias Modification (CBM) intervention aimed at reducing substance use in detained youth.</div></div><div><h3>Method</h3><div>An MI protocol for adult parolees was adapted for adolescents. A total of 52 detained youth received the MI intervention, aimed at enhancing their insights into their substance use and its potential relation with their offenses, plus substance use treatment. These youth were matched with controls from similar populations who received the same CBM without MI.</div></div><div><h3>Results</h3><div>Changes in motivation over time were examined with a repeated-measures analysis of variance. Results showed no change in motivation over time, nor a significant effect of condition (MI vs no MI).</div></div><div><h3>Conclusion</h3><div>Although application of the MI protocol was feasible, no effect was found on motivation, in contrast to the original adult-focused protocol. Certain core facets of the original protocol, such as client reflection on their history of substance use, may be less applicable to detained youth whose use history is relatively brief. The severity of their substance use behavior should also be taken into account in any future applications.</div></div><div><h3>Plain language summary</h3><div>Motivational interviewing (MI) is an evidence-based method to increase behavioral change and treatment engagement. In this study, 52 detained youth received a 6 session MI protocol in addition to a cognitive bias modification (CBM) intervention targeting substance use, and they were matched with controls from a prior study where youth received CBM only. Neither group showed a change in motivation. These findings suggest that future MI-based interventions should consider the needs and developmental stages of youths with substance use.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"2 4","pages":"Pages 301-310"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Pathways From Maltreatment to Substance Use Through Delay Discounting During Adolescence and Into Young Adulthood","authors":"Kristin M. Peviani PhD ,&nbsp;Claudia Clinchard MS ,&nbsp;Warren K. Bickel PhD ,&nbsp;Brooks Casas PhD ,&nbsp;Jungmeen Kim-Spoon PhD","doi":"10.1016/j.jaacop.2024.02.003","DOIUrl":"10.1016/j.jaacop.2024.02.003","url":null,"abstract":"<div><h3>Objective</h3><div>Children and adolescents exposed to maltreatment are at a greater risk for substance use disorders in adulthood. However, developmental processes that explain how maltreatment experiences may influence substance use behaviors remain unclear. We investigated whether delay discounting (ie, the preference for immediate over delayed rewards), a critical indicator of self-regulation, serves as a key mechanism linking maltreatment and substance use. We used a developmental cascade model with a dimensional approach to test the direct and indirect effects of neglect and abuse on substance use during adolescence and across the transition from adolescence to young adulthood.</div></div><div><h3>Method</h3><div>The present study includes 167 adolescents (53% male; mean age = 14 years at time 1) who provided data on delay discounting and cigarette, alcohol, and cannabis use frequency across 5 time points (ages 14-18, approximately 1 year between assessments). At ages 18 to 19, adolescents provided reports of their exposure to maltreatment during adolescence (across ages 13-17).</div></div><div><h3>Results</h3><div>Using structural equation modeling, developmental cascade models tested whether the effects of neglect and abuse on cigarette, alcohol, and cannabis use were mediated through delay discounting over time. Our results indicate that adolescents exposed to neglect may be especially vulnerable to cannabis use over time via elevated delay discounting. Neglect experiences predicted greater cigarette use over time.</div></div><div><h3>Conclusion</h3><div>These findings underscore the critical role of delay discounting in prevention and intervention efforts aimed at mitigating the risks of substance use development among young people who have been exposed to neglect during adolescence.</div></div><div><h3>Plain language summary</h3><div>This study used a developmental cascade model to examine whether delay discounting (ie, choosing smaller, immediate rewards over larger rewards with a delay) may be a mechanism linking maltreatment and substance use (cigarette, alcohol, and cannabis use) during adolescence. One hundred sixty-seven adolescents aged 13-14 were assessed in a computerized delay discounting task across 5 time points over 6 years. Results indicated that adolescent neglect was associated with higher delay discounting, which in turn was associated with increased substance use, especially cannabis use. These findings highlight delay discounting as a potential intervention target to mitigate substance use risk in adolescents who have experienced neglect.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"2 4","pages":"Pages 239-249"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent and Interactive Impacts of Prenatal Exposure to Legal Substances and Childhood Trauma on Emotion Processing in Pre-Adolescents: Preliminary Findings From the ABCD Study","authors":"Lauren Lepow MD ,&nbsp;Ariella Wagner MS ,&nbsp;Siddhartha Peri BS ,&nbsp;Faith Adams BS ,&nbsp;Srinivasan Anantha Ramakrishnan BS ,&nbsp;Md Ashad Alam PhD ,&nbsp;Riaz B. Shaik PhD ,&nbsp;Nicholas A. Hubbard PhD ,&nbsp;Harold W. Koenigsberg MD ,&nbsp;Yasmin Hurd PhD ,&nbsp;Susan F. Tapert PhD ,&nbsp;Iliyan Ivanov MD ,&nbsp;Muhammad A. Parvaz PhD","doi":"10.1016/j.jaacop.2024.04.009","DOIUrl":"10.1016/j.jaacop.2024.04.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This paper investigated the effects of prenatal drug exposure (PDE), childhood trauma (CT), and their interactions on the neurobiological markers for emotion processing.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Here, in a non-clinical sample of pre-adolescents (9-10 years of age) from the Adolescent Brain Cognitive Development (ABCD) Study (N = 6,146), we investigate the impact of PDE to commonly used substances (ie, alcohol, cigarettes, and marijuana), CT, and their interaction on emotion processing. From the Emotional N-back functional magnetic resonance imaging task data, we selected 26 regions of interests, previously implicated in emotion processing, and conducted separate linear mixed models (108 total) and accounted for available environmental risk factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;PDE was associated with reductions in response bias related to the processing of fearful compared to happy faces in widespread cortical regions (including the superior frontal and fusiform gyri and the inferior parietal lobule). Reduced response bias in the superior frontal gyrus emerged as PDE driven and was present regardless of CT status, but correlated with several items on the Child Behavior Checklist only in those children with both PDE and CT. The lower response bias of the left inferior parietal lobule, on the other hand, was observed only in children with both PDE and CT, and correlated with internalizing and externalizing behaviors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The study’s results support the diathesis–stress model, and suggest that PDE may confer vulnerability to the effects of later CT through altered neurodevelopment. Children experiencing these “double-hit” conditions may represent at-risk individuals who could benefit from early interventions to mitigate the onset of psychopathology. Because of limitations in the way that PDE was reported in the ABCD Study, including lack of severity measures and retrospective reporting, results are not sufficient for making recommendations or dictating policy for pregnant persons. Nevertheless, this study is a necessary first step in examining the interactive effects of prenatal and early-life exposures, as well as many aspects of the sociodemographic and psychological environment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;This study looked at how prenatal drug exposure of commonly used substances (alcohol, cigarettes, and cannabis) and childhood trauma affect brain activity related to processing emotions in children from the Adolescent Brain Cognitive Development (ABCD) Study. Using brain imaging data from 6,146 children aged 9-10, the study found that prenatal drug exposure was associated with differing brain activity to emotional faces in several brain regions involved in emotion processing. Children who experienced both prenatal drug exposure and childhood trauma showed altered brain activity patterns that correlated with greater behavioral problems repo","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"2 4","pages":"Pages 274-289"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to a Special Series on Substance Use Disorder","authors":"Kara S. Bagot MD (Deputy Editor)","doi":"10.1016/j.jaacop.2024.10.004","DOIUrl":"10.1016/j.jaacop.2024.10.004","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"2 4","pages":"Pages 229-230"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transparency: Disclosure of Financial Interests","authors":"","doi":"10.1016/j.jaacop.2024.10.003","DOIUrl":"10.1016/j.jaacop.2024.10.003","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"2 4","pages":"Pages 326-328"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scope","authors":"","doi":"10.1016/S2949-7329(24)00080-2","DOIUrl":"10.1016/S2949-7329(24)00080-2","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"2 4","pages":"Page A1"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143164543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Risk of Suicide Attempts Among Adolescents With Food Allergy in the United States","authors":"Saurabh Kalra MS, MPH ,&nbsp;Evan M. Kleiman PhD ,&nbsp;Shireen L. Rizvi PhD ,&nbsp;Irina B. Grafova PhD ,&nbsp;Paul R. Duberstein PhD ,&nbsp;Deepak Kalra MD, MPH, PhD","doi":"10.1016/j.jaacop.2024.11.005","DOIUrl":"10.1016/j.jaacop.2024.11.005","url":null,"abstract":"<div><h3>Objective</h3><div>Food allergy (FA) is a growing public health concern that has been associated with feelings of sadness, hopelessness, shorter sleep duration, and being bullied—all linked to suicide risk. Given the limited prior research, this study aimed to examine the association between FA and suicidal behavior.</div></div><div><h3>Method</h3><div>Data from the Centers for Disease Control and Prevention Youth Risk Behavior Survey (2015-2019) were analyzed. This nationally representative sample included 22,017 adolescents 14 to 18 years old. To assess the association between FA and medically serious suicide attempts, several multivariate logistic regressions were conducted adjusting for effects of sadness/hopelessness, suicidal ideation, shorter sleep duration, being bullied, physical activity, and other covariates. Additionally, a sensitivity analysis was conducted to explore the association between FA and all suicide attempts, including attempts not requiring medical attention.</div></div><div><h3>Results</h3><div>Among the participants, 15.6% (n = 3,435) reported FA, and 2.3% (n = 501) reported serious suicide attempts. Within the serious suicide attempt group, 31.9% (n = 160) reported FA compared with 15.2% (n = 3,275) among participants who did not report serious suicide attempts. Multivariate analyses revealed that adolescents with FA had higher odds of reporting suicide attempts requiring medical intervention (adjusted odds ratio 1.63, 95% CI 1.23-2.16). In the sensitivity analysis, FA continued to show significance when broadening the outcome to include all suicide attempts, regardless of whether medical attention was required (adjusted odds ratio 1.35, 95% CI 1.09-1.68).</div></div><div><h3>Conclusion</h3><div>Health care practitioners caring for adolescents with FA should be cognizant of their increased susceptibility for suicidal behavior.</div></div><div><h3>Plain language summary</h3><div>Adolescents with food allergies have a higher risk of serious suicide attempts. The study found that those with food allergies were 63% more likely to attempt suicide compared to their peers without food allergies. Clinicians should consider mental health risks in adolescents with food allergies and offer appropriate support.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 548-556"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Disturbances Are Associated With Depressive Symptoms and Suicidality Among Adolescents in Pediatric Primary Care","authors":"Giana I. Teresi MS ,&nbsp;Molly Davis PhD ,&nbsp;Ariel A. Williamson PhD ,&nbsp;Jami F. Young PhD ,&nbsp;John A. Merranko MA ,&nbsp;Tina R. Goldstein PhD","doi":"10.1016/j.jaacop.2024.11.004","DOIUrl":"10.1016/j.jaacop.2024.11.004","url":null,"abstract":"<div><h3>Objective</h3><div>Sleep disturbances increase in adolescence and are associated with depression and suicide risk. However, research on enhancing depression and suicide risk assessment in clinical settings using behavioral markers, such as sleep, remains limited. Pediatric primary care (PPC) provides an opportunity for early risk identification, yet few studies examine how sleep disturbances, which are commonly reported, readily observable, and modifiable, are associated with concurrent depression and suicidality in PPC settings. This study examined the prevalence of adolescent sleep disturbances and concurrent associations with depression and suicidality in a large, sociodemographically diverse PPC sample.</div></div><div><h3>Method</h3><div>Between November 15, 2017, and February 1, 2020, 70,590 adolescents (ages 12-17) completed the Patient Health Questionnaire-9 modified for teens (PHQ-9-M) at PPC well visits. Logistic regressions examined associations between PHQ-9-M sleep item responses, sociodemographic variables, and depression and suicidality.</div></div><div><h3>Results</h3><div>Nearly 40% of youth endorsed sleep disturbances at their well visit via the PHQ-9-M sleep item. Youth who were older, female, racial or ethnic minoritized, and Medicaid insured were more likely to endorse sleep disturbances (odds ratios ≥1.03, <em>p</em>s &lt; .001). Youth who endorsed sleep disturbances lasting several days or more were more than 20 times more likely to have a PHQ-9-M total score in the clinical range (odds ratio 23.31, 95% CI [21.64, 25.13]) and 4 times more likely to endorse any suicidality item (odds ratio 4.14, 95% CI [3.89, 4.41]).</div></div><div><h3>Conclusion</h3><div>Findings underscore the clinical utility of screening for sleep disturbances in PPC. Considering the significant associations between sleep disturbances and concurrent depression and suicidality, PPC providers may consider screening for and managing sleep disturbances.</div></div><div><h3>Plain language summary</h3><div>This study utilized retrospective data from pediatric primary care well visits occurring between November 2017 and February 2020 from a large healthcare network. The goal was to determine the rate and sociodemographic characteristics of youth reporting sleep disturbances in well visits, as well as how sleep disturbances were associated with concurrent depression and suicidality. Of 70,590 adolescents (12-17 years old) with well-visit data, 37% endorsed at least some difficulty falling or staying asleep or sleeping too much. Youth who endorsed sleep disturbances were more likely to be older, female, from a minoritized racial or ethnic group, and Medicaid insured, and were 23 times more likely to also have elevated depressive symptoms and 4 times more likely to endorse suicidality. Findings highlight the importance of screening for sleep disturbances in pediatric primary care clinics.</div></div><div><h3>Clinical guidance</h3><div>• Sleep disturbance","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 589-600"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review: Investigating Biomarkers of Anhedonia and Amotivation in Depression and Cannabis Use","authors":"Jesse D. Hinckley MD, PhD ,&nbsp;Bradley T. Conner PhD ,&nbsp;Roseanne Mauch MD ,&nbsp;Patrice A. Arkfeld MS ,&nbsp;Devika Bhatia MD ,&nbsp;Emma E. Smith BS ,&nbsp;Ellie Svoboda MLIS, AHIP ,&nbsp;Manpreet K. Singh MD, MS","doi":"10.1016/j.jaacop.2024.08.005","DOIUrl":"10.1016/j.jaacop.2024.08.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To assess biological factors associated with anhedonia in depression and amotivation in cannabis use (PROSPERO: CRD42023422438).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;A systematic review was conducted of 8 electronic databases. Inclusion criteria included original research studies that investigated the association of biological factors or behavioral tasks with depression combined with concepts of anhedonia or cannabis combined with concepts of amotivation including apathy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The review included 44 articles that evaluated biological factors associated with anhedonia in depression and 2 articles that evaluated biological factors associated with amotivation in cannabis use. Overall, anhedonia was operationalized as loss of anticipatory pleasure or consummatory pleasure using a range of measures. No biological factor or behavioral task was consistently associated with anhedonia in depression. Neuroimaging studies encompassed heterogeneous study designs and analytic approaches, with little overlap among findings of brain regions associated with anhedonia. Regions of interest most frequently associated with anhedonia across functional and structural neuroimaging and tasked-based neuroimaging studies included the anterior cingulate cortex, nucleus accumbens, and medial prefrontal cortex. No biochemical marker, including interleukin-6 or C-reactive protein, was consistently associated with anhedonia, and most tested associations between biochemical markers and anhedonia were not significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Heterogeneous study designs and self-reported assessments of anhedonia have yielded variable findings across the literature. Neuroimaging studies of adolescents with depression and cannabis use reveal similar neurobiological deficits in reward processing. Prospectively examining these deficits may inform developmental pathways that underlie the etiology of these disorders and identify novel treatment targets.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;Depression and cannabis use are both common among adolescents. Clinical phenotypes of anhedonia in depression and amotivation in cannabis use may overlap, complicating diagnostic assessment and management. This systematic review identified 44 articles that evaluated biologic factors associated with anhedonia in depression and two articles that evaluated biologic factors associated with amotivation in cannabis use. Most articles were neuroimaging studies that encompassed mixed study designs. Neuroimaging studies of adolescents with depression and cannabis use revealed similar neurobiological deficits in reward processing. Prospectively examining these deficits may inform developmental pathways that underly the etiology of these disorders and identify distinct treatment targets.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study preregistration information&lt;/h3&gt;&lt;div&gt;A systematic review of anhedonia and amotivation in depression and cannabi","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 379-405"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vortioxetine for Major Depressive Disorder in Children: 12-Week Randomized, Placebo-Controlled Study","authors":"Michael Huss MD ,&nbsp;Robert L. Findling MD, MBA ,&nbsp;Melissa P. DelBello MD, MS ,&nbsp;Oscar Necking MD ,&nbsp;Maria L. Petersen MD ,&nbsp;Simon Nitschky Schmidt MSc ,&nbsp;Monika Rosen PhD","doi":"10.1016/j.jaacop.2024.11.002","DOIUrl":"10.1016/j.jaacop.2024.11.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To evaluate efficacy, safety, and tolerability of vortioxetine in children ages 7 to 11 years with major depressive disorder.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Patients meeting criteria for incomplete improvement in depressive symptoms (Children’s Depression Rating Scale–Revised [CDRS-R] total score ≥40 plus &lt;40% reduction and Parent Global Assessment Global Improvement score &gt;2) after 4 weeks of single-blind lead-in treatment with a brief psychosocial intervention plus placebo were randomized 1:1:1:1 to 8-week double-blind treatment with brief psychosocial intervention and placebo, vortioxetine 10 mg/day, vortioxetine 20 mg/day, or fluoxetine 20 mg/day. Following preplanned interim analysis, enrollment to fluoxetine was stopped, and patients were randomized 1:1:1 to placebo, vortioxetine 10 mg, or vortioxetine 20 mg. The primary end point was change in CDRS-R total score from baseline to week 8 for average of vortioxetine 10-mg and 20-mg doses vs placebo.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 683 patients enrolled in single-blind lead-in treatment, 540 were randomized to the double-blind period. The mean (SE) change from randomization to week 8 in CDRS-R total score for average of vortioxetine 10-mg and 20-mg doses vs placebo was −19.6 (1.2) and −17.5 (1.4), with a mean difference of −2.1 (1.2) (2-sided &lt;em&gt;p&lt;/em&gt; = .0937). Overall, 47% of patients reported treatment-emergent adverse events in the double-blind period; nausea was the most common adverse event in the vortioxetine groups (11.1%-12.6%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;No statistically significant differences were observed in improvement in CDRS-R total score between placebo and vortioxetine; hence, efficacy of vortioxetine for treatment of major depressive disorder in children could not be confirmed. Safety and tolerability data were similar to that seen in adolescents and adults, with no outstanding safety concerns.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;This global study evaluated the efficacy, safety, and tolerability of vortioxetine in children aged 7-11 years with major depressive disorder (MDD). Those who did not improve after 4 weeks of initial treatment with placebo and psychotherapy (540 children) were randomly assigned to a placebo, vortioxetine 10-mg/d, or vortioxetine 20-mg/d for 8 weeks and psychotherapy. The primary measure was the change in depressive symptoms using the Children’s Depression Rating Scale-Revised (CDRS-R); children on vortioxetine showed a slight improvement in CDRS-R total scores compared to those on placebo. Vortioxetine (average of 10-mg/d and 20-mg doses/d) was not more effective than placebo (mean difference of –2.1 points; &lt;em&gt;p&lt;/em&gt; = 0.0937). Safety and tolerability measures were similar to previous studies of adults and adolescents treated with vortioxetine, with nausea being the most common adverse effect in the vortioxetine groups (11.1% among participants receiving vortioxetine 20-m","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 3","pages":"Pages 736-748"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}